bluuebunny/crossref_metadata_2025 huggingface dataset:
Preexisting Heart Disease Underlies Newly Diagnosed Atrial Fibrillation After Acute Ischemic Stroke
Authors: Rizos Timolaos , Horstmann Solveig , Dittgen Felix , Täger Tobias , Jenetzky Ekkehart , Heuschmann Peter , Veltkamp Roland
Published: January 2016

Background and Purpose—

Whether newly diagnosed atrial fibrillation (nAF) after stroke reflects underlying heart disease and represents an increased risk of cardioembolic stroke, or whether it is triggered by neurogenic mechanisms remains uncertain. We investigated, whether cardiovascular risk factors and echocardiographic parameters in patients with nAF are similar to patients with known AF (kAF) and differ from patients without AF.

Methods—

Consecutive acute ischemic stroke patients were enrolled into a prospective stroke database. All patients with echocardiography were included and univariable and multivariable testing was applied to compare clinical characteristics and echocardiographic findings among patients with nAF, kAF, and no AF.

Results—

A total of 1397 patients were included (male, 62.3%; median age, 71 years). AF was present in 320 (22.9%) patients. Of those, nAF was present in 36.2% (116/320) and kAF in 63.8% (204/320). No clinical or echocardiographic factor was independently associated with detection of nAF compared with kAF but a trend toward larger left atrial diameters in patients with kAF was observed (
P
=0.070). In contrast, patients with nAF were more often female (
P
<0.001), older (
P
<0.001) and had a larger left atrial diameters (
P
<0.001) compared with patients without AF. While stroke severity in patients with nAF and kAF was similar, patients without AF had less severe strokes.

Conclusions—

Stroke patients with nAF and with kAF share common cardiovascular risk factors, have similar echocardiographic findings and suffer equally severe strokes. We conclude that preexisting heart disease is the major cause of AF that is first diagnosed after stroke.
Enhanced Effective Connectivity Between Primary Motor Cortex and Intraparietal Sulcus in Well-Recovered Stroke Patients
Authors: Schulz Robert , Buchholz Anika , Frey Benedikt M. , Bönstrup Marlene , Cheng Bastian , Thomalla Götz , Hummel Friedhelm C. , Gerloff Christian
Published: January 2016

Background and Purpose—

Ischemic strokes with motor deficits lead to widespread changes in neural activity and interregional coupling between primary and secondary motor areas. Compared with frontal circuits, the knowledge is still limited to what extent parietal cortices and their interactions with frontal motor areas undergo plastic changes and might contribute to residual motor functioning after stroke.

Methods—

Fifteen well-recovered patients were evaluated 3 months after stroke by means of functional magnetic resonance imaging while performing visually guided hand grips with their paretic hand. Dynamic causal modeling was used to investigate task-related effective connectivity between ipsilesional posterior parietal regions along the intraparietal sulcus and frontal key motor areas, such as the primary motor cortex, the ventral premotor cortex, and the supplementary motor area.

Results—

Compared with healthy controls of similar age and sex, we observed significantly enhanced reciprocal facilitatory connectivity between the primary motor cortex and the anterior intraparietal sulcus of the ipsilesional hemisphere. Beyond that and as a fingerprint of excellent recovery, the coupling pattern of the parietofrontal network was near-normal. An association between coupling parameters and clinical scores was not detected.

Conclusions—

The present analysis further adds to the understanding of the parietofrontal network of the ipsilesional hemisphere as a prominent circuit involved in plastic changes after stroke.
Risk of Stroke After the
International Classification of Diseases
-Ninth Revision Discharge Code Diagnosis of Hypertensive Encephalopathy
Authors: Lerario Michael P. , Merkler Alexander E. , Gialdini Gino , Parikh Neal S. , Navi Babak B. , Kamel Hooman
Published: January 2016

Background and Purpose—

Although chronic hypertension is a well-established risk factor for stroke, little is known about stroke risk after hypertensive encephalopathy (HE), when neurologic sequelae of hypertension become evident. Therefore, we evaluated the risk of stroke after a diagnosis of HE.

Methods—

We identified all patients discharged from California, New York, and Florida emergency departments and acute care hospitals between 2005 and 2012 with a primary
International Classification of Diseases
, Ninth Edition, Clinical Modification discharge diagnosis of HE (437.2). Patients discharged with a primary diagnosis of seizure (345.x) served as negative controls, whereas patients with a primary diagnosis of transient ischemic attack (435.x) were positive controls. Our primary outcome was the composite of subsequent ischemic stroke or intracerebral hemorrhage. Kaplan–Meier survival statistics were used to calculate cumulative outcome rates, and Cox proportional hazard analysis was used to examine the association between index disease types and outcomes while adjusting for vascular risk factors.

