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The purpose of this study was to examine high school music teachers' knowledge of music therapy, interest in music therapy, and career recommendations for music therapy relative to other music careers. High school music teachers (N  = 65) from one southeastern state completed a researcher-designed survey instrument designed to investigate these areas. Results indicated varied levels of knowledge about music therapy, although teachers who previously attended institutions that offered music therapy degree programs provided higher knowledge ratings than those who had not attended institutions with music therapy programs. Additionally, participants reported a relatively high interest in music therapy and a willingness to promote it as a career to their students. Participants reported that they were most likely to recommend music education as a career to their students, followed by music performance and music therapy. In response to open-ended questions, participants indicated that they believed personal characteristics were the most important qualities of prospective music therapists and that musical characteristics were the most important qualities of prospective music educators. They also expressed an interest in more information about music therapy, especially related to job characteristics. Implications of these findings and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

There is strong consumer demand for local, value- added food products; however, these smaller scale food manufacturing operations tend to face more challenges in understanding and complying with food safety regulations, specifically, the Food Safety Modernization Act (FSMA) Preventive Controls for Human Food (PCHF) rule. An eight- module educational program was developed to introduce food safety throughout the product development life cycle and included concepts related to the FSMA PCHF rule. The program was offered in person (n = 2) and virtually (n = 6) to 143 participants in total, who were mostly early-stage food developers. Most (74%, n = 90) had little to no prior food safety-related training and experience. The majority (93%, n = 90) agreed they will apply the knowledge and skills learned in the course to food applications, such as developing food safety plans, label review, and good manufacturing practices. Self-rated level understanding for each module ranged from 4.4 to 4.6 on a 5-point Likert scale. Overall, participants felt better prepared to conduct various food safety activities after taking the course, supporting the need for nonmandatory training opportunities to enhance FSMA PCHF regulatory compliance. These types of training may be important for small-scale operations to improve the learning outcome and regulatory compliance. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic in the United States caused disruptions in care seeking and delivery during the spring of 2020, including for contraceptive care. We examined how some individuals experienced and responded to barriers to accessing contraceptive care by conducting a content analysis of relevant Reddit posts. We collected 2666 posts by scraping relevant subreddits from February 1, 2020, to April 15, 2020, and filtering by selected keywords. Among the 101 posts on contraception and the COVID-19 pandemic, we explored three main themes: barriers to accessing general healthcare during the early pandemic, problems and concerns specific to contraceptive use, and attempts to navigate the obstacles to contraceptive care or use-related concerns. The Reddit posts demonstrated the disruptive force the early pandemic had on contraceptive care and provided a unique window into the concerns posters expressed on Reddit during this time. Many posters asked questions related to accessing contraception and side effects and sought reassurance from these online forums. Our results suggest that there were barriers to accessing reliable, high-quality, and evidence-based information about contraception during this disruption in care. The findings also underscore that conversational and interactive means of seeking out information are important modes for learning about and discussing contraception for some and may be especially helpful during clinic closures and other restrictions on access. [ABSTRACT FROM AUTHOR]

Introduction: Self-efficacy (SE) has been explored extensively within the field of psychology. Despite a rich literature demonstrating its positive effect on various behavioral outcomes, including psychological treatment outcomes, little is known about the impact of SE on outcomes related to obsessive-compulsive disorder. To fill this critical gap in the literature, this study aims to examine the relationship between SE beliefs and contamination-related approach behavior and to determine whether increasing SE may improve engagement in exposure-based interventions for contamination fears. Method: Participants (N = 120) were randomly assigned to complete a contamination-related behavioral approach task (CR-BAT) immediately following either a SE-boosting exercise or a non-SE related control. Results: Self-reported contamination-relevant SE was positively correlated with approach behavior during the CR-BAT. However, there were no differences between conditions in contamination-related SE or approach behavior during the CR-BAT. Nevertheless, participants in the SE-boosting condition reported lower levels of anxiety during the CR-BAT than did those in the control condition, suggesting that the manipulation was effective in reducing subjective distress. Discussion: Future research using more effective methods to manipulate SE is required to examine the causality of this relationship. [ABSTRACT FROM AUTHOR]

The coronavirus pandemic began to spread in the United States in March of 2020. Concerns about the virus prompted widespread restrictions at higher education institutions, which resulted in a sudden shift to remote learning. Though music therapy education integrated online components prior to the pandemic, few courses were mostly or completely online. Consequently, the unexpected transition to remote learning presented challenges for both music therapy faculty and students. Among these challenges was the impact of the pandemic on clinical training, as pandemic restrictions limited in-person contact and prompted music therapists to shift to telepractice. These changes in service delivery also prompted changes in clinical training, leaving some music therapy faculty to simultaneously learn, teach, and supervise telepractice. However, many music therapy educators had little experience with telepractice, and information was limited on teletraining and supervision. In this article, we present two case examples of music therapy training/supervision practices in the United States. We outline how we developed these practices for individual and group-based clinical teletraining for pre-intern music therapy students. Included are strategies related to technology, music interventions, and pre-internship supervision, along with the frameworks that supported our decisions as we developed the teletraining and supervision models. The information presented in these case examples highlights the need for effective teletraining and supervision strategies to help students acquire music therapy competencies remotely. We hope the lessons we learned will help others generate innovative ideas and methods for remote learning, particularly in relation to clinical training. [ABSTRACT FROM AUTHOR]

