What works for wellbeing? A systematic review of wellbeing outcomes for music and singing in adults

"Anees Has Measles": Storytelling and Singing to Enhance MMR Vaccination in Child Care Centers Amid Religious Hesitancy

This study explores the enhancement of MMR vaccination rates in the deep south of Thailand through a culturally tailored intervention that incorporates storytelling and singing, aligning with local cultural and religious values. The "Anees has Measles" intervention, developed with input from community stakeholders including health workers, religious leaders, and parents, featured traditional melodies in its singing activities. The intervention comprised two main components: storytelling sessions and singing activities, both utilizing culturally resonant content and formats to effectively engage the community. Conducted from December 2019 to March 2020 across eight districts in five provinces, the study targeted children aged 18 months to 5 years in government child care centers. Results indicated a substantial increase in MMR vaccination coverage from 44.3% to 72.0% twelve months post-intervention, and further to 77.0% at 48 months post-intervention, representing a significant and sustained improvement (p < 0.001). This marked and continuous increase demonstrates the effectiveness of culturally adapted health education in areas with significant vaccine hesitancy. The findings highlight the importance of integrating culturally and religiously sensitive methods into public health strategies, significantly enhancing vaccine acceptance and coverage in diverse and conservative settings. This approach suggests a broader applicability for similar interventions in comparable contexts globally.

Musical activity in a subsample of the German National Cohort study

Musical activities (MA) such as singing, playing instruments, and listening to music may be associated with health benefits. However, evidence from epidemiological studies is still limited. This study aims at describing the relation between MA and both sociodemographic and health-related factors in a cross-sectional approach. A total of 6717 adults (50.3% women, 49.7% men, median age: 51 years (IQR 43-60) were recruited from the study center Berlin-Mitte of the German National Cohort (NAKO), a population-based prospective study. This study is based on a sample randomly selected from the population registry of Berlin, Germany, aged 20 to 69 years. 53% of the participants had been musically active at least once in their life (56.1% women, 43.9% men). Playing keyboard instruments (30%) and singing (21%) were the most frequent MA. Participants listened to music in median 90 min per day (IQR 30.0-150.0). Musically active individuals were more likely to have a higher education, higher alcohol consumption, were less likely to be physically active, and had a lower BMI compared to musically inactive individuals. This large population-based study offers a comprehensive description of demographic, health, and lifestyle characteristics associated with MA. Our findings may aid in assessing long-term health consequences of MA.

Re-engaging with arts and cultural activities at the Life Rooms: 'It's given me spring'

BACKGROUND

Mersey Care NHS Foundation Trust's Life Rooms initiative is an established and successful model of integrating arts and culture within NHS provision. In the face of COVID-19, the Life Rooms was restructured to provide a full suite of online resources. Following the lifting of restrictions, in-person arts provision returned to the Life Rooms sites. Additional evidence in respect of the impact on mental health and wellbeing of the return to in-person arts and cultural activities provided by the Life Rooms, as well as the relative merits of online and in-person arts and cultural activities, is needed to inform future planning around in-person, online, and/or hybrid provision.

METHODS

Interviews with practitioners delivering cultural and creative courses at the Life Rooms (n = 8) and users of the Life Rooms (n = 5) were conducted to explore the impact of the return to in-person arts provision at the Life Rooms, as well as the merits of online and in-person arts provision. Data were analysed using thematic analysis.

RESULTS

Three overarching themes were identified: 'Provision, access, and reach'; 'Value of arts and creativity'; and 'Challenges with the Life Rooms model in the new normal'. The findings demonstrate the critical role of arts and cultural provision in providing stigma-free environments to reconnect the vulnerable and isolated. As re-engagement remained slow, there is a need to be responsive to hesitation around re-engaging in-person. The Life Rooms online learning offer remained vital for those who are vulnerable or otherwise unable to access in-person activities.

CONCLUSIONS

As our findings show a demand for maintaining online provision that enables accessibility together with in-person provision that boosts community connectedness, ensuring continued online access alongside in-person delivery should be prioritised. As mental health demands could continue to grow in coming years as the pandemic evolves, in-person arts engagement could have an important role in meeting mental health needs.

Dedalo Vola project: The effect of choral singing on physiological and psychosocial measures. An Italian pilot study

Several studies have been conducted that show the crucial role of active participation in music in health promotion (e.g. Dingle et al., 2021; Sheppard & Broughton, 2020); however, little research has focused on the biopsychosocial effects of choral singing. The present study aims to evaluate the effectiveness, in terms of improving physiological and psychosocial factors, of a choral program for middle-aged and older individuals. We integrated our study with qualitative observations of the atmosphere and flow state experienced by the choristers. The data were collected before and after 12 weeks of training, with 23 participants took part in the study. They experienced significant improvements in weight, oxygen saturation, heart rate, and satisfaction of psychological needs. A beneficial trend, although not statistically significant, were observed for blood pressure, cholesterol, triglycerides, stress, psychological needs, and mental health. The observations progressively revealed a more cohesive and focused group. Our findings support the potential for cross-disciplinary collaboration between healthcare and arts policy to promote and enhance health and well-being throughout the lifespan.

Social prescribing for individuals with mental health problems: An ethnographic study exploring the mechanisms of action through which community groups support psychosocial well-being

Background

Social prescribing involves connecting individuals to community groups and activities, often to support their mental health and well-being. It has received increasing support in recent years across the NHS. There is a strong evidence base for the benefits of different types of community activities, including exercise groups, arts groups and nature interventions, on mental health outcomes, however, less is known about how these groups impact mental health and well-being. This study explores through what individual-level mechanisms (the 'how') these groups support psychosocial well-being.

Methods

An ethnographic study was conducted over 12-months to explore key shared, individual-level mechanisms across 4 social prescribing community groups: football, singing, gardening and reading. This study focused mostly on those with severe mental illness, whereas previously most social prescribing studies have focused on mild to moderate mental health problems. To frame the findings, a 'multi-level theoretical framework of mechanisms of action' of leisure activities was used.

Results

Key shared psychological mechanisms were: increased self-confidence and self-esteem, increased purpose/meaning, increased sense of achievement, experience of pleasure; social mechanisms included: increased social support, formation of friendships and reduced loneliness, enhanced sense of community and belonging; behavioural mechanisms were: increased independence and openness to experience, reduction in addictive behaviours and building healthier habits, increased work-seeking behaviour, and provision of structure & routine.

Conclusions

It is hoped that the findings of this study can help referring professionals increase their understanding of exactly how such groups support individuals' mental health, thus enhancing referring practices.

[Effects of classical or heavy metal music in humans and animals: implications for intensive care medicine]

BACKGROUND

The importance of music in intensive care medicine is still controversial and the mechanisms of music are unclear. It is important whether different music styles (classical music [CM], Heavy Metal [HM] show measurable effects on blood pressure (BP) or heart rate (HR) in humans or not. It is also unclear whether behavioral patterns are influenced by music (CM, HM) in animals.

METHODS

We studied the influence of CM (Bach, Orchestral Suite No. 3, BWV 1068) and HM (Band Disturbed: Indestructible) compared to a control group (CO) without music exposure in 120 healthy subjects (60 study subjects, 60 control subjects) and 36 young pigs (18 Pietrains, 18 Wiesenauer Minipigs) according to an identical study protocol (21 minutes of music exposure (CM, HM) or 21 minutes of no music (C0).

