Exploring the role and impact of group songwriting with multiple stakeholders in recovery-oriented mental health services

Introduction At the heart of successful operational transformation to recovery-oriented mental health services is the establishment of meaningful, respectful and equitable relationships between multiple “stakeholders” including service users, providers and carers. Group songwriting has a possible role to play in fostering such relationships as it offers opportunities to practice core life skills, adopt new roles, and, encourages respect for the perspectives of others. Methods This study explored the potential role and impact of group songwriting in recovery-oriented mental health services. A total of eight service users and one staff member took part in three song-writing focus groups led by a qualified music therapist. Afterwards, semi-structured individual interviews were carried out to explore participants’ personal experiences of focus group participation. Interview transcripts were analysed using Thematic Content Analysis. Results Three original songs were composed in three focus groups. The lyrics reflected themes including (a) mental health service growth, (b) empowerment and freedom during music engagement and (c) empathy for others. Analysis of nine interviews revealed four themes including: “Group songwriting breaks down barriers in ways that help to promote equality,” “Group songwriting offered new perspectives,” “Group songwriting can expose perceived vulnerabilities” and, “Group songwriting may be approached with knowledge of music’s capacity to promote well-being.” Discussion Findings suggest that group songwriting offers stakeholders a meaningful, reciprocal and equitable space that can foster the concept of co-production that is foundational to effective recovery-oriented working in mental health

The book of dissertations by third year students of the School of Architecture, University of Limerick. Two thousand and eleven. The Saul Press

The book of dissertations by third year students of the School of Architecture, University of Limerick. Two thousand and eleven. The Saul Pres

Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest.

BACKGROUND Guidelines recommend normocapnia for adults with coma who are resuscitated after out-of-hospital cardiac arrest. However, mild hypercapnia increases cerebral blood flow and may improve neurologic outcomes. METHODS We randomly assigned adults with coma who had been resuscitated after out-of-hospital cardiac arrest of presumed cardiac or unknown cause and admitted to the intensive care unit (ICU) in a 1:1 ratio to either 24 hours of mild hypercapnia (target partial pressure of arterial carbon dioxide [Paco2], 50 to 55 mm Hg) or normocapnia (target Paco2, 35 to 45 mm Hg). The primary outcome was a favorable neurologic outcome, defined as a score of 5 (indicating lower moderate disability) or higher, as assessed with the use of the Glasgow Outcome Scale-Extended (range, 1 [death] to 8, with higher scores indicating better neurologic outcome) at 6 months. Secondary outcomes included death within 6 months. RESULTS A total of 1700 patients from 63 ICUs in 17 countries were recruited, with 847 patients assigned to targeted mild hypercapnia and 853 to targeted normocapnia. A favorable neurologic outcome at 6 months occurred in 332 of 764 patients (43.5%) in the mild hypercapnia group and in 350 of 784 (44.6%) in the normocapnia group (relative risk, 0.98; 95% confidence interval [CI], 0.87 to 1.11; P = 0.76). Death within 6 months after randomization occurred in 393 of 816 patients (48.2%) in the mild hypercapnia group and in 382 of 832 (45.9%) in the normocapnia group (relative risk, 1.05; 95% CI, 0.94 to 1.16). The incidence of adverse events did not differ significantly between groups. CONCLUSIONS In patients with coma who were resuscitated after out-of-hospital cardiac arrest, targeted mild hypercapnia did not lead to better neurologic outcomes at 6 months than targeted normocapnia. (Funded by the National Health and Medical Research Council of Australia and others; TAME ClinicalTrials.gov number, NCT03114033.)