Students attending college rely on a variety of social and financial resources to cover the personal and academic costs of higher education. The most common tool for students is financial aid, which may include loans, needs-based grants, and work–study. Federal financial aid is designed to increase accessibility for individuals to pursue a college degree and is generally determined by their family's assets or socioeconomic status. Research has suggested positive and negative relationships between students' socioeconomic status and their academic outcomes. As this relationship has yet to be explored in music therapy, the primary purpose of this study was to explore the current financial needs and economic diversity of American undergraduate music therapy students. A survey was sent in April of 2020 for dissemination to undergraduate music therapy majors. Students from across the United States (n = 346) completed the questionnaire. Key findings included (a) most music therapy students (61.7%) took out student loans during the 2019–2020 academic year and expect substantial levels of debt upon graduation (>$10,000); (b) about one-third (34.4%) of respondents received the Pell Grant, a needs-based grant, in the past year; (c) a considerable majority (77.5%) were employed during school; and (d) 97% of students received additional financial assistance from their families. This study also compared the needs between BIPOC (Black, indigenous, people of color) and white students. Implications of findings as they relate to music therapy education and further research regarding the financial need and socioeconomic status are also discussed. [ABSTRACT FROM AUTHOR]

Experiencing a stroke can lead to difficulties with emotion regulation and mood disorders like depression. It is well documented that poststroke depression (PSD) affects a third of all stroke survivors. Higher levels of depression and depressive symptoms are associated with less efficient use of rehabilitation services, poor functional outcomes, negative impacts on social participation, and increased mortality. Mood in the acute phases of stroke recovery may be a key factor influencing the depression trajectory with early depression predicting poor longitudinal outcomes. The purpose of the study was to examine the effect of one active music therapy (AMT) treatment on mood following a first-time ischemic stroke during acute hospitalization. Forty-four adults received AMT defined as music-making interventions that elicit and encourage active participation. The Faces Scale was used to assess mood immediately prior to and following the treatment. A significant change in mood was found following one treatment. Comment analysis indicated that participants viewed music therapy as a positive experience. Findings here support the use of brief AMT to provide early psychological support to stroke survivors. Continued investigation into the role of music therapy in early stroke recovery is recommended. [ABSTRACT FROM AUTHOR]

Employment opportunities in any industry are largely driven by several macroenvironmental factors. The global outbreak of COVID-19 slowed operations and transactions due to the extended lockdowns and changed consumer behaviors. The purpose of this study was to forecast the 2020 employment trends in the North Carolina textile industry from pre-pandemic data and to explore the potential impact of COVID-19 on employment in the industry. Data were obtained from the NC Department of Commerce Labor & Economic Analyses on employment, number of establishments, and wages for each of four textile businesses: textile mills, textile retail, textile wholesale, and textile services. Time series forecast models were built for data from 2014-2019 which were used to forecast data for 2020. In general, the number of establishments, employment and wages could be forecasted accurately for the first quarter of 2020. However, virtually none of the forecasts for the second quarter of 2020 were accurate. Interestingly, a few of the third and fourth quarter forecasts were accurate. Some of the inconsistencies could be unique to textiles because of its existing slow decline. [ABSTRACT FROM AUTHOR]

Despite a rich literature on the effects of self-efficacy (SE) on various outcomes, there is little discussion of its effects on obsessive-compulsive disorder (OCD). The purpose of this study was to develop and validate the Facing-Contamination Self-Efficacy Scale (FC-SES), a measure of beliefs about one's capability to face OCD-relevant contamination triggers. The final sample consisted of 129 participants, age 18 and over, who were recruited through Amazon's Mechanical Turk. Factor structure, reliability, and validity were assessed using exploratory factor analysis, Cronbach's alpha, and correlational analyses, respectively. Factor analysis yielded 2 clearly interpretable factors: human-related contamination (9 items), and animal-related contamination (5 items). The 14-item FC-SES demonstrated very good internal consistency reliability (α =.87), as well as good convergent and discriminant validity. Results suggest the FC-SES is a valid and reliable tool that can be used in future research exploring the relationship between SE and contamination-related OCD symptoms. [ABSTRACT FROM AUTHOR]

A survey was designed and conducted to measure knowledge of, attitudes toward, and implementation of food safety practices among food manufacturers operating at shared-use processing facilities in the northeastern United States (Connecticut, Delaware, Maine, Massachusetts, Maryland, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, and Washington, D.C.). The survey was distributed online and through the mail. Survey responses were analyzed using SPSS software, and significance was reported at < 0.05. Knowledge item categories included general food safety (6 questions), prerequisite programs (12 questions), and hazard analysis and preventive controls (14 questions). Although respondents (= 47) had an overall correct knowledge score of 82 ± 10, they scored below the 80% mastery threshold for the category of hazard analysis and preventive controls at 77 ± 15. The overall attitude score, based on a 5-point Likert scale, was 4.8 ± 0.3, reflecting a positive attitude toward food safety practices related to food processing. Respondents who received ongoing food safety-related training had higher (< 0.05) self-confidence in conducting food safety-related activities, indicating the importance of ongoing training. Although overall knowledge was satisfactory, the below-mastery score in food safety requirements demonstrated the need for targeted training that would prepare audiences for regulatory compliance. [ABSTRACT FROM AUTHOR]

Music teachers play an important role in exposing students to career options in the field of music. As a result, there is a need to explore music education students' interest in and knowledge of music therapy. The purpose of this study was to investigate music education students' exposure to, knowledge of, and willingness to promote music therapy as a career option for prospective collegiate students. A survey was given to 254 music education majors from four research institutions, two with and two without music therapy degree programs. Participants answered demographic, yes/no, Likert-type scale, and open-ended questions about their exposure to, knowledge of, and willingness to promote careers in music therapy. Results indicate that exposure to music therapy occurred in both pre-collegiate and college settings, and that music teachers appear to be influential in exposing students to music therapy. Students often sought out information on music therapy independently, which played an important role in how individuals learned about music therapy, though it has the potential of providing misinformation. Significant differences were found in participants' knowledge and willingness to promote music therapy as a career option based on the presence of music therapy degree programs. Exposure seemed to be a key factor in music therapy knowledge and promotion; thus, music therapists need to ensure accurate dissemination of music therapy-related information in both pre-collegiate and college settings. Increasing the visibility of the field has the potential to expand interest and potentially attract young musicians well suited for a career in music therapy. [ABSTRACT FROM AUTHOR]