RESULTS

We were able to clearly demonstrate in 36 pigs that CM led to significantly more activity behavior than HM or CO (p<0,01). HM caused significantly more stress behavior than CM or CO (p<0,01). In humans, there was a decrease in BPsyst, BPdiast or HR (beats per minute [bpm]) among CM: decrease BPsyst -7,5±9,1 mm Hg, BPdiast -4,9±7,5 mm Hg, HR -7,2±10,2 bpm. This was observed less frequently in HM: BPsyst -3,6±7,1 mm Hg, BPdiast -2,7±6,9 mm Hg, HR -5,9±9,0 bpm. The influence of BP and HR was significantly lower in CO compared to music: BPsyst -2,3±7,2 mm Hg, BPdiast -2,0±7,3 mm Hg, HR -5,8±12,3 bpm.

CONCLUSIONS

BP and HR in humans and behavioral patterns in animals are clearly influenced by music. CM leads more frequently to activity behavior in animals and to lower BP and HR in humans compared to HM or CO. In both animal breeds, stress behavior was observed more frequently in HM compared to CM or CO. Therefore, music may play a role in intensive care medicine.

A quasi-experimental mixed-method pilot study to check the efficacy of the "SOUND" active and passive music-based intervention on mental wellbeing and residual cognition of older people with dementia and dementia professionals' burnout: a research protocol

Purpose

The SOUND method offers an innovative blended intervention based on music circle-activities and cognitive stimulation approaches which was co-designed by musicians, health professionals, older people with dementia, family caregivers and researchers, for its application in dementia settings. The purpose of the paper is to describe the detailed procedure of the quasi-experimental pilot study.

Method

The experimental phase of SOUND uses a mixed-method design encompassing qualitative and quantitative observations, cognitive testing, self-report and interviewer-assisted questionnaires to investigate the effectiveness of the intervention for 45 people with dementia and 45 professionals (15 in every study country: Italy, Portugal, Romania).

Results

The pilot study will be the first implementation of the SOUND intervention aiming to investigate the feasibility and preliminary effects of the method.

Conclusion

The novelty of SOUND is its multicomponent method, including the most evidenced features for improving the wellbeing of participants.

The need for robust critique of arts and health research: the treatment of the Gene Cohen et al. (2006) paper on singing, wellbeing and health in subsequent evidence reviews

BACKGROUND

This paper considers weaknesses in a study by Cohen et al. (2006) on the impacts of community singing on health. These include high demand characteristics, lack of attention to attrition, flawed statistical analysis, and measurement. Nevertheless, the study is uncritically cited, in evidence reviews, with findings taken at face value.

METHODS

Google Scholar, SCOPUS and BASE citation functions for Cohen et al. identified 32 evidence reviews in peer-reviewed journals. Eleven of these reviews, published between 2010 and 2023, focused on creative arts interventions.

RESULTS

We demonstrate limitations in the Cohen et al. research which undermine the conclusions they reach regarding the health benefits of group singing. Subsequent evidence reviews take the findings at face value and offer little critical commentary.

DISCUSSION

We consider what is needed to improve evidence reviews in the field of creative arts and health research.

CONCLUSIONS

A more robust approach is needed in reviewing research evidence in the field of arts and health. The Cohen et al. paper is not suitable for inclusion in future evidence reviews.

Impact of a Virtual Game, 'Name That Band,' on Older People's and PharmD Students' Feelings of Social Isolation During COVID-19

Background Prior to the COVID-19 pandemic, PharmD students at the University of Arizona (UArizona) had a long-standing relationship with the older people at St. Luke's Home, a local Eden Alternative assisted-living community. Hosting community engagement programs for assisted-living residents was challenging with COVID-19 precautions and older individuals suffering from social isolation and loneliness. Objective To determine the impact of playing a virtual game, 'Name That Band,' on older people's and PharmD students' feelings of social isolation during the COVID-19 pandemic. Methods Questionnaires were administered before and after a virtual game to residents at St. Luke's Home and PharmD students at UArizona. Participants were asked about their mood before COVID-19 and pre-and postgame, as well as their social interactions and feelings of loneliness using the Modified UCLA Three-Item Loneliness Scale, which assesses a composite score of lack of companionship, feelings of being left out, and isolation. Results Fifteen older people and 11 students participated in the game (N = 26). All participants completed the pregame survey and 25 completed the postgame survey. The older people reported fewer feelings of isolation and loneliness (measured by a reduction in UCLA Loneliness Scale score) postgame compared with pregame. The students reported a higher total UCLA Loneliness Scale score during the pandemic than prepandemic, but there was no difference in their scores postgame compared with pregame. More older people and students reported feeling 'happy' after playing the virtual game together compared with before the pandemic and before playing. The aspect of the activity that helped older people and students feel more socially engaged was playing a game. Conclusion A social intervention using a virtual game may be a tool that can be used to decrease feelings of isolation and increase engagement for older people residing in an assisted-living community.

"It doesn't feel like exercise": a realist process evaluation of factors that support long-term attendance at dance classes designed for healthy ageing

Introduction

Dance can positively impact older people's health and wellbeing across cultures and socioeconomic groups, countering age-related physical, sensorimotor and cognitive decline.

Background/objectives

The RIPE (Really Is Possible for Everyone) Dance program aims to improve older people's physical, mental, cognitive and social wellbeing by integrating engaging dance sequences with evidence-based fall prevention exercises. We sought to identify what mechanisms support observed long-term participation in this program, including by people living with challenging health conditions.

Methods

Following a realist evaluation approach, we co-developed and tested program theories iteratively with participant interviewees (n = 20), dance teachers (n = 2) and via observation of a dance class. Initial data were dual-coded and emergent findings were interrogated by the research team. Findings were organised to express Program activities + Context + Mechanism = Process outcomes configurations.

Results

We identified four program theories comprising 14 mechanisms which explained long-term attendance: 1. RIPE Dance benefits my body and mind (trust in the program, belief in health benefits), 2. RIPE Dance helps me feel good about myself (self-efficacy, pride in achievement, psychological safety, defying expectations, feeling valued), 3. RIPE Dance creates camaraderie (social connection, mutual support, rapport with the teacher), and 4. RIPE Dance is uplifting (raised spirits, fun, synchrony, musical reactivity).

Conclusion

The RIPE Dance program provides effective and enjoyable 'exercise in disguise' for older people with diverse mobility profiles.

Significance/implications

This research confirms that participation in dance can contribute significantly to healthy, happy ageing. Findings detail program activities that were most strongly associated with process outcomes, offering guidance for further program development, implementation and scaling up.

Creative aging in virtual spaces: using museum content and music therapy to explore cultural diversity

Introduction

During the pandemic, many creative aging programs stopped being delivered in person, and practitioners turned to various virtual platforms to deliver content for older adults to maintain their cognitive, physical, and psychosocial well-being. Collaborators from a university-based music therapy program and a global music museum developed asynchronous virtual programs, one for wellness populations and another for memory care settings. Content was developed and delivered by the paper's principal investigators in collaboration with the museum's curatorial team and an upper division music therapy class composed of juniors and first-year graduate equivalency students (n = 21). The asynchronous program included museum gallery content and music therapy interventions of singing, movement, and/or instrument playing based on highlighted geographic regions. The purpose of the study was to explore older adults' experiences when participating in the program.

Methods

Fifty-six older adults from three post-acute care facilities (two skilled nursing facilities and one assisted living center) served as participants. Older adult participants were categorized as cognitively healthy (n = 27) or those diagnosed with dementia (n = 29) and attended five music sessions over 8 weeks, ranging from 30 to 60 min in length. A within-subject repeated measures design was used to investigate the impact of the creative aging program on older adults' psychosocial well-being and engagement behaviors. Psychosocial well-being for cognitively healthy older adults were measured with the Multicultural Quality of Life Index, Engagement in Meaningful Activity Survey, and the PROMIS Social Isolation Short Form-4a. Psychosocial well-being for older adults with memory loss was measured with the Quality of Life in Late-Stage Dementia tool.