Results—

We identified 8233 patients with HE, 191 091 with seizure, and 308 680 with transient ischemic attack. The 1-year cumulative rate of ischemic stroke or intracerebral hemorrhage after HE was 4.90% (95% confidence interval [CI], 4.45–5.40) when compared with 0.92% (95% CI, 0.88–0.97) after seizure and 4.49% (95% CI, 4.42–4.57) after transient ischemic attack. The risk of intracerebral hemorrhage was significantly elevated in those with HE (hazard ratio, 2.0; 95% CI, 1.7–2.5) but not in those with transient ischemic attack (hazard ratio, 1.0; 95% CI, 0.9–1.1), when compared with seizure patients.

Conclusions—

Patients discharged with a diagnosis of HE face a high risk of future cerebrovascular events, particularly intracerebral hemorrhage.
A synopsis of the exindusiate species of Cyathea (Cyatheaceae-Polypodiopsida) with bipinnate-pinnatifid or more complex fronds, with a revision of the C. lasiosora complex
Authors: Lehnert Marcus
Published: January 2016

A summary of the Neotropical exindusiate species of Cyathea with bipinnate-pinnatifid or more complex fronds is presented. It is a polyphyletic group containing species of the obsolete genera Trichipteris and Sphaeropteris subg. Sclephropteris with several unresolved species complexes, like Cyathea lasiosora and C. pilosissima from the eastern Andean foothills and the Amazonian lowland. This study shows that their confusion is mainly due to intraspecific variability in the abundance of laminar hairs in C. lasiosora, which overlaps with that of C. pilosissima, and that the latter species is less frequently collected than the former. With sufficient material at hand, both stand clearly apart in petiolar characters, e.g., C. lasiosora lacking hairs here vs. C. pilosissima with hairs 1–3 mm long. A close relationship of C. pilosissima with species of the obsolete, artificial Sphaeropteris senilis group (C. senilis, C. parianensis, C. lockwoodiana) is discussed. Cyathea lasiosora (Amazon basin) forms a parapatric species complex with C. wendlandii (Central America and Chocó), C. schlimii (northern Andes) and C. atrocastanea (eastern Brazil). A taxon that shares the petiole morphology with C. lasiosora and the laminar morphology with C. lockwoodiana is separated as a new species: Cyathea calamitatis. Further described are C. diabolica from southern Ecuador and C. margarita from western Colombia and Ecuador.
Taxonomic Transfer of the Red Algal Genus Gloiosaccion to Chrysymenia (Rhodymeniaceae, Rhodymeniales), Including the Description of a New Species, Chrysymenia pseudoventricosa, for the Gulf of Mexico
Authors: Schmidt William E , Gurgel Carlos Frederico D. , Fredericq Suzanne L.
Published: January 2016

Gloiosaccion Harvey, with type G. brownii (Rhodymeniaceae, Rhodymeniales), is a red algal genus characterized by the presence of large, hollow and saccate vesicle-shaped thalli arising from small solid axes. Whereas Gloiosaccion has traditionally been viewed as being closely related to Botryocladia (Agardh) Kylin, a multi-marker phylogenetic analysis based on chloroplast-encoded rbcL and UPA and nuclear LSU rDNA sequences instead places Gloiosaccion brownii and G. pumila in the Chrysymenia clade that includes the generitype C. ventricosa (Lamouroux) J. Agardh. Gloiosaccion is reduced to synonymy with Chrysymenia J. Agardh, a taxonomic move first advocated by De Toni in 1900. In addition to C. brownii (Harvey) De Toni, “Gloiosaccion” brownii var. firmum Harvey and “G.” pumilum J. Agardh are recognized as the distinct species Chrysymenia coriacea comb. et stat. nov. and C. pumila (J. Agardh) Weber-van Bosse, respectively. A new species, C. pseudoventricosa sp. nov. is proposed to accommodate specimens going under the name C. ventricosa (J.V. Lamouroux) J. Agardh from the Gulf of Mexico and Caribbean Sea.
The identity of Schizoglossum theileri (Apocynaceae, Asclepiadoideae)
Authors: Bester Stoffel Petrus , Glen Melissa, F. , Nicholas Ashley
Published: January 2016

Schizoglossum theileri (Apocynaceae, Asclepiadoideae) is found to be conspecific with Asclepias meliodora and is here formally reduced to synonymy under the latter.
Cluster Analysis of Tropical Cyclone Tracks over the Western North Pacific Using a Self-Organizing Map
Authors: Kim Han-Kyoung , Seo Kyong-Hwan
Published: January 2016

