The Use of Singing and Playing Wind Instruments to Enhance Pulmonary Function and Quality of Life in Children and Adolescents with Cystic Fibrosis

Although Cystic Fibrosis (CF) is one of the most fatal and devastating lung diseases in the world, treatments to enhance lung capacity and Quality of Life (QOL) are still in their infancy. The purpose of this study was to investigate the effects of music therapy, specifically singing or playing a wind instrument, on pulmonary function and QOL in children and adolescents with CF. Three participants with CF participated in this two week study, which consisted of two, thirty minute sessions a day, for a total of twenty sessions. The sessions for one week of the study included singing, playing the recorder, or playing the kazoo, and the other week included talking, playing board games or playing video games. The Pulmonary Function Test (PFT) results and the Cystic Fibrosis Questionnaire (CFQ) results were used in this descriptive study as outcome variables. These data were collected three times throughout the study: pre-study, mid-study and post-study. For two participants, PFT results showed a higher increase during the music week, than during the non-music week. For the third participant, he did not complete the study, and only participated in the full non-music week and two days of the music week. His PFT results increased more during the non-music week. No significant trends were found when comparing the CFQ results. Suggestions for future research are discussed

Psychosocial Adjustment to Cancer in Younger Adults with Hodgkin Lymphoma or Testicular Cancer: Transitions to Survivorship

Background: Cancer is an unexpected diagnosis in young adulthood, which can disrupt normal developmental milestones. Testicular cancer and Hodgkin lymphoma typically affect young adults, however relatively few studies have explored the psychosocial impact of these cancers. This thesis aimed to explore the process of psychosocial adjustment to these cancers in young adulthood in order to inform intervention development and service provision. Methods: Patients who had completed treatment for testicular cancer or Hodgkin lymphoma were recruited from three hospitals in England through invitation from the clinical team. Qualitative semi-structured interviews were conducted over two time points in the year following treatment completion with 28 participants (18 testicular cancer and 10 Hodgkin lymphoma survivors), aged between 21-44 years old (22 male and 6 female). In total, 48 interviews were conducted. Data were analysed using grounded theory. Findings: Positive psychosocial adjustment involved the overall process of dismantling the current and future threats of cancer, which entailed two transitions of gaining a sense of perspective over the threats of cancer and striving to get on with life and restore normality. The first transition was achieved by the processes of weighing up the significance of cancer, taking an active approach to overcoming the threats and positively reframing the threats of cancer. The second transition was achieved through the processes of accepting and normalising the threats of cancer, re-establishing a sense of security and letting go of fears, and preserving and enhancing a normal self. Negative psychosocial adjustment entailed two transitions; losing a sense of perspective over the threats of cancer (Transition 1) and struggling to achieve a sense of normality after cancer (Transition 2). The first transition included the processes of holding negative illness perceptions, taking a generalised view of cancer and adopting a stoical and silent approach. The second transition included the processes of struggling to accept the threats, losing a sense of security after treatment completion and ruminating on fears. Conclusions: This theory highlights both positive and negative adjustment trajectories in young adult cancer survivors. This has implications for the development of psychosocial interventions aimed at supporting negatively adjusted patients. In particular, health professionals could promote adjustment through addressing negative illness beliefs, preparing patients for the transition to survivorship and facilitating peer support. Young adults exhibited preferences for informal psychosocial support, which has implications for the development of one-to-one peer mentoring interventions, as well as other interventions that may promote self-management

Unconventional Wisdom: Estimating the Economic Impact of the Democratic and Republican National Political Conventions

We use daily hotel occupancy, price, and revenue data to analyze the economic impact of the 2008 and 2012 Democratic and Republican National Conventions. We find that political conventions generate approximately 29,000 room nights of lodging, though this figure is offset by lower hotel occupancy during the week before and, to a lesser extent, after conventions. Conventions increase hotel revenue by approximately $20 million on average, a figure which suggests that host cities’ claims of economic impacts of$150 million or more may be implausible

Evaluation of an occupational therapy led Paediatric Burns Telehealth Review Clinic: exploring the experience of family/carers and clinicians

Introduction: Children with deep-partial or full-thickness burns often require complicated post-surgical care and rehabilitation, including specialist occupational therapy (OT) intervention, to achieve optimal outcomes. Those from rural and remote areas rarely have access to these services and must travel to a tertiary referral hospital to access follow-up, placing them at higher risk of complications and poorer outcomes. The OT-Led Paediatric Burn Telehealth Review (OTPB) Clinic, based at Townsville University Hospital in northern Queensland, Australia, was set up to address this inequity. The aim of this study was to investigate the experience of both family members and clinicians in using the OTPB Clinic. Methods: A qualitative approach, guided by interpretive phenomenology, was used. Eight family members and six clinicians participated in semi-structured interviews conducted by phone or telehealth. Thematic analysis was used to identify key themes. Results: Four major themes were derived through thematic analysis: continuity of care, family-centred care, technology and building of rural capacity. Conclusion: Family and clinicians confirm benefits of a telehealth service for delivering care to rural and remote children after burn injury. The results show this expanded-scope, OT-led telehealth model provides quality patient-centred and expert clinical advice within local communities and builds the skill and capacity of local clinicians. Areas for service enhancement were uncovered. This telehealth model can be translated to other clinical subspecialties across Australia

Development of an occupational therapy-led paediatric burn telehealth review clinic

