Psychosocial singing interventions for the mental health and well-being of family carers of patients with cancer:Results from a longitudinal controlled study

OBJECTIVE: The mental health challenges facing people who care for somebody with cancer are well documented. While many support interventions focus on provision of information or cognitive behavioural therapy, the literature suggests that psychosocial interventions could also be of value, especially given the low social support frequently reported by carers. Singing is a psychosocial activity shown to improve social support, increase positive emotions, and reduce fatigue and stress. This study explored whether weekly group singing can reduce anxiety, depression and well-being in cancer carers over a 6-month period. DESIGN: A multisite non-randomised longitudinal controlled study. SETTING: The Royal Marsden National Health Service Trust in Greater London. PARTICIPANTS: 62 adults who currently care for a spouse, relative or close friend with cancer who had not recently started any psychological therapy or medication. INTERVENTIONS: On enrolment, participants selected to join a weekly community choir for 12 weeks (n=33) or continue with life as usual (n=29). OUTCOME MEASURES: The primary outcome was mental health using the Hospital Anxiety and Depression Scale. The secondary outcome was well-being using the Warwick Edinburgh Mental Wellbeing Scale. Using linear mixed effects models, we compared the change in mental health and well-being over time between the two groups while adjusting for confounding variables including demographics, health-related variables, musical engagement and length of time caring. RESULTS: Participants in the choir group showed a significantly greater decrease in anxiety over time than participants in the control group (B=-0.94, SE=0.38, p=0.013) and a significantly greater increase in well-being (B=1.25, SE=0.49, p=0.011). No changes were found for depression. Sub-group analyses showed carers with anxiety or below-average well-being were most likely to benefit. CONCLUSIONS: This study builds on previous research showing the mental health benefits of singing for people with cancer by showing that weekly singing can also support anxiety and well-being in cancer carers

Group singing in bereavement:Effects on mental health, self-efficacy, self-esteem and well-being

OBJECTIVES: Bereavement is associated with negative affective, cognitive, behavioural and physiological responses. However, factors, such as coping, self-efficacy and self-esteem, can buffer negative effects of grief, and can be increased through mutual support interventions, such as shared leisure activities. This study used a non-randomised controlled design to explore the effects of group choir singing on mental health among people who have been bereaved due to cancer. METHODS: A total of 58 adults bereaved in the last 5 years who had not started psychological therapy in the last 12 weeks or medication for anxiety or depression in the last month were recruited and elected to join a choir (n=29) or participate in the non-intervention control group (n=29). Joining a choir involved engaging in 90 min weekly singing and social sessions for 12 weeks with a post-intervention assessment at week 24. We used linear mixed effects models adjusted for demographics, health-related variables, musical engagement and time since bereavement to model changes over time between the two groups in symptoms of anxiety, depression, well-being, self-efficacy and self-esteem. RESULTS: Participants who sang in a choir had more stable symptoms of depression and levels of well-being, as well as gradual improvements in their sense of self-efficacy and self-esteem over the 24 weeks. In contrast, those in the control group showed gradual increases in depressive symptoms, reductions in levels of well-being and self-esteem and no improvement in their self-efficacy. These results were independent of all covariates. CONCLUSIONS: Weekly group singing could be a promising mutual support intervention for people experiencing grief. TRIAL REGISTRATION NUMBER: NCT02756780

The Library Ireland Week (LIW) job swop initiative Experiences from Maynooth University Library

Each year, as part of Library Ireland Week (LIW), Irish libraries are encouraged to engage in job swops. This initiative, championed by the Library Association of Ireland (LAI) (https://libraryassociation.ie/) is straightforward, with individual libraries organising swops and absorbing any costs involved. This article describes the experiences of six library assistants from Maynooth University (MU) (https://www.maynoothuniversity.ie/library) Ireland, who participated in job swop

A multicriteria decision analysis comparing pharmacotherapy for chronic neuropathic pain, including cannabinoids and cannabis-based medical products