Results

Cognitively healthy older adults showed an increase in psychological/emotional wellness after participating in the program, while older adults with memory loss appeared less irritable and physically uncomfortable and seemed to enjoy interacting with others more. Surprisingly, the cognitively healthy older adults also showed an increase in social isolation between the start and end of the program, which may not be related to the intervention, but to the fact that all three sites had COVID outbreaks during the study and had to pause their group activities programming and residents were required to stay in their rooms. Additionally, the music interventions fostered engagement behaviors of interest (facial expression, posture), and response (body movement, eye contact, and musical interaction with the leaders in the videos) for both groups of older adults. Instrument interventions were most engaging for cognitively healthy older adults. Singing interventions were most engaging for older adults with dementia, whereas movement interventions were less engaging for older adults with dementia.

Discussion

Findings suggest that creative aging virtual programs can be delivered in asynchronous settings to enhance older adults' well-being and foster engagement. Additionally, virtual programming may be used to augment ongoing programming or used to reach older adults when distance is a factor to enhance older adults' well-being.

Expanding the social cure: a mixed-methods approach exploring the role of online group dance as support for young people (aged 16-24) living with anxiety

There is an increased interest in whether online arts interventions support mental health and social connections. This study explored eight weeks of online group dance as support for young people (aged 16-24) living with anxiety. The applicability of the 'social cure' theoretical framework to the novel context of an online dance class was sought. The study utilised an embedded QUAL+quan design, incorporating participatory focus group discussions (n = 3 groups; n = 11 participants) and one-on-one interviews (n = 2 participants), creative reflections (n = 16 participants) and ethnographic fieldnotes, and a repeated measures design with surveys at three timepoints (week 1, n = 27; week 4, n = 18; week 8, n = 14). Thematic analysis identified two overarching themes demonstrating how the dance classes (i) provided the opportunity to co-construct a meaningful shared identity and (ii) supported holistic wellbeing. The quantitative findings supported this, suggesting lower anxiety, depression, and loneliness and higher wellbeing, self-esteem, self-efficacy, and group closeness. This study expands the social cure to its application to an online dance context for the first time.

Help is on its Way: Exploring the Mental Health and Wellbeing Outcomes of a Massed Community Choir Program

BACKGROUND

This paper explores the mental health and wellbeing outcomes of a massed community choir program in Australia.

METHODS

This study employed a mixed methods approach. Data were collected via a survey of choir participants (N = 305), four qualitative interviews and focus groups with facilitators and participants (N = 22), and two workshops with organising staff (N = 5). Questions were derived from a co-designed program logic, and data were triangulated and analysed thematically.

RESULTS

Participants reported feeling a sense of connectedness (psychological), but also experiencing connection (social) with their fellow singers. Psychological outcomes included the sensations of affect, arousal, and affirmation. Social outcomes included experiencing belonging, inclusion, and sharing. These positive psycho-social experiences promoted positive mental health and wellbeing outcomes in the large group of participating singers.

CONCLUSIONS

This paper addresses gaps in our understanding about the mental health and wellbeing outcomes fostered by community choirs at scale.

A qualitative systematic review of the experiences of sharing music for people living with dementia and their family care partners: the thread of connection

BACKGROUND

There is a global need for interventions that support the wellbeing of people living with dementia and their family care partners. Studies show that shared musical activities may achieve this. Our systematic review aimed to synthesise existing research exploring dyads' experiences of shared musical activities across a range of contexts.

METHOD

From 31 October 2020 we searched PubMed, PsycInfo, CINAHL Complete, EMBASE, RILM, Web of Science Core Collection, Google Scholar and ProQuest Dissertations & Theses for studies published up to 14 April 2021, and hand searched five music therapy journals plus citation lists. Thirteen qualitative studies reporting on dyads' experiences and perspectives of shared musical activities across a range of settings were included. Studies with mixed populations or mixed modality interventions were excluded. We analysed the final studies using thematic synthesis, engaging in reflective discussions and reflexivity throughout. The quality of included studies was assessed using the CASP qualitative checklist. This study is registered on PROSPERO: CRD42020169360.

RESULTS

Six themes were identified from 13 studies: 1) shared musical activities support wellbeing for people living with dementia, 2) music groups become ecological systems, 3) shared musical activities are experienced differently over time, 4) shared musical activities are experienced by me and as we, 5) music is a supportive structure, and 6) the thread of connection (an overarching theme). A GRADE-CERQual assessment found moderate to high confidence in these findings. Findings informed the development of the Contextual Connection Model of Health Musicking.

CONCLUSION

Shared musical activities foster experiences of connection for people living with dementia and their family care partners. Experiences of connection are supported through professional facilitation and the structural aspects of music, and are influenced by the setting and changes over time. These experiences of connection play a central role in supporting dyadic and individual wellbeing. These findings are largely relevant to a western cultural context; future research should seek to include more diverse cultural experiences.

Art engagement and psychological well-being among community-dwelling older adults in Japan: an observational cross-sectional study

OBJECTIVES

Art engagement, which includes individual art activities and museum and gallery visits, potentially contributes to improving psychological well-being. However, there is insufficient evidence of its effects on the older population, and few reports are from Asia, including Japan. This study examined the association between art engagement and psychological well-being among older adults in Japan.

STUDY DESIGN

An observational cross-sectional study design was used.

METHODS

Community-dwelling older adults aged ≥60 years were recruited from the visitors to public facilities (including community centres, sports centres and cultural centres) in Aichi, Japan, in 2022, and completed questionnaires. The psychological well-being assessment included five domains according to Seligman's PERMA framework: Positive emotion, Engagement, Relationship, Meaning and Accomplishment. Regarding art engagement, the frequencies of active art engagement (e.g. activities by individuals and participation in groups, such as music and painting) and receptive art engagement (e.g. visiting museums, galleries and the theatres) were assessed.

RESULTS

A total of 522 participants were included in the analysis (mean age = 74.1 years; 78.0% females). Results from the multivariable linear regression analysis, which adjusted for demographic and socio-economic factors, revealed that higher frequencies of active art engagement were significantly associated with higher scores in all five PERMA domain scores. Higher frequencies of receptive art engagement were significantly associated with higher levels of Positive emotion, Engagement and Meaning domain scores, but were only marginally associated with the Accomplishment domain and were not associated with the Relationships domain.

CONCLUSIONS

This study indicates that art engagement has the potential to enhance psychological well-being among older adults. National and local government strategies to increase accessibility to art and cultural activities for older adults are recommended.

Hobby engagement and mental wellbeing among people aged 65 years and older in 16 countries

Growing aging populations pose a threat to global health because of the social and psychological challenges they experience. To mitigate this, many countries promote hobby engagement to support and improve mental health. Yet, it remains unclear whether there is consistency in benefits across different national settings. We harmonized measures of hobby engagement and multiple aspects of mental wellbeing across 16 nations represented in five longitudinal studies (N = 93,263). Prevalence of hobby engagement varied substantially across countries, from 51.0% of Spanish respondents to 96.0% of Danish respondents. Fixed effects models and multinational meta-analyses were applied to compare the longitudinal associations between hobbies and mental wellbeing. Independent of confounders, having a hobby was associated with fewer depressive symptoms (pooled coefficient = -0.10; 95% confidence intervals (CI) = -0.13, -0.07), and higher levels of self-reported health (pooled coefficient = 0.06; 95% CI = 0.03, 0.08), happiness (pooled coefficient = 0.09; 95% CI = 0.06, 0.13) and life satisfaction (pooled coefficient = 0.10; 95% CI = 0.08, 0.12). Further analyses suggested a temporal relationship. The strength of these associations, and prevalence of hobby engagement, were correlated with macrolevel factors such as life expectancy and national happiness levels but overall, little variance in findings was explained by country-level factors (<9%). Given the relative universality of findings, ensuring equality in hobby engagement within and between countries should be a priority for promoting healthy aging.