Context: Burns are a common injury in children. Rural and remote children with burn injuries are disadvantaged if their burns require hospitalisation and specialist rehabilitation. Most specialist burn rehabilitation is provided in regional or metropolitan cities by a multidisciplinary team. Therefore, rural and remote burn patients are required to travel to access these services. This project aimed to develop an Occupational Therapy (OT)-Led Paediatric Burn Telehealth Review Clinic (OTPB Clinic) at Townsville University Hospital (TUH) to provide ongoing rehabilitation to rural and remote children after burn injury closer to home. Issues: Local audits identified inequitable service delivery to children from rural and remote areas after burn injury. A project officer was appointed to develop the OTPB Clinic, including comprehensive guidelines to support sustainability. An expanded scope role was undertaken by the treating OT, and allied health assistants were engaged to promote efficient service delivery. Lessons learned: The OTPB Clinic commenced in 2017 and was evaluated using patient satisfaction surveys and number of clinical encounters pre- and post-implementation. During the implementation period, 28 rural or remote paediatric burn patients were reviewed. Review frequency increased from 20-week to 8-week intervals. Travel time was reduced by approximately 12 hours per appointment. Families identified numerous benefits of the clinic including continuity of care and reduced time away from work. Less than 4% of patients required re-engagement with paediatric surgeons for surgical intervention. The model has the potential to be transferred to other tertiary referral burns services

Is maternal nutrition knowledge more strongly associated with the diets of mothers or their school-aged children?

Objective Maternal nutrition knowledge has frequently been identified as an important target for nutrition promotion interventions. The aim of the present study was to investigate whether maternal nutrition knowledge is more strongly associated with the mother\u27s own diet or that of her child.Design Cross-sectional multivariate linear regression with interactions analyses of survey data.Setting Socio-economically disadvantaged neighbourhoods in Victoria, Australia.Subjects Five hundred and twenty-three mothers and their children who participated in the Resilience for Eating and Physical Activity Despite Inequality (READI) study, a cross-sectional survey study conducted in 2009 among women and their children residing in socio-economically disadvantaged neighbourhoods.Results In adjusted models, for three (vegetable, chocolate/lollies and soft drink consumption) out of the seven dietary outcomes assessed, there was a significant association between maternal nutrition knowledge and maternal diet, whereas for the children\u27s diets none of the seven outcomes were associated with maternal nutrition knowledge. Statistical comparison of regression coefficients showed no difference between the maternal nutrition knowledge–maternal diet association and the maternal nutrition knowledge–child diet association.Conclusions Promoting maternal nutrition knowledge may represent an important avenue for improving diet in mothers from socio-economically disadvantaged neighbourhoods, but more information is needed on how and when this knowledge is translated to benefits for their children\u27s diet

Dismantling the present and future threats of testicular cancer: a grounded theory of positive and negative adjustment trajectories

Testicular cancer commonly affects men in the prime of their lives. While survival rates are excellent, little previous research has examined men’s experiences of adjustment to survivorship. We aimed to explore this issue in younger testicular cancer survivors

A qualitative metasynthesis exploring the impact of prostate cancer and its management on younger, unpartnered and gay men

Prostate cancer (PCa) can negatively impact on men’s sexual, urinary and emotional functioning, affecting quality of life. Most men with PCa are older (>= 65 years), married and heterosexual and little is known about the impact on men who are younger, unpartnered or gay. We aimed to synthesise existing qualitative research on these three groups of men. A systematic metasynthesis was undertaken that included data on the unique impacts of PCa on younger (<65 years) (n=7 papers), unpartnered (n=17 papers), or gay or bisexual men (n=11 papers) using a modified meta-ethnographic approach. The three overarching constructs illustrated the magnified disruption to men’s biographies, that included: marginalisation, isolation and stigma– relating to men’s sense of being ‘out of sync’; the burden of emotional and embodied vulnerabilities and the assault on identity– illustrating the multiple threats to men’s work, sexual and social identities; shifting into different communities of practice– such as the shift from being part of a sexually active community to celibacy. These findings suggest that PCa can have a particular impact on the quality of life of younger, unpartnered, and gay men. This has implications for the provision of tailored support and information to these potentially marginalised groups

Prostate cancer and the impact on couples; a qualitative metasynthesis

Purpose: To review and interpret existing qualitative literature on the experiences of couples affected by prostate cancer (PCa). Methods: A metasynthesis was carried out which included a systematic search of seven databases between 2000 and 2016. A modified version of Noblit and Hare’s meta-ethnographic approach was used to synthesise qualitative study findings and inform overarching interpretations. Results: Thirty-seven studies focusing on the experiences of men with PCa and their partner dyad were included producing seven interconnected constructs. The construct accepting change vs seeking continuity reflects the range of ways individuals within the dyad and couples adjust to the diagnosis. Cultivating connection vs disengaging illustrates how couples seek to manage the impact of PCa and its treatment on their relationship, which may lead to a threatened identity, including sexual insecurities. Shielding me, you and us reflects the ways in which couples strive to protect themselves as individuals and/or each other from the impact of PCa. Being a partner and its challenges highlights the responsibilities partners assume and the impact of their supporting role. Yet, partners sometimes report feeling unsupported and side-lined both by the man they are caring for and by healthcare professionals. Couples often recognise the value of facing PCa together. Conclusions: PCa affects both members of the dyad as individuals, as well as the couple’s relationship. How best to support couples and how to overcome difficulties in expressing their concerns to one another requires further consideration. Healthcare professionals should endeavour to employ a couple-focused approach where appropriate