Tropical cyclone (TC) tracks over the western North Pacific (WNP) in 1979–2013 are classified by a self-organizing map technique. A false detection rate method identifies five optimal TC clusters. Physical mechanisms of the intraseasonal and interannual variations in the TC genesis frequency are investigated for each cluster. The five clusters are separated by genesis location, from the westernmost area (east of the Philippines, C1) to the easternmost (~150°E, C5) onset area over the WNP. The intraseasonal Madden–Julian oscillation (MJO) significantly affects the genesis frequency for all clusters except for C5. In particular, MJO phases 5 and 6 (1 and 2) provide significantly favorable (unfavorable) large-scale conditions for TC genesis. Two types of El Niño–Southern Oscillation influence the interannual variation of the genesis frequency for only C2 (generated over the western Philippine Sea and East China Sea) and C4 (formed near the eastern Philippine Sea). Enhanced eastern Pacific sea surface temperature (SST) anomalies lead to a ~40% decrease in the C2 TC frequency through a reversed Walker circulation with downward motion over the WNP. Conversely, increased central Pacific SST anomalies generate a cyclonic Rossby wave northwest of the forcing, inducing a significant increase (~50%) in the C4 TC frequency. The interannual variability for the C5 TCs is strongly controlled by the variation of the western Pacific subtropical high (WPSH). A positive WPSH variation reduces the C5 TC genesis frequency by 66%, while negative WPSH anomalies enhance the frequency by 50%. A prediction scheme using information from the first four 6-h TC locations demonstrates a skillful determination of TC clusters.
Pectus excavatum repair using Prolene polypropylene mesh
Authors: Rasihashemi Seyed Ziaeddin , Ramouz Ali
Published: January 2016

Objective

We aimed to assess the clinical outcomes of our surgical technique for repair of pectus excavatum using Prolene polypropylene mesh.

Methods

Among 29 patients with pectus excavatum, the major complaint was cosmetic dissatisfaction, and the main symptom was exercise dyspnea in 15 patients. The Haller index used to assess pectus excavatum severity; it was significant in 22 patients. In all patients, a 2-layer sheet of Prolene polypropylene mesh was placed behind the sternum.

Results

No serious complication was observed postoperatively, and all patients were satisfied with the cosmetic result. Mitral valve prolapse improved in all cases after 3 months. Spirometry revealed improved pulmonary function after surgery.

Conclusion

With due attention to the advantages of Prolene polypropylene mesh, such as remaining permanently in place, adapting to various stresses encountered in the body, resisting degradation by tissue enzymes, and trimming without unraveling, we concluded that this mesh is suitable for use as posterior sternal support in pectus excavatum patients.
Defamilisation and familisation measures: Can they reduce the adverse effects of pro-market pension reforms on women in Hong Kong and the UK?
Authors: Chau Ruby C.M. , Foster Liam , Yu Sam W.K.
Published: January 2016

This article explores the impact of defamilisation and familisation measures for women with caring responsibilities and their implications for access to pensions in later life in Hong Kong and the UK in the context of pro-market pension reforms. The first part of the article discusses pro-market pension reforms and their effects on women, the second discusses the potential role of defamilisation and familisation measures in reducing the adverse effects of pro-market pension reforms, and the third focuses on pension policies and examples of defamilisation and familisation measures in Hong Kong and the UK. Finally, on the basis of the discussion of the link between defamilisation and familisation measures and pension measures for women, we assert that both Hong Kong and the UK still have much to do in developing multi-option measures throughout the life course, measures that could limit future inequalities in retirement between men and women.
To participate or not to participate in a brand micro-blog
Authors: Zhao Haichuan , Su Chenting , Hua Zhongsheng
Published: January 2016

Customers’ participation is crucial to the brand micro-blog. However, many brand micro-blogs still face the challenge of low interactive or non-interactive participation. In this paper, we propose a conceptual model that specifies four facilitators (information quality, entertainment value, service quality, and social interaction) and two inhibitors (information overload and advertising reactance) as the key determinants of brand micro-blog participation intention, and we propose that these facilitators and inhibitors in combination determine followers’ identification with the brand micro-blog, and identification eventually determines whether the followers will participate in the brand micro-blog. The data of this study was collected through a quasi-experiment conducted within the Sina micro-blog. The findings confirm that information quality, entertainment value, service quality, and social interaction are four significant facilitators of brand micro-blog participation intention. The findings also show that information overload is a significant inhibitor of brand micro-blog participation intention.
Does Self-Efficacy Mediate the Effect of Primary School Teachers’ Emotional Support on Learning Behavior and Academic Skills?
Authors: Kikas Eve , Mägi Katrin
Published: January 2016