The multidimensionality of social wellbeing: interactions from the individual to the collective level in large cities

This paper responds to two questions-What dimensions and indicators are relevant to the construction of social wellbeing? How are the levels of wellbeing distributed in the municipalities of Mexico City? To answer these questions, we use data from the Wellbeing Survey (N = 2,871) that is representative of Mexico City and its municipalities. We employed two methods, DM-R distances, and Mamdani's Fuzzy Inference Method. The results show that all the proposed dimensions and indicators contributed to the building of multidimensional social wellbeing; in the case of some indicators (social security, built environment, and public insecurity) they contributed less. This suggests government interventions should be designed in order to improve the gaps in those areas. The evidence also indicates that community wellbeing is a relevant dimension when measuring social wellbeing in large cities, in addition to identifying areas of intervention for the development of more efficient and inclusive public policies.

Development and validation of BATUTA: a test to evaluate the musical perception of people with hearing impairment

PURPOSE

To describe the development and validation of a test, called BATUTA, that assesses the musical perception of people with hearing impairment that are hearing aid (HA) users. BATUTA is a computerized test with 35 subtests, divided into the rhythm, pitch, and timbre modules, and the participants must answer whether the sound samples and/or parts of the songs, presented in pairs, are the same or not.

METHODS

The BATUTA creation process consisted of four stages: test development, submission to the expert committee for content validation; pilot application with 51 normal hearing participants and retest to validate reliability. The process was based on several recommendations for the development and validation of musical assessment instruments. A deep investigation of the guidelines related to sound samples used, musical attributes evaluated, testing environment and the most appropriate response method was undertaken to ensure dependability.

RESULTS

The Content Validity Index (CVI) and expert agreement rates, when analyzed with the committee's recommendations, resulted in corrections and new audio recordings to ensure compliance to the test. The pilot test scores indicated internal consistency and the retest confirmed the reliability of BATUTA.

CONCLUSION

The results demonstrated the viability of BATUTA to assess the musical perception of people with hearing impairment that are HA users.

Exploring the Synergy of Music and Medicine in Healthcare: Expert Insights into the Curative and Societal Role of the Relationship between Music and Medicine

Our study aimed to investigate the correlation between medicine, health perception, and music as well as the role of music in the healthcare setting. To gain insights into the dynamics between these two fields, we gathered opinions from attendees and presenters at an international conference on music medicine, musicians' health, and music therapy. A team of six interviewers conducted a total of 26 semi-structured interviews. The interview guide focused on four predetermined themes: (1) "music in medicine", (2) "performing arts medicine", (3) "music for the individual", and (4) "music for society". The responses were analyzed using grounded theory methods as well as thematic and content analysis. To enhance the analytical strength, investigator triangulation was employed. Within the predefined themes, we identified several subthemes. Theme 1 encompassed topics such as "listening and performing music for treating diseases and establishing non-verbal relationships", "the value of music in specific disorders, end-of-life care, and pain management", and "the design of sound spaces". Theme 2 explored aspects including the "denial and taboo surrounding physical and mental health issues among musicians", "the importance of prevention", and an antithesis: "pain and suffering driving creativity". Theme 3 addressed the "mental role of music in ordinary and extraordinary life" as well as "music's ability to enable self-conditioning". Lastly, Theme 4 examined the role of music in "cultural self-identification" and "development and education for children". Throughout the interviews, participants expressed a lack of knowledge and awareness regarding interdisciplinary research and the fields of music and medicine. Our findings affirm the significance of music therapy and performing arts medicine as well as the broader relationship between music and medicine. They highlight the potential benefits of perception and experiential pathways for individuals and, consequently, for human society.

Associations between participation in community arts groups and aspects of wellbeing in older adults in the United States: a propensity score matching analysis

Objectives: There is a social gradient in both arts engagement and wellbeing that may have led to an overestimation of the impact of arts engagement on wellbeing. We tested whether participation in community arts groups was associated with wellbeing after removing confounding by demographic, socioeconomic, and health-related factors.Methods: Using propensity score matching, we analyzed data from 12,055 older adults in the Health and Retirement Study. We measured community arts groups participation and concurrent life satisfaction (evaluative wellbeing), positive and negative affect (experienced wellbeing), and purpose in life, constraints on personal control, and mastery (eudaimonic wellbeing).Results: After matching, arts group participation was associated with higher positive affect (average treatment effect on the treated [ATT] = 0.18, 95% CI = 0.12-0.24), life satisfaction (ATT = 0.09, 95% CI = 0.04-0.15), purpose in life (ATT = 0.07, 95% CI = 0.02-0.13), and mastery (ATT = 0.07, 95% CI = 0.01-0.14) than not participating. Participation was not associated with negative affect or constraints on personal control. In sensitivity analyses, these associations were maintained four years later.Conclusion: Arts group participation was associated with the positive elements of evaluative, experienced, and eudaimonic wellbeing. Facilitating participation in community arts groups could help to promote healthy aging, enabling a growing segment of the population to lead more fulfilling and satisfying lives.

COVID-19 pandemic: Does musicianship matter?

The COVID-19 pandemic negatively influenced mental health and the music industry. The present study examined the relationship of between personality traits and emotional regulation with emotional problems and compared this relationship across three groups of individuals living in Türkiye during the COVID-19 pandemic. The sample consisted of 542 participants (238 musicians, 97 artists excluding musicians, and 207 participants who engaged in no form of art). The Depression, Anxiety and Stress Scale (DASS-21), Difficulties in Emotion Regulation Scale-Brief Form (DERS-16), and Basic Personality Traits Inventory were used. Findings showed that difficulties in emotion regulation were positively associated with stress, depression, and anxiety in all groups. The pattern of the relationship between personality traits and outcome measures was similar across musicians and participants who engaged in no form of art, whereas that of difficulties in emotional regulation with personality traits was almost the same across the three groups. Except for the personality traits of extraversion and openness, group comparisons showed no differences across different measures. These findings suggest that difficulties in emotional regulation need to be a target for psychological interventions to reduce emotional problems for all three groups. Being a musician did not make any difference in terms of emotional regulation or the experience of psychological problems.

Reasons for participating in musical activities and their relationship with well-being during and before Covid-19

People tend to participate in musical activities-whether it is making or listening to music-for reasons that are related to basic psychological needs. This study explored whether the coronavirus pandemic (Covid-19) has changed the reasons for participating in musical activities and examined the relationship between these reasons and well-being during as well as before the pandemic. In total, 246 people (between 18 and 35 years) completed a survey during the pandemic, which contained questions relating to the reasons for participating in musical activities-namely the promotion of identity and agency, mood regulation, relaxation and company, enjoyment-and to subjective and eudaimonic well-being before and after the outbreak of the pandemic. Results showed that during the pandemic compared with before, people more often chose music to promote identity and agency, mood regulation, and relaxation and company. Two of the reasons that were invoked more often-namely identity and agency and mood regulation-positively predicted eudaimonic and subjective well-being, respectively, during the pandemic as well as before. Thus, people's reasons for participating in musical activities during the pandemic compared with before changed in a direction consistent with increasing both eudaimonic and subjective well-being.

Identification and Illustration of Means to a Critical Assessment of Music and Health Research Literature

In 2019, the WHO released a scoping review investigating art therapies in evidence-based healthcare practices to identify and understand the gaps in the literature. However, the studies curated were not evaluated for their quality. To address this limitation, several assessment tools to critically appraise music-based research studies that investigate therapies pertaining to preventative healthcare were investigated. Two critical appraisal tools were selected for their robustness and appropriateness for the studies in question: the Joanna Briggs Institute checklists and the Music-Based Intervention Guidelines. These tools were tested by two assessors on a total of 23 music studies from the Preventative and Prevention Health section of the WHO report. Based on the requirements for each critical appraisal tool, seven studies received a full assessment utilizing both checklists. Of these seven, two studies scored on the higher index, indicating that the studies followed a detailed methodology to provide concrete and accurate results. The findings of the study highlighted the limitations of study designs and music-based interventions. With this information, beneficial recommendations for future research in this domain are provided to improve the quality of research, ensuring its place in evidence-based healthcare practices.