While literature exists supporting the use of music for health promotion, scholars have also noted the potential for music-induced harm and other maladaptive effects of music. Harm is a multifaceted construct that can include affective, behavioral, cognitive, identity, interpersonal, physical, and spiritual aspects. As music also represents a multifaceted experience, the relationship between music and harm is complex and can include numerous contextual-, deliverer-, music-, and recipient-based factors. Music-induced harm (MIH) also needs to be clearly defined to understand and protect against it. Therefore, the purpose of this article was to explore the numerous factors influencing how music can result in harm and develop a theoretical model that could be used to inform safe music practices. Drawing from existing models of emotional responses to music, music intervention reporting guidelines, therapeutic functions of music, and holistic wellness, we explored how the interplay between the deliverer, music, and recipient can result in various types of MIH in diverse contexts. We then developed the MIH model to integrate these factors and connect the model with the existing literature. The MIH model highlights the relevance of academic and clinical training, credentialing, occupational regulation, continuing education, and professional organizations that provide accredited curricular oversight to protect people from MIH. Implications for clinical application, limitations, and suggestions for future research are provided. [ABSTRACT FROM AUTHOR]

Music therapy treatment is increasingly being used to promote health, enhance quality of life, and improve functioning in military personnel, but evidence on the use of music interventions with military service members is still emerging. The purpose of this scoping review was to synthesize the available literature regarding music therapy treatment with military personnel by identifying the types of information available, key characteristics, and gaps in the knowledge base. The review was completed using the methodological framework proposed by Arksey and O'Malley. A total of 27 publications met the criteria for review. The results included anecdotal reports, white papers/ briefs, case studies, historical reviews, clinical program descriptions, and research studies. Both active duty and veteran service members were represented in the literature, and post-traumatic stress disorder and traumatic brain injury were the most commonly listed conditions among those served. Music therapy services were offered in both group and individual formats, and drumming was the most common music intervention cited. Most publications accurately represented music therapy, and the historical reviews highlighted the connection between the development of the field of music therapy and the use of music with military personnel. Several gaps were identified, including a lack of specificity in reporting, low levels of evidence, and limited inclusion of women service members. [ABSTRACT FROM AUTHOR]

A state brand was created for Rhode Island (RI) seafood in an effort to encourage the development of the fishing and aquaculture industries. Little was done to assess RI consumers, however, regarding their perceptions and understanding of local seafood. Therefore, a survey (N=968) of RI consumers at least 18 years old was implemented to assess consumer perceptions, purchasing choices, and understanding of local seafood. The majority of RI consumers, regardless of income, education, and locality, would prefer local seafood if they could easily find it in the market and if they could trust the brand to identify product choices. The top three places to purchase seafood were supermarkets, seafood specialty stores, and restaurants. Seafood quality, taste preference, safety at purchase, and absence of contaminants were considered important or very important factors influencing purchasing decisions; however, respondents felt only somewhat knowledgeable about key seafood attributes. More than half of survey consumers (66%) felt that the branding logo, created by the RI Department of Environmental Management, would encourage them to select a local seafood product, and 53% indicated they would be more willing to try a seafood product if it were labeled local. However, only 12% of respondents recognized the brand for local RI seafood. This information will be used by state partners to help develop an outreach strategy to promote the RI seafood brand and local seafood and will be used to inform current policy regarding branding. [ABSTRACT FROM AUTHOR]

Introduction: Burnout is a psychological syndrome that develops in response to chronic interpersonal job stressors and music therapists, like other healthcare providers, are at risk for burnout. To date, over 25 manuscripts related to burnout among music therapists have been published, however, no integration of the information exists. Methods: An integrative review was conducted to provide a comprehensive synthesis of the literature on burnout among music therapists between the years of 1981 and 2017. Results: A total of 26 publications from North America, Europe, and Asia were included, 17 of which were descriptive research studies. The findings indicated that music therapists are at average risk for burnout; however, they also experience more burnout than other mental health workers. Emotional exhaustion was the most experienced dimension of burnout, and Korean music therapists appear to be at greater risk than music therapists in other countries. Hours worked, years in the field, and gender did not appear to be strongly correlated with burnout, but work environment and work demands did appear to be connected. The most common contributors to burnout cited were work environment issues followed by compensation and workload, and individual personality traits may also increase the risk for burnout. However, self-care strategies may lower the degree of burnout experienced. Discussion: Music therapists, like other helping professionals, are at risk for burnout. Strategies for managing and preventing burnout have been suggested, and those strategies are consistent with research in other fields. However, research is needed to explore the effectiveness of specific strategies. [ABSTRACT FROM AUTHOR]

In the United States, intern supervision plays a pivotal role in the pre-professional development of music therapists. While various supervision resources are available, there is limited information on factors that impact supervision practices. A survey was distributed to investigate supervision practices used by music therapy internship directors and supervisors practicing under the American Music Therapy Association guidelines. Survey questions explored the use of supervision approaches or models, factors that influence supervision style (e.g. training), and competency placement/ideal competency placement across internship stages. Seventy-two complete responses were collected. Thirteen respondents reported using specific guidelines for intern supervision. Use of guidelines was influenced by training factors and experience. Supervision style was most influenced by respondents' own supervisor. Differences existed between ideal and actual competency focus across the internship training experience. Results suggest that use of a model of supervision that allows for adaptation of individual developmental needs may be valued by music therapy supervisors and increase satisfaction with supervision. [ABSTRACT FROM AUTHOR]

