Promoting Self-Determination In Music Therapy With Individuals With I/DD Who Communicate Extraverbally: Reflections And Implications For Practice

Self-advocacy is important for all individuals with intellectual or developmental disabilities. In order to work on self-advocacy, skills in self-determination must be established first. Self-determination involves decision-making, choice-making, self-awareness, and acting intentionally. Music therapy may be useful in the promotion of these skills, especially when approached from the perspective of social and affirmative models of disability. In this study, the researcher utilized an action research approach as well as a set of therapeutic guidelines in order to explore the relationship between music therapy and self-determination in individuals with intellectual and/or developmental disabilities who communicate extraverbally. Results from this study show the need to address self-determination in music therapy and be reflexive as music therapists on the how power, choices, and engagement shows up in sessions

Cardiovascular risk associated with the use of glitazones, metformin and sufonylureas: meta-analysis of published observational studies

BACKGROUND: The results of observational studies evaluating and comparing the cardiovascular safety of glitazones, metformin and sufonylureas are inconsistent.To conduct and evaluate heterogeneity in a meta-analysis of observational studies on the risk of acute myocardial infarction (AMI) or stroke in patients with type 2 diabetes using non-insulin blood glucose–lowering drugs (NIBGLD). METHODS: We systematically identified and reviewed studies evaluating NIBGLD in patients with type 2 diabetes indexed in Medline, Embase, or the Cochrane Library that met prespecified criteria. The quality of included studies was assessed with the RTI item bank. Results were combined using fixed- and random-effects models, and the Higgins I(2) statistic was used to evaluate heterogeneity. Sensitivity analyses by study quality were conducted. RESULTS: The summary relative risk (sRR) (95 % CI) of AMI for rosiglitazone versus pioglitazone was 1.13 (1.04–1.24) [I(2) = 55 %]. In the sensitivity analysis, heterogeneity was reduced [I(2) = 16 %]. The sRR (95 % CI) of stroke for rosiglitazone versus pioglitazone was 1.18 (1.02–1.36) [I(2) = 42 %]. There was strong evidence of heterogeneity related to study quality in the comparisons of rosiglitazone versus metformin and rosiglitazone versus sulfonylureas (I(2) ≥ 70 %). The sRR (95 % CI) of AMI for sulfonylurea versus metformin was 1.24 (1.14–1.34) [I(2) = 41 %] and for pioglitazone versus metformin was 1.02 (0.75–1.38) [I(2) = 17 %]. Sensitivity analyses decreased heterogeneity in most comparisons. CONCLUSION/INTERPRETATION: Sulfonylureas increased the risk of AMI by 24 % compared with metformin; an imprecise point estimate indicated no difference in risk of AMI when comparing pioglitazone with metformin. The presence of heterogeneity precluded any conclusions on the other comparisons. The quality assessment was valuable in identifying methodological problems in the individual studies and for analysing potential sources of heterogeneity. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12872-016-0187-5) contains supplementary material, which is available to authorized users

ICAR: endoscopic skull‐base surgery

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Influence of Raster Pattern on Residual Stress and Part Distortion in FDM of Semi-Crystalline Polymers: A Simulation Study

In fused deposition modelling (FDM) based on the selected raster pattern, the developed internal thermal residual stresses can vary considerably affecting the mechanical properties and leading to distinct part distortions. This phenomenon is more pronounced in semi-crystalline than amorphous polymers due to crystallisation. Hence, this study focuses on the simulation of the FDM process of a semi-crystalline polymer (polypropylene) with raster patterns such as line (90°/90°), line (0°/90°), zigzag (45°/45°), zigzag (45°/−45°), and concentric from Cura (slicing software). The simulation provides visualisation and prediction of the internally developed thermal residual stresses and resulting warpage with printing time and temperature. The sample with a line (90°/90°) raster pattern is considered as the reference sample in order to compare the relative levels of residual stress and warpage in the other printed/simulated samples. Among the considered raster patterns, the concentric pattern displays the lowest amount of warpage (5.5% decrease) along with a significant drop in residual stress of 21%. While the sample with a zigzag (45°/−45°) pattern showed the highest increase of 37% in warpage along with a decrease of 9.8% in residual stresses. The sample with a zigzag (45°/45°) pattern, exhibited a considerable increase of 16.2% in warpage with a significant increase of 31% in residual stresses. Finally, the sample with a line (0°/90°) raster pattern displayed an increase of 24% increase in warpage with an increase of 6.6% in residual stresses

Collateralized Debt as the Optimal Contract

In a multiple-good risk-sharing environment with ex post private information, conditions are found under which collateralized debt is the optimal contract. The necessary and sufficient condition is that the borrower values the collateral good more highly than does the lender; otherwise the optimal contract does not resemble debt. Limited collateral can give rise to an endogenous borrowing constraint, driving a further wedge between the intertemporal marginal rates of substitution of the borrower and the lender. (Copyright: Elsevier)debt, financial contracts, optimal contracts, collateral, asymmetric information, borrowing constraints