This study examined the effects of first-grade teachers’ emotional support on task persistence and academic skills in the sixth grade and the mediational role of children’s academic self-concept in these effects. Participants were 524 children (263 boys, [Formula: see text] age in the first grade = 7.47 years), their first-grade homeroom teachers ( n = 53), and sixth-grade math ( n = 34) and literacy ( n = 34) teachers. Academic skills were tested, and students’ task persistence was reported by teachers in the first and in the sixth grade. Students reported on their academic self-concept and their first-grade teacher’s emotional support retrospectively in the sixth grade. First-grade teachers’ emotional support had low facilitative effect on children’s task persistence in language and math lessons, and it supported reading skills. Teacher’s emotional support was related to higher self-concept in reading, and it mediated the effect of emotional support on task persistence and reading skills.
Improvement on ignition and lean blowout performances of a piloted lean-burn combustor
Authors: Liu Cunxi , Liu Fuqiang , Yang Jinhu , Mu Yong , Hu Chunyan , Xu Gang , Su Shangmei
Published: January 2016

This work focuses on optimizing the flame stability by matching the primary spray with swirling air streams in swirl cup which is used as pilot stage of a lean-burn fuel injector. Two configures of pressure-swirl atomizer for pilot spray have been investigated for their ignition and lean blowout (LBO) performances, the new designed pilot atomizer decrease fuel–air ratio ( f/ a) of the ignition limit by about 35%, and capability of LBO is greatly improved with decreasing fuel–air ratio from 0.015 to 0.005. Furthermore, in order to relate the pilot spray characteristics with the combustion performances, the performances of pilot pressure-swirl atomizer working both single and together with swirlers are carried out by optical spray diagnostics in a quiescent open air environment. Fuel planar laser induced fluorescence method for fuel distribution, particle image velocimetry method for velocity of droplets, and Fraunhofer diffraction technique for line-of-sight measurement of D32 are used to visualize the spray. The interactions between pilot spray and pilot, main swirling air streams are analyzed. The relative pressure loss of swirling air streams larger than 3% is recommended for this type of spray facility to make sure high quality of atomization at ignition and near LBO conditions. Improvements of ignition and LBO performances by optimizing the pilot spray illustrate that matching pilot spray with swirling air streams is an effective method to improve capability of stable combustion in fuel-staged multi-injection combustors.
Research of the hydrodynamic lubrication characteristics of different meshing pair profiles in water-flooded single screw compressors
Authors: Li Ting , Liu Zhan , Huang Rui , Liu Fei-long , Feng Quan-ke , Yu Xiao-ling
Published: January 2016

In this paper, we focus on the hydrodynamic lubrication properties of different meshing pair profiles (the gate-rotor tooth flank shape and the corresponding screw thread flank shape) of water-flooded single screw compressors. A test rig was designed to verify whether the water flowing through the meshing pair clearance could take load. Three specimens with different profiles were tested under the water-flooded condition. The balance position of the specimen, the water film thickness under different applied load and the effective water film carrying capacity were tested. A numerical model was proposed to calculate the water film pressure distribution and the effective water film carrying capacity under different film thickness. The numerical solutions were compared with the test results and showed good coherence. The results show that the three specimens can all get balanced under the water film torques and can restore balance after disturbances. The water film at the leading flank of the specimen with multicolumns enveloped profile has the largest water film pressure peak and effective carrying capacity. This study can be applicable in the design of single screw compressors meshing pair profile.
Pay-for-Performance
Authors: Markovitz Adam A. , Ryan Andrew M.
Published: January 2016

Research on the effects of pay-for-performance (P4P) in health care indicates largely disappointing results. This central finding, however, may mask important heterogeneity in the effects of P4P. We conducted a literature review to assess whether hospital and physician performance in P4P vary by patient and catchment area factors, organizational and structural capabilities, and P4P program characteristics. Several findings emerged: organizational size, practice type, teaching status, and physician age and gender modify performance in P4P. For physician practices and hospitals, a higher proportion of poor and minority patients is consistently associated with worse performance. Other theoretically influential characteristics—including information technology and staffing levels—yield mixed results. Inconsistent and contradictory effects of bonus likelihood, bonus size, and marginal costs on performance in P4P suggest organizations have not responded strategically to financial incentives. We conclude that extant heterogeneity in the effects of P4P does not fundamentally alter current assessments about its effectiveness.
A Child in Time and Health
Authors: Pavlicevic Mercédès
Published: January 2016

Music therapists often speak of working with the ‘whole’ child, and of music therapy addressing the multiple needs of children with disabilities, disorders or ‘in crisis’. Since many music therapists work in settings that think of childhood within the developmental framework, and of pathology as distinct from health, how do practitioners fit their experience of the ‘whole’ with the developmental, educational or medical images of the child? In reporting our work to other professionals, how is this ‘wholeness' portrayed – and conveyed? This paper1 explores ‘childhood’ and ‘pathology’ from various perspectives without aligning itself with any one at the expense of another. Rather, it offers various convergences to help conceptualise and describe the whole child in music therapy. Although the notion of the ‘whole’ applies not only to children but to all persons in music therapy, this paper focuses on childhood, which is especially susceptible to being viewed as a ‘developmental’ stage in life.
Using the Evidence Based Medicine Framework to Support Music Therapy Posts in Healthcare Settings
Authors: Edwards Jane
Published: January 2016