Background: Live, attenuated viral vectors that express HIV-1 antigens are being investigated as an approach to generating durable immune responses against HIV-1 in humans. We recently developed a replication-competent, highly attenuated Ad26 vector that expresses mosaic HIV-1 Env (rcAd26.MOS1.HIV-Env, “rcAd26”). Here we present the results of a first-in-human, placebo-controlled clinical trial to test the safety, immunogenicity and mucosal shedding of rcAd26 given orally. Methods: Healthy adults were randomly assigned to receive a single oral dose of vaccine or placebo at 5:1 ratio in a dosage escalation of 10^8 to 10^11 rcAd26 VP (nominal doses) at University of Rochester Medical Center, Rochester, NY, USA. Participants were isolated and monitored for reactogenicity for 10 days post-vaccination, and adverse events were recorded up to day 112. Rectal and oropharyngeal secretions were evaluated for shedding of the vaccine. Humoral and cellular immune responses were measured. Household contacts were monitored for secondary vaccine transmission. Results: We enrolled 22 participants and 11 household contacts between February 7 and June 24, 2015. 18 participants received one dose of HIV-1 vaccine and 4 participants received placebo. The vaccine caused only mild to moderate adverse events. No vaccine-related SAEs were observed. No infectious rcAd26 viral particles were detected in rectal or oropharyngeal secretions from any participant. Env-specific ELISA and ELISPOT responses were undetectable. No household contacts developed vaccine-induced HIV-1 seropositivity or vaccine-associated illness. Conclusions: The highly attenuated rcAd26.MOS1.HIV-Env vaccine was well tolerated up to 10^11 VP in healthy, HIV-1-uninfected adults, though the single dose was poorly immunogenic suggesting the replicative capacity of the vector was too attenuated. There was no evidence of shedding of infectious virus or secondary vaccine transmission following the isolation period. These data suggest the use of less attenuated viral vectors in future studies of live, oral HIV-1 vaccines. Trial registration: ClinicalTrials.gov . [ABSTRACT FROM AUTHOR]

The article discusses issues associated with occupational injury and illness in healthcare workers with special reference to music therapists. It is noted that research reveals that more than 93% of professional musicians are at risk for contracting hearing disorders and they are at risk for various psychological disorders, including anxiety disorders and depression.

A survey was designed and administered to measure knowledge of and attitudes toward on-farm food safety among small- and medium-sized farms in the New England (NE) region (CT, MA, ME, NH, RI, VT). Two methods of distribution were used, based on each state project director's solicitation preference: an on-line survey was distributed through E-mail, and a paper survey was mailed. Survey responses were analyzed using descriptive statistics, 1-way ANOVA and t-tests, using SPSS software, and significance was reported at P < .05. Respondents from small (n = 254) and medium (n = 47) farms had an overall correct knowledge score of 77 ± 13%, related to on-farm food safety practices in the areas of general food safety, water, health and hygiene, planting/growing/harvesting, post-harvest, animal and pest control, and recall/traceback. Knowledge scores were significantly (P < .05) higher among respondents who had received GAP training (80% vs. 73%) and had implemented on-farm food safety practices (79% vs. 71%). The overall attitude score, based on a 5-point Likert scale, was 3.5 ± 0.5, reflecting the importance of on-farm food safety, trust in others to keep produce safe, perception of local/smaller being safer, and perception that their customers value food safety. On-farm food safety had a positive attitude score (4.0 ± 0.9), while trust in others had a low score (2.4 ± 0.8). [ABSTRACT FROM AUTHOR]

Work-life factors are individual, organizational, and societal factors that influence work-life success and balance. Faculty members' perceptions of these factors have been shown to influence job satisfaction, and scholars have suggested that faculty work-life quality and satisfaction has declined in recent years. Trends in worklife satisfaction and balance have been studied for decades, but little is known about the work-life and job satisfaction of music therapy educators. The purpose of this study was to identify specific worklife factors of music therapy faculty in the United States and explore faculty members' perceptions of these factors. A survey link was sent out, and 100 music therapy educators returned surveys (37% response rate). Eighty-nine provided usable responses. Results indicated that music therapy faculty are predominantly female and white, with an average age of 49. Two-thirds were tenured/tenure- track, and the majority worked 41 or more hours per week. Average credits taught per semester were 9.19, which included both traditional and clinical course formats. Other job duties included service, advising, and research. Salary data were mixed in comparison to other music faculty. Most respondents were somewhat or very satisfied with their current position (85.71%), but a substantial portion of respondents were somewhat or very dissatisfied with salary (41.61%), work-life balance (39.29%), and workload (35.72%), with a substantial proportion stating that their workload was higher than other music and non-music faculty. More research is needed to ensure adequate support of future music therapy faculty. [ABSTRACT FROM AUTHOR]

Background: Young children who experience high levels of preoperative anxiety often exhibit distress behaviors, experience more surgical complications, and are at a higher risk for developing a variety of negative postoperative consequences. A significant factor in pediatric preoperative anxiety is the level of anxiety present in their caregivers. Active and passive music therapy interventions addressing anxiety prior to invasive procedures have been met with success.Objective: The purpose of this study was to investigate the comparative effectiveness of two distraction-based music therapy interventions on reducing preoperative anxiety in young pediatric surgical patients and their caregivers.Methods: A total of 40 pediatric patient and caregiver dyads undergoing ambulatory surgery were included in this study. Pediatric preoperative anxiety was measured pre- and post-intervention using the modified Yale Pediatric Anxiety Scale, while caregiver anxiety was measured through self-report using the short-form Strait-Trait Anxiety Inventory-Y6. Participants were randomized to either an active or passive intervention group for a preoperative music therapy session.Results: Results indicated a significant reduction in preoperative anxiety for both patients and their caregivers regardless of intervention type. Neither active nor passive music therapy interventions were significantly more effective than the other.Conclusions: For future studies, the researchers recommend an increased sample size, controlling for various factors such as sedative premedication use, and testing interventions with patients in various stages of development. [ABSTRACT FROM AUTHOR]

