Hearing Loss

In this article we share our personal stories of the loss of a parent during the COVID-19-pandemic. The crisis demonstrated how the medical-scientific apparatus effectively responded to a global health emergency, but also revealed how end of life processes are professionalized in neoliberal societies, where dying and death are outsourced and sanitized, and grieving is increasingly pathologized. Drawing on our backgrounds in music and music therapy, we trace our own experiences of loss to illustrate aspects of our individual and shared bereavement process as it emerged over a 24-month period. We take an intuitive, arts-based, feminist-philosophical approach, where dying and mourning are understood as personal, social, and political events. The article is structured around the presentation of eight poetic fragments from Hearing Loss (Schmid and Halstead, 2023) a co-created digital exhibition on the theme of mourning which includes soundworks, images, narratives, short films, and poems. Through these intimate multi-modal pieces, we reflect how we do loss, and how we might speak about, and listen to, the existential, relational, and transitional experience of losing a loved one in midlife. Our work argues that practices of grieving should be encouraged, shared, and valued to ensure the mournability of every life

Bone marrow lesions and magnetic resonanceImaging–detected structural abnormalities in patients with midfoot pain and osteoarthritis: A cross-sectional study

To compare magnetic resonance imaging (MRI)–detected structural abnormalities in patients withsymptomatic midfoot osteoarthritis (OA), patients with persistent midfoot pain, and asymptomatic controls, and toexplore the association between MRI features, pain, and foot-related disability. One hundred seven adults consisting of 50 patients with symptomatic and radiographically confirmedmidfoot OA, 22 adults with persistent midfoot pain but absence of radiographic OA, and 35 asymptomatic adultsunderwent 3T MRI of the midfoot and clinical assessment. MRIs were read for the presence and severity of abnormal-ities (bone marrow lesions [BMLs], subchondral cysts, osteophytes, joint space narrowing [JSN], effusion-synovitis,tenosynovitis, and enthesopathy) using the Foot Osteoarthritis MRI Score. Pain and foot-related disability wereassessed with the Manchester Foot Pain and Disability Index. The severity sum score of BMLs in the midfoot was greater in patients with midfoot pain and no signs ofOA on radiography compared to controls (P= 0.007), with a pattern of involvement in the cuneiform–metatarsal jointssimilar to that in patients with midfoot OA. In univariable models, BMLs (ρ= 0.307), JSN (ρ= 0.423), and subchondralcysts (ρ= 0.302) were positively associated with pain (P< 0.01). In multivariable models, MRI abnormalities were notassociated with pain and disability when adjusted for covariates. In individuals with persistent midfoot pain but no signs of OA on radiography, MRIfindings suggestedan underrecognized prevalence of OA, particularly in the second and third cuneiform–metatarsal joints, where BMLpatterns were consistent with previously recognized sites of elevated mechanical loading. Joint abnormalities werenot strongly associated with pain or foot-related disability

Comparability of off the shelf foot orthoses in the redistribution of forces in midfoot osteoarthritis patients

Background Midfoot osteoarthritis (OA) is more prevalent and strongly associated with pain than previously thought. Excessive mechanical loading of the midfoot structures may contribute to midfoot OA and studies suggest that functional foot orthoses (FFO) may relieve pain through improving function. This exploratory study aimed to evaluate the mechanical effect of two off-the-shelf FFOs, compared to a sham orthosis in people with midfoot OA. Methods Thirty-three participants with radiographically confirmed symptomatic midfoot OA were randomly assigned to wear either a commercially available FFO or a sham orthosis. After wearing their assigned orthoses for 12 weeks, plantar pressure measurements were obtained under shoe-only and assigned orthoses conditions. Participants assigned to the sham, were additionally tested wearing a second type of FFO at the end of trial. Descriptive mean change (±95% confidence intervals) in plantar pressure for each orthoses condition, versus a shoe only baseline condition are presented. Findings Compared to the shoe only conditions, both FFOs decreased hindfoot and forefoot maximum force and peak pressure, whilst increasing maximum force and contact area under the midfoot. The sham orthosis yielded plantar pressures similar to the shoe-only condition. Interpretation Findings suggest that both types of off-the-shelf FFO may provide mechanical benefit, whilst the sham orthoses produced similar findings to the shoe only condition, indicating appropriate sham properties. This paper provides insight into the mechanisms of action underpinning the use of FFOs and sham orthoses, which can inform future definitive RCTs examining the effect of orthoses on midfoot OA

Foot orthoses in the treatment of symptomatic midfoot osteoarthritis using clinical and biomechanical outcomes: a randomised feasibility study.