The Evidence Based Medicine (EBM)1 framework has been incorporated into the field of healthcare practice over the past decade. Whatever our stance as to its benefits and disadvantages, more and more music therapists in health departments and related clinical posts will be asked to account for their work using this approach to the documentation of clinical effectiveness. It is important that music therapists working within clinical service guidelines understand the framework of EBM and are aware of ways in which they can include its precepts in their justifications for practice and posts. The levels of evidence in an EBM approach are presented and discussed and the issues particular to the application of music therapy research findings are explored. Given the author's experience in paediatric medical settings, some of the examples in this paper will refer to the children's hospital context in particular.
An Investigation into Music Found to Trigger Peak Emotional Experiences during Controlled Listening Experiments
Authors: Lowis Michael J. , Touchin Colin
Published: January 2016

Peak emotional experiences can be triggered inter alia by music (Maslow 1962). 74 college staff members, from a population previously surveyed for incidences of such experiences, listened to music selections under controlled conditions and recorded the timings of any peak events that might have occurred. An attempt was then made to identify and analyse points in the music that had triggered high incidences of peaks, such as changes in harmony, key or loudness. Although there were individual differences, at the macro level the recorded peaks during 25 to 30 minutes of gentle music revealed an alternating high-low response pattern between different pieces, but such a trend was less obvious with upbeat items. Some reasons for these findings are suggested. The results may have value for those who use music for healing purposes, especially music therapists, and for composers or compilers of music programmes who need to anticipate listener reaction.
The Journey through a Barren Landscape to Practising Music Therapist
Authors: Lunt Helen
Published: January 2016

In this article I describe my personal journey through mental illness to practising music therapist, which spans some 30 years. The bleak and barren landscape of the hospitals in which I was an acute patient has now been transformed into a colourful milieu where I practise as a music therapist. The parallel paths of my own illness and my professional training are growing into an integration of my inner and outer life, which is reflected in my music therapy work with people with mental health problems.

The names of all people have been changed to safeguard anonymity. I have used the third person when discussing my own story, also providing additional perspective by using the pseudonym ‘Jane’. The article is in two main sections.
Musically Elicited Images as Unique Clinical Data during the Process of Group Analysis with Traumatised Adults
Authors: Ahonen-Eerikäinen Heidi
Published: January 2016

This paper will discuss the clinical use of musically elicited images – the referential imagery brought up either by therapeutic music listening or clinical improvisation, and created during music therapy. Clinical abstracts of group analytic music therapy will be presented to highlight the reconstruction of traumatic experiences and to illustrate the function of musically elicited images as visualized metaphorical condensations of client's ideas and feelings. The analysis of these images provides a unique opportunity for insight and integration. They connect the client into his/her feeling self, bring up associations, and help to provide a window into events and feelings, which might otherwise be closed. My theoretical approach is based on the psychoanalytical group analytic theories (Foulkes 1964, Foulkes 1990, Foulkes & Anthony 1990) and self-psychological aspects (Harwood 1988a, 1988b). The model of the mind that serves as a frame of reference for the comments that comprise the remainder of this paper draws mainly on Freud (1900), Dowling (1987), Eisnitz (1987), Cillman (1987), Ornstein (1987), Pines (1988, 1996, 2003), Rangell (1987) and Rothstein (1987).
Singing in Therapy: Monitoring Disease Process in Chronic Degenerative Illness
Authors: Magee Wendy L. , Davidson Jane W.
Published: January 2016

Music therapy in the treatment of chronic neurological illness typically focuses on the use of music to address the emotional and psychosocial impact of loss and change stemming from pathology. A range of clinical techniques is described in anecdotal accounts spanning instrumental improvisation, song composition and singing. However, there is scant reference to the musical and emotional experience of singing as a clinical technique with individuals living with chronic degenerative illness. Drawing on the results of an empirical investigation into the effects of music therapy with clients with chronic neurological illness, this paper reveals how singing may be used by clients to monitor their physical disease process.

