Scaffolding, organisational structure and interpersonal interaction in musical activities with older people

The research reported here focuses on the organizational structure and facilitator strategies observed in musical activities with older people. The observations formed one part of the Music for Life Project, funded by the ESRC New Dynamics of Ageing Programme (http://www.newdynamics.group.shef.ac.uk/), which investigated the social, emotional and cognitive benefits of participation in community music making, amongst older people. Three hundred and ninety eight people aged 50+ were recruited from three case study sites offering diverse musical activities. Observations of 33 groups were analysed. Approximately half of the observed time was spent with participants engaged in practical music-making, supported by facilitators who sang or played along, conducted or accompanied. Facilitators spent a relatively small amount of time providing non-verbal modelling and very little participant discussion or facilitator attributional feedback was observed. The findings suggested that facilitators could develop their practice by a) making more extensive use of non-verbal modelling; b) creating space for open questioning and discussion, where participants are encouraged to contribute to setting goals; c) making more extensive use of attributional feedback that empowers learners to control their own learning; and d) vary the organizational structure and style in order to meet a range of diverse needs within groups of older learners

Widening participation and the role of social motivation in students' transitional experiences in higher education

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‘Lowering the bar’ or widening access? Reflections on key findings from a music literacy project commissioned by the Society for Music Analysis

In 2019 the Society for Music Analysis commissioned a report to find out if stakeholders in music education agreed that knowledge and/or skills in music literacy had declined for those applying to study music at university in England. The ensuing mixed methods study collected data from a range of stakeholders through interviews (N = 33), questionnaires (N = 233), a Music Literacy Study Day and informal observation. The findings showed that many participants thought that music literacy, if defined more narrowly, had declined in recent years. In addition, views on priorities in music education differed considerably, aligning with different forms of social justice. Some participants considered the bar to have been lowered in general music education, leading universities to alter their practices to facilitate access. This article reflects on those findings. The authors conclude that there needs to be careful consideration of curricula to prevent taking knowledge and skills away unnecessarily while ensuring that updated curricula are coherent and relevant to contemporary concerns about music education

The role of musical possible selves in supporting subjective well-being in later life

There is now an accepted need for initiatives that support older people's well-being. There is increasing evidence that active engagement with music has the potential to contribute to this. This paper explores the relationship between musical possible selves and subjective well-being in later life. The research reported here formed part of a larger project that focused on how active music-making could support positive cognitive, social and emotional outcomes. The research comprised three UK case study sites, each offering diverse musical activities. A sample aged 50+ (total N = 398), some of whom were novices and others who are more experienced, was recruited to complete questionnaires that included open questions and measures of well-being. In addition, individual interviews (n = 29) and focus groups (n = 15) were carried out, where participants in musical activities reflected on the meaning and function of music-making in their lives. The interpretation presented here suggests that through music many older people found a means by which they were able to formulate well-understood and highly esteemed versions of their possible future selves. This, in turn, may have been a significant factor in helping to navigate the process of ageing in later life with enhanced subjective well-being, including a sense of purpose, a significant degree of autonomy and a strong sense of social affirmation

Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use.

Tobacco and alcohol use are leading causes of mortality that influence risk for many complex diseases and disorders1. They are heritable2,3 and etiologically related4,5 behaviors that have been resistant to gene discovery efforts6-11. In sample sizes up to 1.2 million individuals, we discovered 566 genetic variants in 406 loci associated with multiple stages of tobacco use (initiation, cessation, and heaviness) as well as alcohol use, with 150 loci evidencing pleiotropic association. Smoking phenotypes were positively genetically correlated with many health conditions, whereas alcohol use was negatively correlated with these conditions, such that increased genetic risk for alcohol use is associated with lower disease risk. We report evidence for the involvement of many systems in tobacco and alcohol use, including genes involved in nicotinic, dopaminergic, and glutamatergic neurotransmission. The results provide a solid starting point to evaluate the effects of these loci in model organisms and more precise substance use measures

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common

Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use

Tobacco and alcohol use are leading causes of mortality that influence risk for many complex diseases and disorders 1 . They are heritable 2,3 and etiologically related 4,5 behaviors that have been resistant to gene discovery efforts 6–11 . In sample sizes up to 1.2 million individuals, we discovered 566 genetic variants in 406 loci associated with multiple stages of tobacco use (initiation, cessation, and heaviness) as well as alcohol use, with 150 loci evidencing pleiotropic association. Smoking phenotypes were positively genetically correlated with many health conditions, whereas alcohol use was negatively correlated with these conditions, such that increased genetic risk for alcohol use is associated with lower disease risk. We report evidence for the involvement of many systems in tobacco and alcohol use, including genes involved in nicotinic, dopaminergic, and glutamatergic neurotransmission. The results provide a solid starting point to evaluate the effects of these loci in model organisms and more precise substance use measures

Functional and quality of life outcomes of localised prostate cancer treatments (prostate testing for cancer and treatment [ProtecT] study)

Objective To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision-making. Patients and Methods Men aged 50–69 years diagnosed with localised prostate cancer by prostate-specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external-beam radiotherapy (EBRT) with concurrent androgen-deprivation therapy (ADT) and 77 low-dose-rate brachytherapy (BT, not a randomised treatment). Patient-reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores. Results Treatment-received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL. Conclusion Treatment decision-making for localised prostate cancer can be informed by these 6-year functional and QoL outcomes