Produce contributed to more foodborne illnesses from 2004 to 2013 than any other food category. While the main focus has been on produce contamination on a farm or distribution center, little has been done to understand the role of consumers' food safety practices in the grocery store. This area is of particular importance, since any contamination could be made worse with improper food safety practices in the home. The purpose of this study was to use direct observation and a smartphone application to observe food safety handling and hygiene practices of consumers shopping for produce at grocery stores in Rhode Island. A total of 80 individual consumer observations of produce handling and hygiene practices took place at five grocery stores (16 observations per location). Observed unsafe food safety handling practices of consumers included manipulating produce, putting produce back on the shelf, and tasting produce, in addition to poor personal hygiene practices. Produce scales were unclean in a majority of observations. Results from this study revealed that some consumers at Rhode Island grocery stores engage in unsafe food safety practices when shopping for produce. Education at the point of purchase about best practices of handling produce is needed in order to decrease cross-contamination and exposure of other consumers to contamination. [ABSTRACT FROM AUTHOR]

Breast tumors in pregnancy are often times diagnosed at advanced stages secondary to difficulty distinguishing between pathologic from normal physiologic changes. Often benign, phyllodes tumors are rare fibroepithelial stromal tumors of the breast, most commonly diagnosed in the 4th and 5th decades of life. However, these tumors may be characterized by malignancy with metastases in 10% of cases. In this paper, we report a novel case of a young woman presenting at 8 weeks gestation with a large borderline phyllodes tumor. An exceedingly rare condition, with only nine previously reported cases, phyllodes tumors in pregnancy frequently display more aggressive characteristics with larger median tumor size, more malignant potential, and more rapid growth rate. Here, we describe our experience safely and effectively treating this rare condition in a young gravid women with mastectomy and immediate breast reconstruction in the second trimester. [ABSTRACT FROM AUTHOR]

A needs assessment survey was designed and administered to measure knowledge of and attitudes toward food safety impacts of nonthermal processing technologies of shellfish and produce industry personnel and extension educators. An online survey was sent via e-mail notification with the survey link through professional listserves. The survey evaluated background information, knowledge, attitude, and training needs. A variety of response formats was used. Knowledge/attitude responses were analyzed using descriptive statistics, 1-way ANOVA and t-tests using SPSS software and reported at P < 0.05. Industry ( N = 106) and educator ( N = 52) respondents had below the proficient knowledge score (80%), 50% and 67%, respectively. Question reliability was >0.9. There were no differences in attitudes and knowledge between the 2 industry groups. The total attitude score, based on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree), of the produce and shellfish industry and educator respondents toward nonthermal processing technologies was 3.6 ± 0.4, 3.4 ± 0.5, and 3.6 ± 0.4, respectively. Respondent's slightly indifferent attitude may reflect low knowledge regarding the impact of nonthermal processing technologies on food safety and quality. Both groups indicated a desire for information and/or training. For both industry and educators, common preferred formats for outreach resources were printed materials, Internet/web-based materials, and PowerPoint. Educators identified barriers as equipment cost, lack of information, and lack of product validation. While the majority of the respondents were aware of nonthermal processing, they were not knowledgeable, indicating a need for education and outreach in nonthermal processing methods to both shellfish/produce industry and food safety educators. [ABSTRACT FROM AUTHOR]

Food safety education for children is important for developing a good foundation for food safety knowledge and behaviors. The overall goal of the Food Safety and School Garden Program (FSSGP) was to develop a curriculum that integrated food safety principles into school garden-related activities for elementary school students. Specific objectives of this study were to assess knowledge and evaluate the FSSGP through student activity ratings and student-to-parent/guardian interaction. The two-lesson intervention consisted of a didactic component and interactive activities for four major aspects of food safety principles: bacteria and washing hands, produce, and containers. Students' (n = 194) knowledge, in grades 1-5, was evaluated by use of a 10-question pre- and post-test. Number of correct responses increased from 5.6 ± 1.8 to 8.1 ± 1.9 (P < .001). Knowledge increased within each grade (P < .001) and category (P < .05). Additionally, the majority of students rated all activities as satisfactory or better. Finally, over 80% of students indicated they would tell their parents/guardians about what they learned, and the majority of parents/guardians responding to a follow-up questionnaire indicated that their child had communicated with them about FSSGP topics. This study supports the importance of early education on proper food safety principles in school gardens for elementary school students. [ABSTRACT FROM AUTHOR]

Calciphylaxis, or calcific uremic arteriolopathy, is a rare but particularly morbid condition involving systemic medial calcification of arterioles causing ischemia and subsequent tissue necrosis. Although most commonly occurring over the abdomen and proximal extremities, calciphylaxis can present on nearly any skin surface with a tendency toward areas of increased adiposity. We report a case of a 53-year-old female with end-stage renal disease who presented with bilateral palpable breast masses and overlying skin changes. Diagnostic mammography and percutaneous biopsy of the lesion facilitated the diagnosis of calciphylaxis and she was treated with medical therapy, local wound care, and eventual tissue extirpation. Due to the morbidity attributed to calciphylaxis and associated wound complications, surgical extirpation is at times unavoidable. Once malignancy has been excluded, we recommend nonoperative management with prompt referral to Nephrology for medical optimization, reserving surgical debridement for nonhealing wounds and superinfection. [ABSTRACT FROM AUTHOR]