Objectives: This randomised feasibility study aimed to examine the clinical and biomechanical effects of functional foot orthoses (FFO) in the treatment of midfoot osteoarthritis (OA) and the feasibility of conducting a full randomised-controlled trial. Methods: Participants with painful, radiographically confirmed midfoot OA were recruited and randomised to receive either FFO or a sham control orthosis. Feasibility measures included recruitment and attrition rates, practicality of blinding and adherence rates. Clinical outcome measures were change from baseline to 12 weeks for severity of pain (numerical rating scale), foot function (Manchester Foot Pain and Disability Index) and patient global impression of change scale. To investigate the biomechanical effect of foot orthoses, in-shoe foot kinematics and plantar pressures were evaluated at 12 weeks. Results: Of the 119 participants screened, 37 were randomised and 33 completed the study (FFO=18, sham=15). Compliance with foot orthoses and blinding of the intervention was achieved in three-quarters of the group. Both groups reported improvements in pain, function and global impression of change; the FFO group reporting greater improvements compared to the sham group. The biomechanical outcomes indicated the FFO group inverted the hindfoot and increased midfoot maximum plantar force compared to the sham group. Conclusions: The present findings suggest FFOs worn over 12 weeks may provide detectable clinical and biomechanical benefits compared to sham orthoses. This feasibility study provides useful clinical, biomechanical and statistical information for the design and implementation of a definitive randomised-controlled trial to evaluate the effectiveness of FFO in treating painful midfoot OA

Diagnosis and management in Rubinstein-Taybi syndrome: first international consensus statement

Rubinstein-Taybi syndrome (RTS) is an archetypical genetic syndrome that is characterised by intellectual disability, well-defined facial features, distal limb anomalies and atypical growth, among numerous other signs and symptoms. It is caused by variants in either of two genes (CREBBP, EP300) which encode for the proteins CBP and p300, which both have a function in transcription regulation and histone acetylation. As a group of international experts and national support groups dedicated to the syndrome, we realised that marked heterogeneity currently exists in clinical and molecular diagnostic approaches and care practices in various parts of the world. Here, we outline a series of recommendations that document the consensus of a group of international experts on clinical diagnostic criteria for types of RTS (RTS1: CREBBP; RTS2: EP300), molecular investigations, long-term management of various particular physical and behavioural issues and care planning. The recommendations as presented here will need to be evaluated for improvements to allow for continued optimisation of diagnostics and care

It just makes you feel really good : a narrative and reflection on the affordances of musical fandom across a life course

The study of how music may be important to health and well-being can be seen as an increasingly broad and interdisciplinary field. As issues of health and well-being are routinely understood within the wider context of life style and cultural engagement, musical experiences far outside the professional practices of music therapy and music medicine are now seen to offer “potent and preventative measures to enhance psychophysiological well-being reaching into almost every aspect of life”. Such shifts grow in part from the integration of more expansive definitions of health that underlay the field. Here health is a concept emphasised variously as a “quality of human interaction and engagement”, or “a quality of human co-existence”, a ‘performance’ of processes by which ‘self’ is realised into the world—mentally, physically and socially; whilst musical experiences have been suggested as an ‘immunogen behavior’, that is a health performing practice. This in turn has widened the scope of music and health studies to include any mode of musical participation that holds the potential to promote well-being. Consequently there is a growing interest in how ‘ordinary’ people in ‘everyday’ settings use music to facilitate health, and how self-made musical experiences are used “to regulate emotional or relational states or to promote well-being”, this “lay-therapeutic musicking in everyday life” being considered an important area alongside more specific professional practices. This paper seeks to contribute to this discourse through an exploration of the experiences of being a music fan, a particular form of musical participation that may hold a variety of implications for an individual’s health, well-being and quality of life