MAGNET Survey assessment tool for music therapists repackaged into an interactive eBook. Music therapists can now easily fill out and save forms online for seamless and efficient assessments.
This book introduces the MuSense program, which gives music therapists guidance on how to effectively provide music therapy to individuals with profound and multiple disabilities (PMD). Providing ...numerous case studies and practical information on how to structure sessions, it is a must read for music therapists.
A long‐standing university‐community partnership used a longitudinal randomized control trial to implement and evaluate two couple relationship education (CRE) curricula, ELEVATE and Couples ...Connecting Mindfully (CCM), among an economically and racially diverse population of adult couples. Married and non‐married couples (n = 929 couples) completed baseline surveys and were randomly assigned to either one of the two program groups or to the control group by implementation site. Follow‐up surveys were collected at 2 months, 6 months, and 1 year after baseline. Using an intent‐to‐treat approach, growth curve modeling comparisons of trajectories indicated program effects at 1 year post‐baseline in key outcome areas. Both the ELEVATE and the CCM group reported significant gains in couple relationship skills, couple quality, and family harmony over time compared to the control group that experienced either no change or declines. Further, the ELEVATE group also demonstrated positive program effects on measures of mental health and sleep quality. An assessment of the central premise of CRE indicated that the immediate post‐program improvements in couple relationship skills predicted later couple quality for both program groups. This study indicates that both ELEVATE and CCM can be considered evidence‐based CRE programs for use with a broad population of couples.
Resumen
Una asociación duradera entre la universidad y la comunidad utilizó un ensayo controlado aleatorizado y longitudinal para implementar y evaluar dos currículos de educación sobre las relaciones de pareja, ELEVATE y Couples Connecting Mindfully (CCM), entre una población de parejas adultas económicamente y racialmente diversa. Parejas casadas y no casadas (n = 929 parejas) contestaron encuestas en el momento basal, y luego, en el lugar de implementación, se las distribuyó aleatoriamente a alguno de los dos grupos del programa o al grupo de referencia. Se recogieron encuestas de seguimiento dos meses, seis meses y un año después del momento basal. Utilizando un método por intención de tratar, las comparaciones de trayectorias del modelo de curva del crecimiento indicaron efectos del programa un año después del momento basal en áreas de resultado claves. Tanto el grupo de ELEVATE como el de CCM informaron beneficios significativos en las habilidades para las relaciones de pareja, la calidad de la pareja y la armonía familiar con el tiempo en comparación con el grupo de referencia, que no tuvo ningún cambio ni empeoramientos. Además, el grupo de ELEVATE también demostró efectos del programa en las medidas de salud mental y calidad del sueño. Una evaluación de la premisa fundamental de la educación sobre las relaciones de pareja indicó que las mejoras inmediatas después del programa en las habilidades para las relaciones de pareja predijeron una posterior calidad de la pareja para ambos grupos del programa. Este estudio indica que tanto ELEVATE como CCM pueden considerarse programas factuales de educación sobre las relaciones de pareja aptos para su uso con una amplia población de parejas.
摘要
一个存续较久的大学‐社区伙伴关系使用纵向随机对照试验(RCT)，在经济情况多样化和种族多样化的成年伴侣群体中实施和评估两门伴侣关系教育(CRE)课程，ELEVATE和伴侣有意识连接(CCM)。已婚和未婚夫妇(n = 929对夫妇)完成基线调查，并根据实施地点被随机分配到两个方案组中的任何一个或控制组。随访调查分别在基线后2个月、6个月和1年进行。使用刻意治疗方法，生长曲线建模比较轨迹表明项目在关键结果区域基线后一年的效果。随着时间的推移，ELEVATE组和CCM组在夫妻关系技巧、夫妻质量和家庭和谐方面都有显著提高，而对照组要么没有变化，要么下降。此外，ELEVATE小组还证明了方案对心理健康和睡眠质量等因素的影响。对CRE中心前提的评估表明，项目后伴侣关系技能的立即改善预示着两个项目组以后的伴侣质量。这项研究表明，ELEVATE和CCM都可以被视为基于证据的CRE项目，用于广泛伴侣群体。
Background
Nuts contain a number of nutritional attributes which may be cardioprotective. A number of epidemiological studies have shown that nut consumption may have a beneficial effect on people ...who have cardiovascular disease (CVD) risk factors. However, results from randomised controlled trials (RCTs) are less consistent.
Objectives
To determine the effectiveness of nut consumption for the primary prevention of CVD.
Search methods
We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Web of Science Core Collection, CINAHL, Database of s of Reviews of Effects (DARE), Health Technology Assessment Database (HTA) and Health Economics Evaluations Database (HEED) up to 30 July 2015. We searched trial registers and reference lists of reviews for further studies. We did not apply any language restrictions.
Selection criteria
We included RCTs of dietary advice to increase nut consumption or provision of nuts to increase consumption lasting at least three months and including healthy adults or adults at moderate and high risk of CVD. The comparison group was no intervention or minimal intervention. The outcomes of interest were CVD clinical events and CVD risk factors.
Data collection and analysis
Two review authors independently selected trials for inclusion, ed the data and assessed the risk of bias in included trials.