Many children undergoing surgery develop anxiety, which can lead to negative health outcomes. Music therapy has the potential to help reduce pediatric preoperative anxiety, yet there has been limited research in this area. A retrospective review was conducted of a pilot music therapy program in an ambulatory surgery center. Active, developmentally appropriate music therapy interventions were used to help reduce preoperative anxiety in 103 pediatric patients between ages 2 and 9. Data indicated a trend for improvement in patient affect and emotional expression, both of which are indicators of anxiety reduction. Parents reported that their children’s levels of distress/anxiety were better when receiving music therapy treatment than in previous medical experiences. Parents additionally reported that music therapy benefited both them and their child, and that music therapy improved their perception of the facility. Results suggest that preoperative music therapy can help reduce anxiety in children and their parents. [ABSTRACT FROM AUTHOR]

Controversy remains whether the leukocyte genomic response to trauma or sepsis is dependent upon the initiating stimulus. Previous work illustrated poor correlations between historical models of murine trauma and sepsis (i.e., trauma-hemorrhage and lipopolysaccharide injection, respectively). The aim of this study is to examine the early genomic response in improved murine models of sepsis [cecal ligation and puncture (CLP)] and trauma [polytrauma (PT)] with and without pneumonia (PT+Pp). Groups of naïve, CLP, PT, and PT+Pp mice were killed at 2 h, 1 or 3 days. Total leukocytes were isolated for genome-wide expression analysis, and genes that were found to differ from control (false discovery rate adjusted P < 0.001) were assessed for fold-change differences. Spearman correlations were also performed. For all time points combined (CLP, PT, PT+Pp), there were 10,426 total genes that were found to significantly differ from naïve controls. At 2 h, the transcriptomic changes between CLP and PT showed a positive correlation (rs) of 0.446 (P < 0.0001) but were less positive thereafter. Correlations were significantly improved when we limited the analysis to common genes whose expression differed by a 1.5 fold-change. Both pathway and upstream analyses revealed the activation of genes known to be associated with pathogen-associated and damage-associated molecular pattern signaling, and early activation patterns of expression were very similar between polytrauma and sepsis at the earliest time points. This study demonstrates that the early leukocyte genomic response to sepsis and trauma are very similar in mice. [ABSTRACT FROM AUTHOR]

The number of foodborne illness outbreaks increased in the United States from 2001 to 2010, and 17% of them were associated with produce. Higher risk, whole produce sold at farmers' markets presents unique challenges to food safety practices in regard to temperature controls, potable water, and exposure to contaminants. The purpose of this study was to use direct observations to identify unsafe food handling practices among vendors selling higher risk produce at Rhode Island farmers' markets. This study used, as a tool for data acquisition, a Smartphone application developed to allow concealed direct observations of actual vendors' practices at farmers' markets. Observations were made at fourteen (7 state and 7 private) farmers' markets to collect data on food handling practices of 26 vendors selling higher-risk produce. The mean observation time per vendor was 18.3 ± 5.8 minutes. Vendors' unsafe food handling practices included eating, talking on the phone and touching money, and then touching produce. Use of a Smartphone application was an effective data collection tool in assisting the observer in the recording of farmers' market vendor practices, without being detected. The results of this study will be used as guidance for education programs targeting farmers' market managers and vendors that promote best practices in regard to whole produce. [ABSTRACT FROM AUTHOR]

Food safety practices of food handlers often are observed for research purposes. However, if these observations are not concealed, they can result in unintended behavioral changes, commonly referred to as the Hawthorne effect (HE). Direct concealed observations (DCOs) have been used to minimize the HE during observational data collection in various settings. However, some limitations to data collection can include the need to memorize observations or take notes out of sight of those being observed. We describe a newly developed smartphone and tablet application for use as a data collection tool for DCOs. To further evaluate the use of smartphones as inconspicuous data collection tools, a short survey was developed and disseminated to assess public perceptions of smartphone use in a retail setting. Participants were shown images of individuals using either a smartphone or a clipboard in a retail environment and asked to provide open-ended responses. Ninety-five percent (95%) of participant (n = 85) responses indicated that images of clipboard use in a retail setting suggested evaluative activities (e.g., research, inspection), whereas none of the participants indicated that images of smartphone use in the same environment suggested evaluative activities. These results demonstrate that use of a smartphone for data collection in a retail setting may not be perceived as an evaluative activity, and that its application during DCOs could minimize the HE. This research may be of interest to researchers, regulatory personnel, and food industry professionals who are seeking ways to evaluate the food safety behaviors of food handlers. [ABSTRACT FROM AUTHOR]

Over one million newborns die annually from sepsis with the highest mortality in premature and low-birthweight infants. The inflammasome plays a central role in the regulation of innate immunity and inflammation, and is presumed to be involved in protective immunity, in large part through the caspase-1-dependent activation of interleukin-1 β (IL-1 β) and IL-18. Studies in endotoxic shock, however, suggest that endogenous caspase-1 activity and the inflammasome contribute to mortality primarily by promoting excessive systemic inflammatory responses. We examined whether caspase-1 and the inflammasome also regulate neonatal inflammation, host protective immunity and myelopoiesis during polymicrobial sepsis. Neonatal (5-7 days) C57BL/6 and caspase-1/11−/− mice underwent a low-lethality caecal slurry model of intra-abdominal sepsis (LD25-45). Ablation of caspase-1/11, but not apoptosis-associated speck-like protein containing a CARD domain or nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), improved neonatal survival following septic challenge compared with wild-type mice ( P < 0·001), with decreased concentrations of inflammatory cytokines in the serum and peritoneum. Surprisingly, caspase-1/11−/− neonates also exhibited increased bone marrow and splenic haematopoietic stem cell expansion ( P < 0·001), and increased concentrations of granulocyte and macrophage colony-stimulating factors in the peritoneum ( P < 0·001) after sepsis. Ablation of caspase-1/11 signalling was also associated with increased recruitment of peritoneal macrophages and neutrophils ( P < 0·001), increased phagocytosis by neutrophils ( P = 0·003), and decreased bacterial colonization ( P = 0·02) in the peritoneum. These findings suggest that endogenous caspase-1/11 activity, independent of the NLRP3 inflammasome, not only promotes the magnitude of the inflammatory response, but also suppresses protective immunity in the neonate, so contributing to innate immune dysfunction and poor survival in neonatal sepsis. [ABSTRACT FROM AUTHOR]