Awe as a Pathway to Mental and Physical Health

How do experiences in nature or in spiritual contemplation or in being moved by music or with psychedelics promote mental and physical health? Our proposal in this article is awe. To make this argument, we first review recent advances in the scientific study of awe, an emotion often considered ineffable and beyond measurement. Awe engages five processes-shifts in neurophysiology, a diminished focus on the self, increased prosocial relationality, greater social integration, and a heightened sense of meaning-that benefit well-being. We then apply this model to illuminate how experiences of awe that arise in nature, spirituality, music, collective movement, and psychedelics strengthen the mind and body.

The use of "art" as a resource in recovery from the impact of sexual abuse in childhood: A qualitative systematic review

BACKGROUND

A qualitative systematic review was undertaken to identify the therapeutic impact of arts-based activities as experienced by adults sexually abused in childhood.

METHODS

Sixteen studies, identified through a systematic search protocol , were included in a thematic synthesis. Quality of studies was assessed using the Critical Appraisal Skills Programme tool.

FINDINGS

Arts-based activities were identified as offering a safe space, in which to find a voice, to engage in self-exploration, and to communicate experience and connect with others where a new sense of self and empowerment could emerge.

CONCLUSION

Creative activities can play a significant role in the unique paths to recovery that sexual abuse survivors develop. Limitations to the review derive from the small number of papers, methodological weaknesses of the studies and the variation in focus. More research is needed into impact of specific media, and barriers and enablers to using creative activities as a resource.

Implementation and Strategies of Community Music Activities for Well-Being: A Scoping Review of the Literature

The benefits of community music activities for promoting well-being have been well recognized in previous literature. However, due to their wide variability and flexible approaches, a comprehensive understanding of the research and practice of community music activities for well-being promotion is sparse. The purpose of this scoping review was to synthesize published literature pertaining to community music activities for well-being promotion and identify key implementation characteristics and strategies to inform future practice and research. Studies of community music activities that investigated well-being outcomes in participants of all ages and conditions were eligible for inclusion. Through electronic database and manual searches, a total of 45 studies were identified and included in the analysis. The main findings showed that community music activities for well-being were characterized by a wide range of populations and applications, collaborative work, an emphasis on social components, and musical accomplishments. However, this variability also revealed a lack of consistent and thorough information as well as diversity in well-being conception across studies. The review offers practical recommendations for future research and practice based on the current findings.

Singing Voice Concern in Tertiary Laryngology Practice

OBJECTIVES

To determine the prevalence and characteristics of patients who identify singing voice as a primary concern when presenting with general voice complaints to a voice clinic.

METHODS

Data were collected from medical records on demographics, medical history, laryngoscopy exam, diagnosis, and subsequent treatments; and from self-report questionnaires including the Voice Handicap Index-10 (VHI-10) and clinical voice questionnaire.

RESULTS

A total of 17% of patients presenting to a voice clinic with general voice problems who completed a VHI-10 identified singing voice as a primary concern. Compared to the reference cohort, patients concerned about singing voice report greater handicap on several questions of the VHI-10, particularly in personal and social life impact, loss of income, unpredictability of vocal clarity, subjective upset, and subjective handicap. Those concerned with singing voice were also more concerned about their vocal problem, and both more likely to be recommended voice therapy and participate in voice therapy despite no statistical differences in categorical diagnoses.

CONCLUSIONS

When considering both professional and recreational singers, voice concerns occurred in 17% of the cohort under study. Patients with singing voice concerns are accounted for largely by recreational singers, who remain poorly characterized in the literature. We underscore the importance of sensitivity and responsivity to the needs of this group of patients.

Mental distress links with physical activities, sedentary lifestyle, social support, and sleep problems: A Syrian population cross-sectional study

Background

Mental diseases are very widespread and difficult to treat, affecting around 12% of the global population in 2019. Since social interaction is crucial to human existence and loneliness has been proven to be a significant predictor of depressive symptoms, it stands to reason that social connection problems would also contribute to depression. Physical inactivity seems to weaken and aggravate insulin tolerance alterations, glucose homeostasis, and plasma triglyceride levels, thereby influencing one's mood and happiness. This suggests that physical inactivity may be a significant risk factor for mental illness. This research contributes to our understanding of the mental health situation in Syria by exploring associations between a set of measurable characteristics that may be adjusted.

Methods

An online quantitative cross-sectional study was conducted between March and April 2022 in Syria, using a structured questionnaire that assesses data on behaviors of health, health in general, wellbeing, and adult population quality of life.

Results

Among 1,224 respondents (371 men and 853 women), women have shown higher levels of mental distress, sleep issues, low engagement in structured activities, and a difficult work environment than men. Women experiencing mental anguish have reported being more sedentary, participating in less scheduled activities, and receiving less social support.

Conclusions

There are observable connections between high sedentary time and women experiencing mental distress. The mental health of Syrian women in distress was associated with a lack of participation in both organized activities and physical exercise in their free time. Furthermore, sleep issues and financial troubles were seen in persons with mental diseases of both males and females.

Building community through higher music education: a training program for facilitating musical engagement among older adults

Preparing music students to design and carry out community-based initiatives can be an effective way to enhance their employability and their wellbeing. With a large body of evidence now pointing to the benefits of musical engagement for older adults, both for individuals and for society as a whole, there is considerable opportunity and value in training aspiring professional musicians to work with and on behalf of those in their third and fourth age. This article describes a seminar designed by a Swiss conservatoire in collaboration with local nursing homes involving residents and music university students in a 10-week group music making program. On the basis of the positive results to emerge in terms of health, wellbeing and career preparation, we aim to provide information relevant for colleagues to replicate this seminar in other higher music education institutions. Moreover, this paper aims to shed light on the complexity of designing music students' training so that they acquire the competences needed to deliver meaningful, community-based initiatives alongside their other professional training commitments, and to provide directions for future research. The development and implementation of these points could foster the increase and sustainability of innovative programs beneficial for older adults, musicians and local communities.

Intervention and mediation effects of a community-based singing group on older adults' perceived physical and mental health: the Sing4Health randomized controlled trial

ObjectiveTo examine short- and long-term effects of a group singing program on older adults' perceived physical and mental health levels, and also investigate subjective well-being (life satisfaction, positive/negative affect and hedonic balance), body balance and serum biomarkers (C-reactive protein and erythrocyte sedimentation rate) as putative mediating mechanisms, controlling for the cognitive status of the participants. Design: The randomized controlled trial included 149 participants (60 to 95 years), allocated to an immediate intervention group (IG) or a wait-list active control group (WLG). The intervention comprised 34 sessions of group singing during 4-months. Main outcome measures: Self-report measures of physical health, anxiety, stress, and depression. Blinded assessments were conducted at baseline, post-intervention (4 months) and follow-up (6 months). Results: Participants in the IG reported a lower decline in perceived physical health after the intervention, as compared to the WLG. These benefits were maintained at follow-up. Singing-related changes in physical and mental health outcomes were mediated via an increase in positive affect. Moderation results showed that participants with very low cognitive functioning reported more anxiety and depression symptoms after the intervention. Conclusions: These findings provide further understanding on the psychological and physical mechanisms and effects of group singing in older adults.

Me and us: Cultivating presence and mental health through choir singing

BACKGROUND

An increasing body of qualitative and quantitative research suggests that choir singing can improve mental and physical health and wellbeing. A recurring phenomenon is social agency and social and emotional competences. However, there is little consensus about the underlying impact mechanisms and the special nature of music as a medium for music-based social-emotional competence.

