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Objective: This study investigated patient outcomes of care before and after transitioning to a surgical intensivist-led trauma-intensive care unit (ICU) team. The intensivist team provided daily multidisciplinary rounds and continuity of care. Prior to an intensivist model, general surgeons cared for trauma patients admitted to the unit. Methods: Outcomes of 1,078 trauma patients, admitted to the ICU at a Level II trauma center, under care of general surgeons (1/2011-8/2012, n = 449) were retrospectively compared with care managed by a surgical intensivist team (1/2013-5/2015, n = 629) by Pearson Chi-squared and Wilcoxon tests. A multivariable logistic regression technique was used to control for covariates. Demographics and injury severity were analyzed. The primary outcome was ICU mortality. The secondary outcomes were length of stay (LOS), ventilator-free and ICU-free days, and ICU readmission rate. Other data collected included palliative care consultation. Results: There were no statistically significant differences in ICU mortality (P = 0.055), hospital LOS (P = 0.481), ventilator-free days (P = 0.174), or ICU readmission rate (P = 0.587). The surgical intensivist team consulted palliative care more frequently (4.0% vs 13.5%, P < 0.001), while managing more trauma patients who were older than 65 years (P < 0.001) with lower Glasgow Coma Scale (P = 0.048) and higher injury severity (P = 0.025) and abbreviated injury scale (P < 0.001) scores. Discussion: There were no differences in outcomes. However, incorporating palliative care consultation in the ICU is essential in the support of critically ill patients and their families. These data demonstrate that a surgical intensivist team utilized palliative care more often in the management of trauma patients admitted to the ICU. [ABSTRACT FROM AUTHOR]

The combination of music therapy and spiritual care for persons with dementia is largely unstudied. The primary purpose of this study was to analyze the outcomes of a co-led combined spiritual care and music therapy (SCMT) group offered to persons with moderate to advanced dementia living in an extended care setting. A secondary purpose was to identify useful intervention strategies used in music therapy and spiritual care collaboration as informed by Kitwood's (1997a, 1997b) concept of personhood. The researchers were interested in the meaning and significance of the group for participants, especially in terms of self-expression and well-being as well as the associated skills and practices that facilitated positive outcomes. A mixed-methods approach of phenomenological methods and dementia care mapping (Kitwood & Bredin, 1992) was used. Study areas included determining what measurable outcomes were indicators of responsiveness to the interventions; what participation in the group meant for the participants; and what skills and practices demonstrated by the leaders facilitated positive outcomes. Key findings from both quantitative and qualitative measures indicated multiple positive outcomes including social involvement and cohesion, inclusion, identity, attachment and belonging, occupation, interaction, expression, positive moods, and comfort. Participants indicated that the spiritual content of the group and the experience of feeling spiritually connected with others were particularly important. The implications for continued research and further development of this form of combined music therapy and spiritual care practice are noted. [ABSTRACT FROM AUTHOR]

An interview with music therapist Denise Grocke in Australia is presented. She describes the role to be played by music therapy in mental health settings in Australia 40 years later. Grocke discusses the Registration process work in the country. She also gives a sampling of the dissertation topics she is now supervising in music therapy.

The article discusses various reports published within the issue, including one by Andrée Leesard and Julie Myre-Bisaillon on the representational systems in young learners, another by Laurel Young on community music for cancer patients, and another one by David Akombo on ethnomusic therapy.

This case study presents a brief eight-session series using the Bonny Method of Guided of Imagery and Music (a music-centered depth method in therapeutic work) with a client suffering with the grief process after her daughter's sudden death. Core content is highlighted through a retrospective lens that offers further analysis and insight into the metaphors that emerged. Bonde's concept of GIM as a metaphor-based therapy is explicated and applied to the case content, examining 3 levels of metaphoric expression redefined here as metaphor, mastery, and mythopoesis. This single subject case study demonstrates that Guided Imagery and Music can be an effective avenue for the expression and resolution of significantly painful material that is often unspeakable in day-to-day contexts. [ABSTRACT FROM AUTHOR]