The article presents a speech by Lori F. Damrosch, the President of the American Society of International Law, delivered at the International Law Weekend (ILW) conference at the Fordham University School of Law in New York City in 2014. It informs that the speech was based on the theme "Democratization of Foreign Policy And International Law 1914-2011" focusing on topics including democratization, self-determination, and international law.

Neonates have increased susceptibility to infection, which leads to increased mortality. Whether or not this as a result of implicit deficits in neonatal innate immune function or recapitulation of innate immune effector cell populations following infection is unknown. Here, we examine the process of emergency myelopoiesis whereby the host repopulates peripheral myeloid cells lost following the initial infectious insult. As early inflammatory responses are often dependent upon NF-κB and type I IFN signaling, we also examined whether the absence of MyD88, TRIF or MyD88 and TRIF signaling altered the myelopoietic response in neonates to polymicrobial sepsis. Following neonatal polymicrobial septic challenge, hematopoietic stem cell (HSC) expansion in bone marrow and the spleen were both attenuated and delayed in neonates compared with adults. Similar reductions in other precursors were observed in neonates. Similar to adult studies, the expansion of progenitor stem cell populations was also seen in the absence of MyD88 and/or TRIF signaling. Overall, neonates have impaired emergency myelopoiesis in response to sepsis compared with young adults. Despite reports that this expansion may be related to TLR signaling, our data suggest that other factors may be important, as TRIF–/– and MyD88–/– neonatal HSCs are still able to expand in response to polymicrobial neonatal sepsis. [ABSTRACT FROM PUBLISHER]

Background: Blood product transfusions are associated with increased morbidity and mortality. The purpose of this study was to determine if implementation of a restrictive protocol for packed red blood cell (PRBC) and fresh frozen plasma (FFP) transfusion safely reduces blood product utilization and costs in a surgical intensive care unit (SICU). Study Design: We performed a retrospective, historical control analysis comparing before (PRE) and after (POST) implementation of a restrictive PRBC/FFP transfusion protocol for SICU patients. Univariate analysis was utilized to compare patient demographics and blood product transfusion totals between the PRE and POST cohorts. Multivariate logistic regression models were developed to determine if implementation of the restrictive transfusion protocol is an independent predictor of adverse outcomes after controlling for age, illness severity, and total blood products received. Results: 829 total patients were included in the analysis (PRE, n=372; POST, n=457). Despite higher mean age (56 vs. 52 years, p=0.01) and APACHE II scores (12.5 vs. 11.2, p=0.006), mean units transfused per patient were lower for both packed red blood cells (0.7 vs. 1.2, p=0.03) and fresh frozen plasma (0.3 vs. 1.2, p=0.007) in the POST compared to the PRE cohort, respectively. There was no difference in inpatient mortality between the PRE and POST cohorts (7.5% vs. 9.2%, p=0.39). There was a decreased risk of urinary tract infections (OR 0.47, 95%CI 0.28-0.80) in the POST cohort after controlling for age, illness severity and amount of blood products transfused. Conclusions: Implementation of a restrictive transfusion protocol can effectively reduce blood product utilization in critically ill surgical patients with no increase in morbidity or mortality. [ABSTRACT FROM AUTHOR]

Background: Individuals undergoing medical procedures frequently experience pain and anxiety. Music-based interventions have the potential to help alleviate these symptoms. Objective: This review investigated the effects of music-based interventions (music therapy and music medicine) on pain and anxiety in children and adults undergoing medical procedures. Methods: This systematic review examined randomized controlled trial music intervention studies to manage patient-reported pain and/or anxiety during medical procedures. All studies were published in English and peer-reviewed journals. Quality and risk of bias were assessed using criteria from the Checklist to Evaluate a Report of a Nonpharmacological Trial (CLEAR-NPT). Results: Fifty studies met inclusion criteria, the majority of which (84%) had a high risk of bias. It was not possible to perform a meta-analysis because studies varied greatly in terms of medical procedure and intervention type. Results varied across studies, with approximately half (48%) indicating less anxiety for music intervention participants; fewer studies (36%) reported less pain for music intervention participants. Conclusions: There is a need to clearly define and differentiate between music therapy and music medicine interventions in procedural support research. Further research is necessary to determine which patients would benefit most from music interventions during medical procedures, and which interventions are most beneficial. To improve research quality and reduce risk of bias, when designing studies investigators need to carefully consider factors related to design, including randomization, treatment allocation concealment, blinding outcome assessors, and intention-to-treat analysis. In addition, more detailed intervention reporting is needed when publishing results. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effects of behavioral contracting on preservice elementary teachers' performance achievement on the soprano recorder. Participants were elementary and special education majors (N = 60) enrolled in an undergraduate elementary music methods course. The study used a withdrawal design (ABA) composed of 2-week baseline-contract-baseline phases. Participants performed an assigned excerpt on the soprano recorder at the conclusion of each phase, and the tempo and number of errors performed were scored as data points for each participant. Results showed that participants performed with significantly higher tempos and significantly fewer errors during the contracting phase. Following the contracting phase, participants' performed tempo continued to increase even in the absence of the behavioral contract. These results are consistent with previous research suggesting that behavioral contracting does have a positive impact on students' performance skills. [ABSTRACT FROM AUTHOR]