AIM

This research was carried out to explore how the participants experienced engaging and singing in the choir A Song for the Mind in order to understand the social and emotional aspects in relation to choir singing and mental health.

METHOD

Six women and two men were interviewed. The study involved open-ended interviews and applied Paul Ricoeur's phenomenological-hermeneutic theory of interpretation in processing the collected data.

FINDINGS

Two themes emerged-The Singing Me and Cultivating Us. Joining the choir, singing and engaging with the lyrics, helped the participants get in contact with complex feelings and visualise and express challenges. This formed feelings of connecting to oneself and opening up to become aware of the world such as nature, the other person and the choir. Songs, melodies, tones, lyrics-singing together-formed a relation between the participants and the other and the group. This was a meaningful, and to some, a life-changing experience, and an important learning process to the professionals. As the participants are sensing and connecting to themselves, there is an opening for growing a nascent presence and awareness.

CONCLUSION

Joining the initiative A Song for the Mind instils an attention to the other person(s). The singing process seems to evoke presence, leading to awareness towards relational aspects and solidarity. In a choir singing perspective, and health care practice in general, this can be seen as a budding and ground-breaking formation of cultural activities holding learning and empowering potentials instilling mental health.

The Use of Music to Manage Burnout in Nurses: A Systematic Review

OBJECTIVE

There is a high prevalence of burnout in nurses. This systematic review investigates the use of music to manage burnout in nurses.

DATA SOURCE

MEDLINE (Ovid), MEDLINE InProcess/ePubs, Embase, APA PsycINFO, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched.

STUDY INCLUSION AND EXCLUSION CRITERIA

Full-text articles were selected if the study assessed the use of music to manage burnout in nurses. Burnout was defined according to the International Classification of Diseases 11th Revision.

DATA EXTRACTION

Data were extracted using an Excel sheet. The second and third authors independently extracted study characteristics, frequency and type of music engagement, measures of burnout, and burnout outcomes (occupational stress, coping with stress, and related symptoms such as anxiety).

DATA SYNTHESIS

Study and outcome data were summarized.

RESULTS

The literature search resulted in 2210 articles and 16 articles were included (n = 1205 nurses). All seven cross-sectional studies reported upon nurses' self-facilitated use of music including music listening, playing instruments, and music entertainment for coping or preventing stress, supporting wellbeing, or enhancing work engagement. Externally-facilitated music engagement, including music listening, chanting, percussive improvisation, and song writing, was reported in the four randomized controlled trials and five cohort studies with reductions in burnout outcomes.

CONCLUSIONS

Self-facilitated and externally-facilitated music engagement can help to reduce burnout in nurses.

Back to live: Returning to in-person engagement with arts and culture in the Liverpool City Region

On July 19th 2021, the UK government lifted the COVID-19 restrictions that had been in place since March 2020, including wearing masks, social distancing, and all other legal requirements. The return to in-person events has been slow and gradual, showing that audiences are still cautious when (and if) they resume engaging in arts and culture. Patterns of audience behavior have also changed, shifting toward local attendance, greater digital and hybrid engagement, and openness to event format changes. As the arts and cultural industry recovers from the pandemic, it is important to adopt an audience-oriented approach and look at the changing patterns of engaging in arts and culture. This study aims to better understand the impact of the pandemic on the patterns of cultural and arts engagement. Eight qualitative interviews were conducted to explore the changes in arts and cultural engagement since the restrictions were lifted, focusing particularly on the audience’s experiences of returning to in-person arts and cultural events in the Liverpool City Region (LCR). Using framework analysis, three themes were identified from the data: The new normal: reframing pre-pandemic and pandemic experiences of arts and culture, Re-adjusting to in-person provision, and Moving forward: online and blended provision. The findings show that the pandemic altered the ways that people engage in arts and culture. The “new normal,” a blend of pandemic and pre-pandemic experiences, illustrates how the pandemic has highlighted and reconfigured the importance of arts and culture, in terms of personal and cultural identity. Resuming in-person engagement after a long break, participants noted that they were able to feel more like themselves again. Arts and culture were perceived to be beneficial in rebuilding personal resilience and confidence. Engaging in arts and culture, following the isolating experience of the pandemic, has also helped participants feel reconnected to others through their shared experiences. Finally, the findings suggest that online provision remains vital for many, ensuring wider inclusivity, particularly for vulnerable audiences. At the same time, it is important to acknowledge the barriers to online inclusion and the possibility of this resulting in a growing digital divide.

Does Reality Television-Style Singing Influence Singing Self-Concept?

HYPOTHESIS

Due to upward social comparison, we hypothesized that exposure to reality television singing (a technically demanding style of contemporary commercial music singing) would negatively influence singing self-concept compared to hearing amateur singers or plain, unembellished singing by professionals.

STUDY DESIGN AND METHODS

A between-subjects, online experiment was used. A sample of 212 individuals (Mage = 33.14; 69.30% female) participated in the study. After completing a background section, participants were randomly allocated into one of the experimental conditions (hearing one of four versions of a well-known song: a control version with piano and no singing, amateur singing, professional plain singing, and professional singing in the style of reality television singing). Participants were then asked to judge the performance they heard and to respond to items concerning their singing self-concept (including singing ability).

RESULTS AND CONCLUSIONS

A series of ANCOVAs was used to examine the impact of the experimental condition on the participants' performance judgments and singing self-concept. The amateur singing was judged as the lowest quality. While there was no significant difference by experimental condition regarding possessing good singing ability, the experimental condition did affect people's singing aspirations and perceived ability to sing along with the performers. The pattern of results suggests that exposure to reality television-style singing may have negative impacts on people's singing self-concept via upward social comparison. Self-concept has been identified as an important predictor of musical engagement and participation and plays a role in motivating action. These results encourage music educators, singing voice pedagogues, and community musicians seeking to promote musical and singing participation to be aware of cultural influences on an individual's singing self-concept.

The health impacts of place-based creative programmes on older adults' health: A critical realist review

Place-based creative programmes can help alleviate the structural and place-related problems that affect older adults' health. However, it is unclear why these programmes achieve positive outcomes, and how these may vary across contexts. This critical realist review aimed to address these gaps. We were able to evidence why these programmes may work for older people's mental, social and physical health. Place-based creative programmes impact on health because they support social relatedness, motivation, self-continuity and self-efficacy. However, the circumstances under which and for whom these programmes work remain hidden since existing studies do not report sufficiently on context. We set out some of the general aspects of context that could form the basis of minimum standards for reporting.

Association of Music Interventions With Health-Related Quality of Life: A Systematic Review and Meta-analysis

IMPORTANCE

Increasing evidence supports the ability of music to broadly promote well-being and health-related quality of life (HRQOL). However, the magnitude of music's positive association with HRQOL is still unclear, particularly relative to established interventions, limiting inclusion of music interventions in health policy and care.

OBJECTIVE

To synthesize results of studies investigating outcomes of music interventions in terms of HRQOL, as assessed by the 36- and 12-Item Health Survey Short Forms (SF-36 and SF-12).

DATA SOURCES

MEDLINE, Embase, Web of Science, PsycINFO, ClinicalTrials.gov, and International Clinical Trials Registry Platform (searched July 30, 2021, with no restrictions).

STUDY SELECTION

Inclusion criteria were randomized and single-group studies of music interventions reporting SF-36 data at time points before and after the intervention. Observational studies were excluded. Studies were reviewed independently by 2 authors.

DATA EXTRACTION AND SYNTHESIS

Data were independently extracted and appraised using GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluations) by multiple authors. Inverse-variance random-effects meta-analyses quantified changes in SF-36 mental and physical component summary (respectively, MCS and PCS) scores from preintervention to postintervention and vs common control groups.