Main results
We included five trials (435 participants randomised) and one ongoing trial. One study is awaiting classification. All trials examined the provision of nuts to increase consumption rather than dietary advice. None of the included trials reported on the primary outcomes, CVD clinical events, but trials were small and short term. All five trials reported on CVD risk factors. Four of these trials provided data in a useable format for meta‐analyses, but heterogeneity precluded meta‐analysis for most of the analyses. Overall trials were judged to be at unclear risk of bias.
There were variable and inconsistent effects of nut consumption on CVD risk factors (lipid levels and blood pressure). Three trials monitored adverse events. One trial reported an allergic reaction to nuts and three trials reported no significant weight gain with increased nut consumption. None of the included trials reported on other secondary outcomes, occurrence of type 2 diabetes as a major risk factor for CVD, health‐related quality of life and costs.
Authors' conclusions
Currently there is a lack of evidence for the effects of nut consumption on CVD clinical events in primary prevention and very limited evidence for the effects on CVD risk factors. No conclusions can be drawn and further high quality longer term and adequately powered trials are needed to answer the review question.
Abstract
Fiber free exclusive enteral nutrition (EEN) is an effective steroid-sparing treatment used to induce clinical remission in children with Crohn’s disease (CD). However, the mechanism ...underlying the beneficial effects of EEN remains obscure. We have generated a novel mouse strain that harbors mutations in two CD susceptibility genes (i.e, NOD2 and CYBB) and found that these mice spontaneously develop an early-onset (4 weeks of age), TH1-type gut inflammation, that closely recapitulates the human disease when exposed to a specific murine microbiota. Disease in Nod2/Cybb (DKO) mutants was triggered by a single mucus-dwelling anaerobe, Mucispirillum schaedleri, which markedly accumulates in the intestinal lumen and mucus layer prior to disease development. Given that our mouse model resembles early-onset CD, we have established a novel humanized mouse model of early-onset CD in which germ-free Nod2/Cybb mutants were colonized with microbiotas from early-onset-CD patients and their healthy first-degree relatives. We have found that the early-onset-CD-associated microbiota triggered intestinal inflammation in gnotobiotic DKO mice with all the hallmarks of the human disease. Using the murine and humanized models of early-onset CD we have found that administration of a fiber-free diet prevents the development of colitis and inhibits intestinal inflammation in colitic animals. Furthermore, identification of Mucispirillum as a trigger in our mouse model has allowed us to study the effects of dietary interventions on disease-causing microbes. Remarkably, we have found that a fiber-free diet alters the intestinal localization of Mucispirillum. Mechanistically, the absence of dietary fiber reduces the availability of nutrients and impairs Mucispirillum’s unique metabolic pathway in the intestinal mucus. Thus, appropriate localization of the pathobiont in the mucus layer is critical for the onset of disease, which can be disrupted by fiber exclusion. These results suggest that probing the intestinal niche and metabolism of disease-causing microbes will likely lead to the discovery of novel, more targeted therapies for the treatment of CD.
Summary
Background
Atherosclerotic cardiovascular disease is a key cause of morbidity in non‐alcoholic fatty liver disease (NAFLD) but appropriate means to predict major acute cardiovascular events ...(MACE) are lacking.
Aim
To design a bespoke cardiovascular risk score in NAFLD.
Methods
A retrospective derivation (2008‐2016, 356 patients) and a prospective validation (2016‐ 2017, 111 patients) NAFLD cohort study was performed. Clinical and biochemical data were recorded at enrolment and mean platelet volume (MPV), Qrisk2 and Framingham scores were recorded one year prior to MACE (Cardiovascular death, acute coronary syndrome, stroke and transient ischaemic attack).
Results
The derivation and validation cohorts were well‐matched, with MACE prevalence 12.6% and 12%, respectively. On univariate analysis, age, diabetes, advanced fibrosis, collagen proportionate area >5%, MPV and liver stiffness were associated with MACE. After multivariate analysis, age, diabetes and MPV remained independently predictive of MACE. The “NAFLD CV‐risk score” was generated using binary logistic regression:
0.06*(Age) + 0.963*(MPV) + 0.26*(DM1) – 16.44;
1Diabetes mellitus: 1: present; 2: absent.
(AUROC 0.84). A cut‐off of −3.98 gave a sensitivity 97%, specificity 27%, PPV 16%, and NPV 99%. An MPV alone of >10.05 gave a sensitivity 97%, specificity 59%, PPV 24% and NPV 97% (AUROC 0.83). Validation cohort AUROCs were comparable at 0.77 (NAFLD CV‐risk) and 0.72 (MPV). In the full cohort, the NAFLD CV‐risk score and MPV outperformed both Qrisk2 and Framingham scores.
Conclusions
The NAFLD CV risk score and MPV accurately predict 1‐year risk of MACE, thereby allowing better identification of patients that require optimisation of their cardiovascular risk profile.
The reported interpretation of correlation between ionized calcium levels and other variables—blood pressure, coagulation markers, and hematoma volume—is also of concern. ...it seems much more ...credible that this association reflects critical illness associated hypocalcemia, a known prognostic marker of worse outcomes—for which a treatment aiming at euboxia (i.e., normalization of physiological parameters) is not recommended 3. Furthermore, the authors do not report variable selection for the Cox proportional hazards model, how the model was built, what was the final model fit, and whether the assumption of proportionality of hazards was evaluated any time during statistical analysis 4.
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