There is no clinically available cancer immunotherapy that exploits Langerhans cells (LCs), the epidermal precursors of dendritic cells (DCs) that are the natural agent of antigen delivery. We developed a DNA formulation with a polymer and obtained synthetic 'pathogen-like' nanoparticles that preferentially targeted LCs in epidermal cultures. These nanoparticles applied topically under a patch-elicited robust immune responses in human subjects. To demonstrate the mechanism of action of this novel vaccination strategy in live animals, we assembled a high-resolution two-photon laser scanning-microscope. Nanoparticles applied on the native skin poorly penetrated and poorly induced LC motility. The combination of nanoparticle administration and skin treatment was essential both for efficient loading the vaccine into the epidermis and for potent activation of the LCs to migrate into the lymph nodes. LCs in the epidermis picked up nanoparticles and accumulated them in the nuclear region demonstrating an effective nuclear DNA delivery in vivo. Tissue distribution studies revealed that the majority of the DNA was targeted to the lymph nodes. Preclinical toxicity of the LC-targeting DNA vaccine was limited to mild and transient local erythema caused by the skin treatment. This novel, clinically proven LC-targeting DNA vaccine platform technology broadens the options on DC-targeting vaccines to generate therapeutic immunity against cancer. [ABSTRACT FROM AUTHOR]

Introduction: Animal models for the study of sepsis are being increasingly scrutinized, despite their essential role for early translational research. In particular, recent studies have suggested that at the level of the leukocyte transcriptome, murine models of burns, trauma and endotoxemia markedly differ from their human equivalents, and are only weakly similar amongst themselves. We compared the plasma cytokine and leukocyte transcriptome responses between two different low-lethality murine models of polymicrobial intra-abdominal sepsis. Methods: Six to ten week male C57BL/6j mice underwent either the ‘gold standard’ cecal ligation and puncture (CLP) model of intra-abdominal sepsis or administration of a cecal slurry (CS), where cecal contents are injected intraperitoneally. Surviving mice were euthanized at two hours, one or three days after sepsis. Results: The murine leukocyte transcriptomic response to the CLP and CS models of sepsis was surprisingly dissimilar at two hours, one, and three days after sepsis. The Pearson correlation coefficient for the maximum change in expression for the entire leukocyte transcriptome that changed significantly over time (n = 19,071) was R = 0.54 (R2 = 0.297). The CS model resulted in greater magnitude of early inflammatory gene expression changes in response to sepsis with associated increased production of inflammatory chemokines and cytokines. Two hours after sepsis, CLP had more significant expression of genes associated with IL-10 signaling pathways, whereas CS had greater expression of genes related to CD28, apoptosis, IL-1 and T-cell receptor signaling. By three days, the changes in gene expression in both sepsis models were returning to baseline in surviving animals. Conclusion: These analyses reveal that the murine blood leukocyte response to sepsis is highly dependent on which model of intra-abdominal sepsis is employed, despite their similar lethality. It may be difficult to extrapolate findings from one murine model to another, let alone to human sepsis. [ABSTRACT FROM AUTHOR]

Context Many medical students consume alcohol in excess, which can compromise their professionalism and increase their risk of future alcohol dependency. Just one study in Japan has examined the social influences of alcohol consumption among medical students. Eighty-six per cent ( n = 821) of their respondents reported experiencing some form of alcohol-related harassment since the beginning of medical school. No similar research has been conducted in the UK. Methods A cross-sectional online questionnaire of medical students at three British medical schools. In total, 216 students answered questions regarding their experiences of alcohol-related provocation (as targets and instigators), the rate of occurrence of events and their distress following acts of provocation. An open-ended question enabled respondents to report personal experiences of alcohol-related provocation. Results Seventy-five per cent ( n = 162) of respondents reported experiencing alcohol-related provocation during the past year, with 49.1% ( n = 106) reporting instigating acts of provocation. The most prevalent experience (both for targets and instigators) was coercion to drink an entire alcoholic beverage at once as part of a game. Most acts of alcohol-related provocation generated little or no distress. Males were significantly more likely to experience some events than females. Thirty-two personal narratives of alcohol-related provocation were reported (only three reported resisting provocation). Thematic analysis identified three themes with differing power relations: ongoing 'peer-peer provocation' as a commonplace social activity, hierarchical 'peer provocation' at initiation ceremonies and 'team-mate provocation' at sports socials as bonding exercises. The tone of the narratives depended on the context in which the events described occurred. Conclusions Alcohol-related provocation occurs among some UK medical students and may present professionalism issues to medical students. Medical schools may wish to integrate more teaching regarding behaviour around alcohol into their curricula by addressing students' explicit and implicit attitudes towards alcohol consumption. [ABSTRACT FROM AUTHOR]

As a quickly growing trend among job seekers, video résumés represent an area where practice has outpaced research. This study investigated whether the theory of planned behavior (TpB) can be used to understand future job seekers ( n = 154) video résumé submission intentions and behaviors. Results supported the TpB model. Attitudes, subjective norms, and perceived behavioral control predicted intentions, which in turn predicted video résumé creation behaviors. Compared with perceived behavioral control, attitudes and subjective norms were more important predictors. As one of the first empirical studies on video résumés, this research breaks important new ground. It also extends what is known about the TpB because it is the first study to use a relative importance analysis to statistically compare the influence of the theory's antecedent constructs. [ABSTRACT FROM AUTHOR]