A critical realist evaluation of a music therapy intervention in palliative care

BACKGROUND: Music therapy is increasingly used as an adjunct therapy to support symptom management in palliative care. However, studies to date have paid little attention to the processes that lead to changes in patient outcomes. To fill this gap, we examined the processes and experiences involved in the introduction of music therapy as an adjunct complementary therapy to palliative care in a hospice setting in the United Kingdom (UK). METHODS: Using a realistic evaluation approach, we conducted a qualitative study using a variety of approaches. These consisted of open text answers from patients (n = 16) on how music therapy helped meet their needs within one hospice in Northern Ireland, UK. We also conducted three focus groups with a range of palliative care practitioners (seven physicians, seven nursing staff, two social workers and three allied health professionals) to help understand their perspectives on music therapy's impact on their work setting, and what influences its successful implementation. This was supplemented with an interview with the music therapist delivering the intervention. RESULTS: Music therapy contains multiple mechanisms that can provide physical, psychological, emotional, expressive, existential and social support. There is also evidence that the hospice context, animated by a holistic approach to healthcare, is an important facilitator of the effects of music therapy. Examination of patients' responses helped identify specific benefits for different types of patients. CONCLUSIONS: There is a synergy between the therapeutic aims of music therapy and those of palliative care, which appealed to a significant proportion of participants, who perceived it as effective

A randomised controlled pilot and feasibility study of music therapy for improving the quality of life of hospice inpatients.

BACKGROUND: Evidence about the effectiveness of music therapy for improving the quality of life of palliative care patients is positive but weak in terms of risk of bias. METHODS: This study aimed to determine the feasibility of a randomised controlled trial to evaluate the effectiveness of music therapy for improving the quality of life of hospice inpatients, as measured by the McGill Quality of Life questionnaire. Objectives included recruitment of 52 participants over 12 months and provision of data to support the calculation of the required sample size for a definitive randomised trial, taking into account the retention rates of recruited participants; and evaluation of the viability of the intervention and the acceptability of the assessment tool. The design was a single-centre, researcher-blinded randomised pilot and feasibility study involving two parallel groups. Participants were recruited from one inpatient hospice unit in Northern Ireland. Eligibility criteria were an Eastern Cooperative Oncology Group performance status of two or lower and an Abbreviated Mental Test score of seven or more. Consenting patients were randomly allocated to the intervention or control group using a 1:1 allocation ratio. The intervention group received up to six individual music therapy sessions over 3 weeks in addition to usual care. The control group received usual care only. RESULTS: Fifty one participants were recruited over 12 months. Twenty five were allocated to the intervention group and 26 to the control group. Seventy one percent of participants were lost to follow up by week 3, the proposed primary endpoint. The primary endpoint was moved from week 3, when 71% were lost to follow up to week 1, when 33% were lost. The McGill Quality of Life questionnaire was generally acceptable to participants. In order to detect a small to moderate effect size of 0.3, a fully powered study would require the recruitment of 698 participants. CONCLUSIONS: A Phase III randomised controlled trial to evaluate the effectiveness of music therapy in improving the quality of life of hospice inpatients is feasible. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02791048 . Registered 6 June 2016

Developing an Integrated Ocean Observing System for New Zealand

New Zealand (NZ) is an island nation with stewardship of an ocean twenty times larger than its land area. While the challenges facing NZ’s ocean are similar to other maritime countries, no coherent national plan exists that meets the needs of scientists, stakeholders or kaitiakitanga (guardianship) of NZ’s ocean in a changing climate. The NZ marine science community used the OceanObs’19 white paper to establish a framework and implementation plan for a collaborative NZ ocean observing system (NZ-OOS). Co-production of ocean knowledge with Māori will be embedded in this national strategy for growing a sustainable, blue economy for NZ. The strengths of an observing system for a relatively small nation come from direct connections between the science impetus through to users and stakeholders of an NZ-OOS. The community will leverage off existing ocean observations to optimize effort and resources in a system that has historically made limited investment in ocean observing. The goal of the community paper will be achieved by bringing together oceanographers, data scientists and marine stakeholders to develop an NZ-OOS that provides best knowledge and tools to the sectors of society that use or are influenced by the ocean

Community Involvement to Reduce Insect Threats to Urban Forests

While urban trees increase property values and improve human health, healthy urban trees also reduce potential infestation of nearby native forests. We developed a collaborative program to raise public consciousness of risks to trees from invasive insects before injury has occurred. The Nevada Department of Agriculture entomologist trained Extension Master Gardeners to recognize the threats, signs, and symptoms of alien arthropod species. They then taught classes in venues around the state, bringing awareness of potential problems. By 2013, over 700 professionals and local residents had attended a class, increasing the number of educated and concerned observers around Nevada

Thank You to Our 2022 Peer Reviewers

Plain Language Summary Thank you to the 1528 reviewers who provided 2647 reviews during 2022 to ensure the high quality and integrity of JGR‐Oceans manuscripts. Key Points The editors thank the 2022 peer reviewers New editorial practices reduce pressure on reviewers Co‐reviewer tool allows collaboration with students and postdoc

Thank You to Our 2021 Reviewers

Plain Language Summary Thank you to the 1,371 reviewers who provided 2,661 reviews during 2021 to ensure the same quality and integrity of JGR‐O manuscripts. Key Point The editors thank the 2021 peer reviewer