Grounded theory research with this population has revealed that music therapy elicits processes in which individuals monitor the physical changes caused by their disease process (Magee and Davidson 2004). Based upon these research findings, this paper illustrates that individuals living with illnesses which cause loss of voice function may find the act of singing a highly physical experience. As such, singing may be used to monitor subtle changes which have occurred due to the disease process. Individuals living with degenerative illness may use singing within therapy as a way to defy their illness process and as an expression of life's breath running through the body. Singing and voice work within clinical music therapy is therefore not only a vehicle for emotional expression, but also an invaluable tool in gaining an understanding of the client's experience, offering a boundaried environment for exploration of loss and degeneration. Finally, the paper provides a theoretical framework for the emotional experience of singing songs of personal meaning in therapy.
Steering a Path through Change: Observations on the Process of Training
Authors: Watson Tessa
Published: January 2016

There are very few papers or articles that focus upon either learning and teaching, or student change, in the music therapy training experience. This paper considers the process of change during training. The student perspective is considered by using quotations from trainee music therapists. These quotations have been gathered over several years through small research projects studying learning and teaching. These quotations from students will be used to illustrate the author's thoughts about change and the process of training. Theories of learning and teaching are used to further illuminate the author's conceptualisation of student training.

The author would like to thank those students who completed questionnaires.
Early Intervention Music Therapy for Adolescent Mothers and Their Children
Authors: Abad Vicky , Williams Kate
Published: January 2016

Adolescence is a unique and challenging period of growth, change and possible turmoil as a young person transitions towards adulthood. The capacity to provide quality parenting at this time is likely to be compromised because the teenage mother simultaneously experiences the challenges of adolescence and first time parenthood. Research suggests that teenage mothers are significantly less supportive, more detached, more intrusive, and more negative / hostile, when compared to older mothers, and may be less able to provide a stimulating learning environment.

Sing & Grow is a national early intervention music therapy project provided by Playgroup Associations and funded by the Commonwealth Government of Australia. The project provides 10 weekly group music therapy sessions to parent and child (aged 0 to 3 years) dyads from families in communities identified as marginal as a result of various circumstances, including adolescent and young parenthood.

Outcomes of clinical programmes conducted to date show that the central provision of music has been successful in promoting a range of non-musical parenting outcomes for adolescent and young mothers. This includes observed increases in their repertory of skills in relating to and interacting with their child in more gentle and nurturing ways.
The Role of Rhythm in the Development, Maintenance and Management of Stereotypic Behaviours
Authors: Sharp Laura , McGee Anna
Published: January 2016

Rhythm has long been used by music therapists and others as a means of redirecting individuals with specific difficulties towards effective learning and social engagement. There is a wide literature stemming neither from musicology nor from music therapy which considers the role of rhythm within natural child development. This review describes how rhythmic processing has been conceptualised as facilitating learning in the mainstream child. It is widely postulated that rhythmical movements, typically thought to promote physical development, can present inappropriately, resulting in maladaptive distraction to a child's development. These actions, referred to as ‘stereotypic behaviours’, are discussed in relation to a number of rhythm-based strategies suggested in the literature as having a role in minimising the presentation of such behaviours. The management of stereotypic behaviours, specifically in individuals with autistic spectrum disorder (ASD), is also discussed.
From Performer to Container
Authors: Inada Masami
Published: January 2016

This article explores the case of a musically accomplished client for whom an indirect therapeutic intervention involving musical improvisation was provided within the context of a psychiatric music therapy group.

In making music in a group, musically accomplished clients can dominate the music making with their strong musical skills. Their means of participating in group improvisational play often reflects a self-protective narrowing down of awareness.

The case considered here demonstrates that ‘performers' in such groups can learn to relax their defensive stance and play supportive music when the therapist facilitates the development of the group by modelling collaborative improvisation, rather than by intervening directly. An example of this kind of therapeutic intervention is described from a psychoanalytic perspective, focusing on the improvisational playing of the client and group in different phases of the case.
An Investigation into Time Relationships in Co-Improvisation with Children Having Epileptic Fits
Authors: Eugster Mario
Published: January 2016

This qualitative research project investigates aspects of time and timing in co-improvisation with children suffering from epilepsy. Recently, a growing interest in time and timing has emerged in the field of music therapy. However, the impact of epilepsy on time relationships in music therapy has not been systematically explored to date.

Using both video recordings of sessions and interviews with therapists experienced in working with epileptic children as data, the impact of epilepsy on musical time relationships is explored. Time relationships are understood to include not only the relationship between the therapist's and client's timings, expressed in timing of musical activity and body movements, but also the subjective experiences of time a therapist has whilst working with epileptic children, especially when they have a seizure.

The findings of this study support and complexify previous theoretical writings on time and timing in the music therapy literature. The impact of an epileptic seizure on the timing between client and therapist is analysed. The complex relationships between timing and psycho-physiological changes are explored, including possible effects of the therapist's emotional responses on timing. The findings of the study suggest that music therapists share certain experiences of time in work with epileptic children. Finally, there is a discussion of music-therapeutic strategies used by therapists when time relationships are affected by an epileptic episode.
Music Therapy with Children and Adolescents in Mainstream Schools: A Systematic Review
Authors: Carr Catherine , Wigram Tony
Published: January 2016

This article identifies existing research and clinical activity utilising music therapy with mainstream children, as well as a potential need for music therapy with this client group. A systematic review was undertaken of music therapy literature relating to work with children in mainstream schools: 60 papers were identified, 12 of which were outcome studies. Statistical and government data provide a background to the current status and needs of children in the UK.