MAIN OUTCOMES AND MEASURES

SF-36 or SF-12 MCS and PCS scores, defined a priori.

RESULTS

Analyses included 779 participants from 26 studies (mean [SD] age, 60 [11] years). Music interventions (music listening, 10 studies; music therapy, 7 studies; singing, 8 studies; gospel music, 1 study) were associated with significant improvements in MCS scores (total mean difference, 2.95 points; 95% CI, 1.39-4.51 points; P < .001) and PCS scores (total mean difference, 1.09 points; 95% CI, 0.15-2.03 points; P = .02). In subgroup analysis (8 studies), the addition of music to standard treatment for a range of conditions was associated with significant improvements in MCS scores vs standard treatment alone (mean difference, 3.72 points; 95% CI, 0.40-7.05 points; P = .03). Effect sizes did not vary between music intervention types or doses; no evidence of small study or publication biases was present in any analysis. Mean difference in MCS scores met SF-36 minimum important difference thresholds (mean difference 3 or greater).

CONCLUSIONS AND RELEVANCE

In this systematic review and meta-analysis, music interventions were associated with clinically meaningful improvements in HRQOL; however, substantial individual variation in intervention outcomes precluded conclusions regarding optimal music interventions and doses for distinct clinical and public health scenarios.

Regional Innovation in Arts Provision Spawned by COVID-19: “It Became a Lifeline for a Lot of People Who Are Stuck at Home”

Although the impact of the global COVID-19 pandemic on the arts and cultural sector due to the closure of galleries, museums, arts venues, and other cultural assets represents a significant health risk, new opportunities for arts and cultural engagement have arisen. Interviews with 24 representatives including service providers and creative practitioners from 15 arts and cultural organizations within the Liverpool City Region were conducted. The aim was to examine the impact of COVID-19 on arts and cultural provision and on organizations and people providing these services, as well as to understand the perceptions of service providers and practitioners of the effects on those whom arts and cultural organizations serve, including those who would usually access arts through formal healthcare routes (e.g., through collaboration with health partners). Interview data were analyzed using framework analysis. Four overarching themes were identified: Response: Closures, adaptations, and new directions; Challenges of online provision; Value of online provision; and the future of the arts. The arts and cultural sector has innovated rapidly, notably with accelerated digitalisation. Alternative provision has been “a lifeline” for vulnerable groups, such as those with mental health difficulties. Arts organizations have been most effective in reaching vulnerable, isolated and disadvantaged populations when they have worked in close collaboration with health and social care providers. The implementation of hybrid provision is an important move forward for the sector in light of our findings that alternative modes of provision are advantageous additions to service as usual. Given the increasing concerns about the mental health sequelae of the pandemic in the UK, arts and cultural engagement could play a pivotal role in the future recovery period.

Lebenskompetenzen als Ressourcen für die psychosomatische Behandlung

Zusammenfassung. Lebenskompetenzen stellen Fähigkeiten dar, aus denen eine salutogene Lebensführung resultiert. Dadurch können sie sowohl als Basis als auch als wichtiger Indikator für den therapeutischen Prozess dienen. Hier wird ein Selbsteinschätzungsinstrument vorgestellt, welches an N = 2 054 Patientinnen und Patienten der stationären psychosomatischen Behandlung erhoben wurde und dessen Konstrukt in zweifacher Erhebung exploratorisch und konfirmatorisch validiert wurde. Der Fragebogen LK-18 umfasst 18 Items, die sich in 6 Faktoren mit je 3 Items gliedern lassen. Diese sind Wohlbefinden, Selbstregulation, Engagement, Sinnerleben, Selbstwirksamkeit, sowie Sozialkontakte. Die Werte für Cronbachs α liegen zwischen .74 und .85, im Gesamtwert bei .91. Die RMSEA von .062 deutet auf eine akzeptable Modellpassung hin. Als externe Korrelate zeigen psychosomatische Symptombelastungen nach dem ICD10-basierten Symptomrating (ISR) und posttraumatische Störungen meist mittlere negative Korrelationen im Bereich -.22 bis -.69 ( p < .001). Die Ergebnisse demonstrieren die Validität des Fragebogens und seine Veränderungssensitivität, wodurch der Einsatz in der psychosomatischen Diagnostik als geeignetes Zusatzinstrument als sinnvoll erachtet werden kann.

How Singing can Help People With Dementia and Their Family Care-Partners: A Mixed Studies Systematic Review With Narrative Synthesis, Thematic Synthesis, and Meta-Integration

Background: Recent research on the efficacy of music-based interventions for people with dementia have focused on specific outcomes and methods, and singing has been noted as a particularly beneficial activity. However, due to heterogeneity of research methods, there is a need to synthesise the findings of both quantitative and qualitative research in order to better understand both the impact and potential mechanisms of singing for people in this population.

Method: This systematic review included quantitative, qualitative and mixed-methods studies, and analysed these using a systematic mixed-studies synthesis (with a results-based convergent approach). Quantitative and qualitative data were initially synthesised using a narrative synthesis and thematic synthesis method, respectively, before a final meta-integration method was used to synthesise common themes across the two data forms.

Results: Electronic and hand search strategies revealed 1,815 relevant studies, 40 of which met the full eligibility criteria. Narrative synthesis of quantitative data revealed six key outcome areas (quality of life; psychological well-being; cognition; engagement; activities of daily living; care-partner well-being), and thematic synthesis of qualitative data generated seven themes relating to the impact and mechanisms of singing (pragmatic elements; social benefits; mood; identity; memory; flow-on effects; and relationships). Meta-integration identified four key areas relating to the impact and mechanisms of singing for people with dementia and care-partners: psychological well-being, quality of life, cognition, and care-partner well-being.

Conclusion: Results from the syntheses suggest that singing can positively impact the lives of people with dementia and their care-partners, although due to heterogeneity of study design and outcome measures, it is difficult to draw conclusions based on quantitative data alone. Qualitative data provides further context and insights from participant perspectives, and when integrated with quantitative data, contextual factors that may influence the benefits that participants experience from singing are revealed.

How Do Music Activities Affect Health and Well-Being? A Scoping Review of Studies Examining Psychosocial Mechanisms

Background: This scoping review analyzed research about how music activities may affect participants' health and well-being. Primary outcomes were measures of health (including symptoms and health behaviors) and well-being. Secondary measures included a range of psychosocial processes such as arousal, mood, social connection, physical activation or relaxation, cognitive functions, and identity. Diverse music activities were considered: receptive and intentional music listening; sharing music; instrument playing; group singing; lyrics and rapping; movement and dance; and songwriting, composition, and improvisation.

Methods: Nine databases were searched with terms related to the eight music activities and the psychosocial variables of interest. Sixty-three papers met selection criteria, representing 6,975 participants of all ages, nationalities, and contexts.

Results: Receptive and intentional music listening were found to reduce pain through changes in physiological arousal in some studies but not others. Shared music listening (e.g., concerts or radio programs) enhanced social connections and mood in older adults and in hospital patients. Music listening and carer singing decreased agitation and improved posture, movement, and well-being of people with dementia. Group singing supported cognitive health and well-being of older adults and those with mental health problems, lung disease, stroke, and dementia through its effects on cognitive functions, mood, and social connections. Playing a musical instrument was associated with improved cognitive health and well-being in school students, older adults, and people with mild brain injuries via effects on motor, cognitive and social processes. Dance and movement with music programs were associated with improved health and well-being in people with dementia, women with postnatal depression, and sedentary women with obesity through various cognitive, physical, and social processes. Rapping, songwriting, and composition helped the well-being of marginalized people through effects on social and cultural inclusion and connection, self-esteem and empowerment.