Background: Pharmacological management of chronic neuropathic pain (CNP) still represents a major clinical challenge. Collective harnessing of both the scientific evidence base and clinical experience (of clinicians and patients) can play a key role in informing treatment pathways and contribute to the debate on specific treatments (e.g., cannabinoids). A group of expert clinicians (pain specialists and psychiatrists), scientists, and patient representatives convened to assess the relative benefit–safety balance of 12 pharmacological treatments, including orally administered cannabinoids/cannabis-based medicinal products, for the treatment of CNP in adults. Methods: A decision conference provided the process of creating a multicriteria decision analysis (MCDA) model, in which the group collectively scored the drugs on 17 effect criteria relevant to benefits and safety and then weighted the criteria for their clinical relevance. Findings: Cannabis-based medicinal products consisting of tetrahydrocannabinol/cannabidiol (THC/CBD), in a 1:1 ratio, achieved the highest overall score, 79 (out of 100), followed by CBD dominant at 75, then THC dominant at 72. Duloxetine and the gabapentinoids scored in the 60s, amitriptyline, tramadol, and ibuprofen in the 50s, methadone and oxycodone in the 40s, and morphine and fentanyl in the 30s. Sensitivity analyses showed that even if the pain reduction and quality-of-life scores for THC/CBD and THC are halved, their benefit–safety balances remain better than those of the noncannabinoid drugs. Interpretation: The benefit–safety profiles for cannabinoids were higher than for other commonly used medications for CNP largely because they contribute more to quality of life and have a more favorable side effect profile. The results also reflect the shortcomings of alternative pharmacological treatments with respect to safety and mitigation of neuropathic pain symptoms. Further high-quality clinical trials and systematic comprehensive capture of clinical experience with cannabinoids is warranted. These results demonstrate once again the complexity and multimodal mechanisms underlying the clinical experience and impact of chronic pain

The Library Ireland Week (LIW) job swop initiative Experiences from Maynooth University Library

Each year, as part of Library Ireland Week (LIW), Irish libraries are encouraged to engage in job swops. This initiative, championed by the Library Association of Ireland (LAI) (https://libraryassociation.ie/) is straightforward, with individual libraries organising swops and absorbing any costs involved. This article describes the experiences of six library assistants from Maynooth University (MU) (https://www.maynoothuniversity.ie/library) Ireland, who participated in job swop

The Library Ireland Week (LIW) job swop initiative Experiences from Maynooth University Library

Each year, as part of Library Ireland Week (LIW), Irish libraries are encouraged to engage in job swops. This initiative, championed by the Library Association of Ireland (LAI) (https://libraryassociation.ie/) is straightforward, with individual libraries organising swops and absorbing any costs involved. This article describes the experiences of six library assistants from Maynooth University (MU) (https://www.maynoothuniversity.ie/library) Ireland, who participated in job swop

Cannabinoids and the endocannabinoid system in fibromyalgia: A review of preclinical and clinical research.

Characterised by chronic widespread musculoskeletal pain, generalised hyperalgesia, and psychological distress, fibromyalgia (FM) is a significant unmet clinical need. The endogenous cannabinoid system plays an important role in modulating both pain and the stress response. Here, we appraise the evidence, from preclinical and clinical studies, for a role of the endocannabinoid system in FM and the therapeutic potential of targeting the endocannabinoid system. While many animal models have been used to study FM, the reserpine-induced myalgia model has emerged as the most translatable to the clinical phenotype. Inhibition of fatty acid amide hydrolase (FAAH) has shown promise in preclinical studies, ameliorating pain- and anxiety-related behaviour, and not associated with the development of tolerance. Clinically, there is evidence for alterations in the endocannabinoid system in patients with FM, including single nucleotide polymorphisms and increased levels of circulating endocannabinoids and related N-acylethanolamines. Single entity cannabinoids, cannabis, and cannabis-based medicines in patients with FM show promise therapeutically but limitations in methodology and lack of longitudinal studies to assess efficacy and tolerability preclude the current recommendation for their use in patients with FM. Gaps in the literature that warrant further investigation are discussed, particularly the need for further development of animal models with high validity for the multifaceted nature of FM, balanced studies to eliminate sex-bias in preclinical research, and ultimately, better translation between preclinical and clinical research