The emotional and social wellbeing needs of children have been identified as a priority to be addressed by the UK government. However, further research, service-planning and reorganisation is required. There is evidence that music therapy is used with children in mainstream schools both in the UK and abroad. Current literature suggests that music therapy is an effective intervention. The review demonstrates that further research is required if music therapy is to be considered an effective intervention to address the needs of mainstream schoolchildren.
The Use of Performances in Music Therapy Practice in Australia: A Qualitative Study
Authors: O'Grady Lucy , McFerran Katrina
Published: January 2016

The inclusion of performance as a part of the music therapy process is gaining increasing prominence in the literature. Although community music therapy discourse provides a theoretical explanation for the inclusion of performances, better understandings of the practical motivations underlying clinicians' use of performance are needed. Drawing on the responses of 18 Australian music therapists to an emailed questionnaire, this qualitative investigation solicited descriptions of how and why performances were included in their practices and what potential therapeutic outcomes and pitfalls had been experienced. Questionnaire responses were analysed using open coding – an inductive process that facilitates the identification of key ideas from within a data set. Analysis revealed a set of interweaving considerations that led the participating music therapists to use performance, and these were framed into a decision-making tree by the authors. A commitment to the needs of each individual client within performances was identified and this is discussed in light of community music therapy theory. Further investigations of the use of performance in music therapy are needed to better understand the implications of this practice.
An Investigation into Music Therapists' Clinical Experience of Working with the Visually Impaired
Authors: Nightingale Elizabeth
Published: January 2016

The following study set out to investigate how an understanding of music therapists' clinical experience with the visually impaired could inform best practice with this client group. The researcher employed a qualitative methodology rooted in a descriptive phenomenological approach. Five music therapists were interviewed about their clinical experience working with visually impaired clients. Giorgi's (1975) model of meaning condensation was then adopted for the analysis stage. The main conclusion arising from the study was that direct touch played an emphasised role and should be used in a supportive way to facilitate client independence in the areas of orientation and instrumental playing. The use of touch for acknowledgement and encouragement purposes was also found. The increased use of a therapist's spoken voice also emerged, with some interesting views on how changes in tone and pitch could be used more communicatively in the absence of perceived facial expressions. The importance of tactile experiences was made clear both in the process of selecting appropriate instruments and in offering clients vibrotactile opportunities using stringed instruments. Some brief but interesting analysis of the use of the iPad in one participant's clinical work was discussed. Some issues and suggestions were raised for current training programmes. Some areas for further research were identified.
In Search of the Face—An Approach to Mental Handicap
Authors: Zallik Stephanie
Published: January 2016

The article puts forward a case for using music therapy with handicapped people in a way which allows them to overcome the difficulties they have in expressing their needs. The idea of therapy with the mentally ill being more profound in nature than with the mentally handicapped, is discussed and argued against.

The article pursues this theme by considering the relationship between what a handicapped person first presents in the therapy session and what is beneath. The aim of music therapy is therefore to reach those aspects lying beneath the surface. A brief case study is given in order to further illustrate these ideas.
The Role of the Music Therapist in Special Education
Authors: Strange John
Published: January 2016

In a school for children with severe learning difficulties, a full time music therapist may be asked to perform general educational, pastoral and administrative duties. This article examines the impact of these additional responsibilities on therapeutic work, and discusses some possible objections to stepping outside the strictly therapeutic role. The author then outlines ways in which he has found that a wider involvement in the work of the school can enhance the therapist's effectiveness. He concludes that these advantages outweigh the supposed disadvantages.
Vibroacoustic Therapy: The Therapeutic Effect of Low Frequency Sound on Specific Physical Disorders and Disabilities
Authors: Skille Olav , Wigram Tony , Weekes Lyn
Published: January 2016

This article traces the early development of vibroacoustic therapy, and some of the theoretical basis for its use in a treatment procedure. It describes some of the initial work in the Scandinavian countries, gives examples of the type of problems that low frequency sound and music have been particularly effective in treating, and puts into perspective the use of music and sound as a physically effective means of treating people in comparison with the interactive forms of intervention commonly used by music therapists.