Discussion: Music activities offer a rich and underutilized resource for health and well-being to participants of diverse ages, backgrounds, and settings. The review provides preliminary evidence that particular music activities may be recommended for specific psychosocial purposes and for specific health conditions.

Correlation between vocal handicap and quality of life of popular singers

PURPOSE

To evaluate the correlation between vocal handicap index and the quality of life of popular singers.

METHODS

Transversal study. The data was collected through personal interviews and the use of the following instruments: World Health Organization Quality of Life-bref (WHOQOL-bref), the Modern Singing Handicap Index (MSHI) and a questionnaire about the singer's sociodemographic profiles and their self-perceived complaints. The level of significance was 5% (p <0.05). A descriptive analysis of the WHOQOL-bref and the IDCM scores was done using absolute and relative frequencies, mean and standard deviation. Quantitative variables were tested with Komolgorov-Smirnov, using non-parametric tests Kruskal Wallis and U Mann-Whitney. Correlation between the WHOQOL-bref and MSHI instruments was made with Spearman's Correlation Test. Reliability of the instruments tested by Cronbach's Alpha test.

RESULTS

Sample of 206 popular singers who were mostly man, single, with higher education or postgraduate and income of up to six minimum wages a month. Majority of them had high scores in WHOQOL-bref, indicating self-perception of good quality of life. Most singers report vocal complaints. The ones without vocal complaints showed self-perception of a better quality of life and lower vocal handicap with meaningful statistical significance in all WHOQOL-bref domains and MSHI subscales. Singers over 40 years old and with higher incomes showed better perception of their quality of life and lower vocal handicap. There was negative or weak correlation between the MSHI and the WHOQOL-bref.

CONCLUSION

Better quality of life had correlation among the group with lower vocal handicap.

Sing4Health: Randomised controlled trial of the effects of a singing group program on the subjective and social well-being of older adults

Group singing may be an optimal intervention strategy to promote active ageing and well-being; however, evidence with experimental validity is scarce. This study aims to fill this gap by analysing the effects of a 34-session singing group programme (SGP) on participants' subjective and social well-being and the mediating roles of social identification with the singing group and of self-esteem. An RCT with intervention (n = 89) and active waiting-list control (n = 60) conditions was conducted, and a mixed method quantitative and qualitative data collection and analysis were performed. Participants were mostly elderly day-care centre users (M = 76.66 years old; SD = 8.79) with low average levels of education and income. Structured measures of life satisfaction, positive and negative affect, self-esteem, loneliness, social identification and social well-being were collected, as well as interviews on the perceived benefits of participating in the SGP. Results showed significant effects of the SGP on the positive affect, social well-being and marginally on the self-esteem of the participants. The observed effects were sustained at the follow-up. Qualitative analysis corroborated the quantitative results. Mediation analysis showed indirect effects of social identification with the singing group on loneliness and social identification with the social care institution group; and of self-esteem on positive and negative affect.

"It All Makes Us Feel Together": Young People's Experiences of Virtual Group Music-Making During the COVID-19 Pandemic

We know little about the psychological experiences of children and young people who have participated in virtual group music-making during the Coronavirus disease (COVID-19) pandemic. Adopting a mixed-methods design, we worked across three music education hubs in the UK, with a total 13 virtual music groups. These included a range of mainstream ensembles, inclusive ensembles targeting young people with special educational needs and/or disabilities, and inclusive music production spaces, targeting young people from lower socio-economic backgrounds. Reported progress in intra- and inter-personal psychological outcomes was investigated using quantitative and qualitative staff session reports, which were collected since before the pandemic (n1 for in-person sessions = 87, n2 for virtual sessions = 68), and surveys distributed to tutors, young people, and their parents during the first and second United Kingdom (UK) national lockdowns (n3 for qualitative responses = 240, n4 for quantitative responses = 96). Satisfaction of three basic psychological needs of self-determination theory and their relation to joint music-making in virtual spaces was also observed in real time by the researchers performing quantitative checklist observations on 16 separate occasions. Findings indicated that virtual music groups represented a meaningful psychological resource for the participating children and young people, especially considering the lack of opportunities offered by their schools and other extra-curricular activities. Through their participation with virtual group music-making activities, young people used music as a tool for self-expression and emotion management, restored lost musical identities and confidence, and preserved treasured social connections. Virtual alternatives to group music-making appear to indirectly nurture the sense of belongingness, mediated by supportive staff behaviors, but their direct connection, which has been widely reported for in-person group music-making experiences, has not been observed in virtual music groups.

Aging and Health of American Indians and Alaska Natives: Contributions from the Native Investigator Development Program

Objectives: To describe recent advances in our knowledge regarding the health and illness of older American Indians and Alaska Natives, and factors underlying why this special population lives 5.5 years less than the 78.5 years of U.S. all races. Methods: The articles in this supplemental issue, authored by participants in a National Institutes of Health-sponsored early research career development program, examine high priority health concerns that contribute to the increased risk of Native elders for chronic disease and resulting impairment that compromise their life expectancy. Results: Important insights into the roles that racial discrimination, food security, hypertension, alcohol consumption, memory problems, and military service play in the health and well-being of older American Indians and Alaska Natives. Discussion: Early career faculty development programs focused on increasing the diversity of the scientific workforce not only promote greater racial and ethnic minority representation in the field of aging, but can simultaneously add to the knowledge base regarding the health status and function of often ignored, vulnerable older members of communities that suffer significant health disparities.

The Association of Cultural Participation and Social Engagement With Self-Reported Diagnosis of Memory Problems Among American Indian and Alaska Native Elders

Objective: This study examines the association of cultural participation and social engagement with self-reported diagnosis of memory problems among older American Indians and Alaska Natives (AI/ANs). Method: We conducted a cross-sectional study of 14,827 AI/ANs using data from the 2014-2017 cycle of the Identifying Our Needs: A Survey of Elders (ION). Logistic regression was used to examine the association of cultural participation and social engagement with self-reported diagnosis of memory problems. Results: Compared to older AI/ANs who reported high cultural participation and/or high social engagement, those characterized by low cultural participation and/or low social engagement exhibited significantly higher odds of a self-reported diagnosis of memory problems (OR = 1.863, 95% CI: [1.269, 2.734], p = .001). Discussion: Older AI/ANs who described either or both low cultural participation and low social engagement endorsed far more self-reported diagnoses of memory problems, suggesting a strong association that warrants further study for potential causality.

Non-pharmacological Approaches to Depressed Elderly With No or Mild Cognitive Impairment in Long-Term Care Facilities. A Systematic Review of the Literature

Introduction: Compared to old people who live at home, depressive symptoms are more prevalent in those who live in long-term care facilities (LTCFs). Different kinds of non-pharmacological treatment approaches in LTCFs have been studied, including behavioral and cognitive-behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy and life review/reminiscence. The aim of the current review was to systematically review non-pharmacological treatments used to treat depressed older adults with no or mild cognitive impairment (as described by a Mini Mental State Examination score > 20) living in LTCFs. Methods: A research was performed on PubMed and Scopus databases. Following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) flowchart, studies selection was made. The quality of each Randomized Controlled Trial was scored using the Jadad scale, Quasi-Experimental Design studies and Non-Experimental studies were scored based on the Newcastle-Ottawa Scale (NOS) Results: The review included 56 full text articles; according to the type of intervention, studies were grouped in the following areas: horticulture/gardening (n = 3), pet therapy (n = 4), physical exercise (n = 9), psychoeducation/rehabilitation (n = 15), psychotherapy (n = 3), reminiscence and story sharing (n = 14), miscellaneous (n = 8). Discussion and Conclusion: Despite mixed or negative findings in some cases, most studies included in this systematic review reported that the non-pharmacological interventions assessed were effective in the management of depressed elderly in the LTCFs context. Regrettably, the limitations and heterogeneity of the studies described above hinder the possibility to generalize and replicate results.