Much of the case material described in the article (Norwegian and English) is anecdotal. In the latter section of this paper, current research is described.
“The Use of I and Me”: Music Therapy with an Autistic Child
Authors: Levinge Alison
Published: January 2016

This paper provides an account of three significant stages in 18 months of music therapy with an autistic child, Rosa, whom I met when she was nearly two and a half years old. First I introduce her, summarising my understanding of “autism” and the role of music therapy: the approach is psycho-dynamic, influenced by Klein, Winnicott, and Tustin. Then I give a detailed description of a session six months after we started working together. I conclude with an interpretation of the change in our relationship a year later. Four autistic features emerge: (i) destruction and negation followed by repair and affirmation; (ii) confusion of zones; (iii) infantile sexuality; (iv) a sense of emptiness.
DICS Music Therapy: Databases and Data Communication
Authors: van den Berk Pieter , Vodegel Frans , Wigram Tony
Published: January 2016

In introducing this paper on the Documentary Information and Communication System which has been developed over the last two and a half years in the Netherlands, I find it difficult to hide the excitement and enthusiasm I feel for this project and for the men who have pioneered such an important development for music therapy. I have been to four different presentations by Pieter van den Berk and Frans Vodegel and recently spent time in the Netherlands with them discussing how the system can be established in the UK, and how it is being established in other countries. The tremendous value of this resource to music therapy is almost incalculable. Communication is one of the most fundamental elements in music therapy practice, and the essence of this paper is in describing a process by which music therapists can communicate with each other all over the world.

Imagine a situation where after initiating some work with somebody suffering from a particular problem, you experience considerable difficulties in how to proceed. Through the DICS, it would be quite simple to delve into the memory of the computer, and quickly find out all the other practitioners in countries which have established the system who are involved or have been involved in the same area of work, and make contact with them. Additionally, the system will allow us to call up available literature on particular problems that we are working with in music therapy journals and medical journals that have been stored in the system.

Personally, I will find it enormously valuable to establish and build up contact with music therapists all over Europe and in the United States and in Australia who are working in the same area that I am. But the DICS is not only a process of taking, it is also a process of giving. By giving information to the system about music therapy in Great Britain, training, clinical practice and available literature, we will find that not only can we gain from understanding the work of others, but can take pride in the dissemination of our own work abroad.
Mapping the Territory
Authors: Ansdell Gary
Published: January 2016

This paper outlines a model for assessing adult clients in creative music therapy based on a phenomenological approach to organising the descriptive level.
Music Therapy: Challenging Low Self-Esteem in People with a Stroke
Authors: Purdie Heather , Baldwin Steve
Published: January 2016

This paper discusses the theoretical background to the concept of low self-esteem. It investigates the effects of stroke and how low self-esteem can present in a person with a stroke. Thereafter it looks at the behavioural outcomes and the causes of low self-esteem and goes on to examine how music therapy can be used as an intervention to facilitate behavioural and psychological change in the context of stroke rehabilitation.
Lighting up the Mind: Evolving a Model of Consciousness and its Application to Improvisation in Music Therapy
Authors: Usher Julia , Greenfield Susan
Published: January 2016

This paper explores Professor Susan Greenfield's theory of Neuronal Assembly Formation (Neuronal Gestalts) within a clinical music therapy context. Neuronal events in the brain are seen not only as shaping the physiological and communicative responses of the client, but also contributing to the character of the musical material itself, as it evolves in improvisation. This paper describes work with adults with profound learning difficulties living in a long-term residential unit. For these non-verbal clients, music becomes a primary language for translating and exchanging feelings and meanings. Greenfield's Concentric Theory offers new ways of analysing and characterising the somatic and neurological processes of stimulation and arousal underlying this process in each individual. Some current theories of consciousness are compared, and the evidence for possible links between the formation of neuronal assemblies and the development of musical gestalts is investigated through a series of case studies.
Music Therapy with Children Hospitalised for Severe Injury or Illness
Authors: Edwards Jane
Published: January 2016

This paper provides an overview of the needs of children receiving care in hospital, including a review of the research and case-study literature addressing music therapy practice with this population. The use of music therapy in individual programs to address pain, psychosocial needs and anxiety in hospitalised children is described. A brief case study outlines the ways in which the therapist must be flexible and adaptive in approaching the time and space dimensions of work in this context.
The Therapeutic Musical Relationship: A Two-Sided Affair?: A Consideration of the Significance of the Therapist's Musical Input in Co-Improvisation
Authors: Procter Simon
Published: January 2016

Many improvisational models of music therapy involve therapist and client improvising spontaneously together. This is widely described as a form of musical relationship. However, whilst there is much discussion of the client's musical input in the literature, the therapist's music attracts less attention. The author considers reasons why this may be the case and seeks evidence, from the music therapy literature and beyond, as to whether the therapist's musical input is of significance for the therapeutic process. An example of detailed analysis of the author's own clinical work is presented, in order to establish whether the therapist's musical input has an observable impact on the shared musical experience and might thus be judged to be significant for the therapeutic musical relationship. Concluding that it is indeed significant, the author goes on to consider the implications for the way music therapists consider their work.