It just makes you feel really good : a narrative and reflection on the affordances of musical fandom across a life course

The study of how music may be important to health and well-being can be seen as an increasingly broad and interdisciplinary field. As issues of health and well-being are routinely understood within the wider context of life style and cultural engagement, musical experiences far outside the professional practices of music therapy and music medicine are now seen to offer “potent and preventative measures to enhance psychophysiological well-being reaching into almost every aspect of life”. Such shifts grow in part from the integration of more expansive definitions of health that underlay the field. Here health is a concept emphasised variously as a “quality of human interaction and engagement”, or “a quality of human co-existence”, a ‘performance’ of processes by which ‘self’ is realised into the world—mentally, physically and socially; whilst musical experiences have been suggested as an ‘immunogen behavior’, that is a health performing practice. This in turn has widened the scope of music and health studies to include any mode of musical participation that holds the potential to promote well-being. Consequently there is a growing interest in how ‘ordinary’ people in ‘everyday’ settings use music to facilitate health, and how self-made musical experiences are used “to regulate emotional or relational states or to promote well-being”, this “lay-therapeutic musicking in everyday life” being considered an important area alongside more specific professional practices. This paper seeks to contribute to this discourse through an exploration of the experiences of being a music fan, a particular form of musical participation that may hold a variety of implications for an individual’s health, well-being and quality of life

Hearing Loss

In this article we share our personal stories of the loss of a parent during the COVID-19-pandemic. The crisis demonstrated how the medical-scientific apparatus effectively responded to a global health emergency, but also revealed how end of life processes are professionalized in neoliberal societies, where dying and death are outsourced and sanitized, and grieving is increasingly pathologized. Drawing on our backgrounds in music and music therapy, we trace our own experiences of loss to illustrate aspects of our individual and shared bereavement process as it emerged over a 24-month period. We take an intuitive, arts-based, feminist-philosophical approach, where dying and mourning are understood as personal, social, and political events. The article is structured around the presentation of eight poetic fragments from Hearing Loss (Schmid and Halstead, 2023) a co-created digital exhibition on the theme of mourning which includes soundworks, images, narratives, short films, and poems. Through these intimate multi-modal pieces, we reflect how we do loss, and how we might speak about, and listen to, the existential, relational, and transitional experience of losing a loved one in midlife. Our work argues that practices of grieving should be encouraged, shared, and valued to ensure the mournability of every life

Association between clinical and MRI-detected imaging findings for people with midfoot pain, a cross-sectional study

Background: Midfoot pain is common but poorly understood, with radiographs often indicating no anomalies. This study aimed to describe bone, joint and soft tissue changes and to explore associations between MRI-detected abnormalities and clinical symptoms (pain and disability) in a group of adults with midfoot pain, but who were radiographically negative for osteoarthritis. Methods: Community-based participants with midfoot pain underwent an MRI scan of one foot and scored semi-quantitatively using the Foot OsteoArthritis MRI Score (FOAMRIS). Foot pain and disability were recorded using visual analog scales (VAS) and the Modified-Manchester Foot Pain Disability Index (MMFPDI). Associations were assessed for continuous data using Spearman’s Rho, and for categorical data, a Wilcoxon signed rank test. Linear regression was used to explore the association between participant-reported measures and MRI abnormalities, adjusted for age, sex and BMI. Results: Sixty-one participants (70% female, mean age 48.5 years, median BMI 28.6 kg/m2) were included. Median VAS pain was 31/100 mm (IQR 21–47) and median disability was 30/48 (IQR 26–36). There was a moderate association between midfoot pain severity and the number of joints exhibiting joint space narrowing; adjusted results suggested 31% (95% confidence interval 3%–68%) worse VAS pain with each additional affected joint. Greater numbers of joints with cysts were associated with worse VAS pain [14% (0%–31%)] and disability [1.1 units (0–2.2)]. Effusion/synovitis was associated with MMFPDI pain. No other MRI abnormalities were associated with sex, body mass and foot pain/disability measures. Bone marrow lesions, joint space narrowing, cysts and osteophytes occurred more frequently with age. MRI abnormalities were common, particularly in the talo-navicular joint, first and second cuneo-metatarsal joints. Those with dorsal foot pain had more multi-joint involvement, bone marrow lesions, joint space narrowing and cysts and for those with pain on midfoot movement, bone marrow lesions and cysts were reported. Conclusions: In people with midfoot pain, MRI-detected features of osteoarthritis and soft-tissue abnormalities were found, clustered in the medial and intermediate cuneiform joints. These features were more common with age but not associated with pain or disability measures. Younger people with dorsal midfoot pain exhibited early signs of bone and joint features of osteoarthritis and we recommend further imaging studies to determine the clinical and diagnostic significanceThe research is supported by the National Institute for Health Research (NIHR) infrastructure at Leeds. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The work was directly supported by Versus Arthritis studentship (grant no. 18256), the Versus Arthritis Experimental Osteoarthritis Treatment Centre (grant no. 20083) and Versus Arthritis Sports grant (no. 20194). JBA was supported by an NHMRC Early Career Fellowship (ID: 1120560). EMAH, AMK, PGC, DGM and ACR are supported in part by the NIHR Leeds BRC (NIHR203331

Bone marrow lesions and magnetic resonanceImaging–detected structural abnormalities in patients with midfoot pain and osteoarthritis: A cross-sectional study

To compare magnetic resonance imaging (MRI)–detected structural abnormalities in patients withsymptomatic midfoot osteoarthritis (OA), patients with persistent midfoot pain, and asymptomatic controls, and toexplore the association between MRI features, pain, and foot-related disability. One hundred seven adults consisting of 50 patients with symptomatic and radiographically confirmedmidfoot OA, 22 adults with persistent midfoot pain but absence of radiographic OA, and 35 asymptomatic adultsunderwent 3T MRI of the midfoot and clinical assessment. MRIs were read for the presence and severity of abnormal-ities (bone marrow lesions [BMLs], subchondral cysts, osteophytes, joint space narrowing [JSN], effusion-synovitis,tenosynovitis, and enthesopathy) using the Foot Osteoarthritis MRI Score. Pain and foot-related disability wereassessed with the Manchester Foot Pain and Disability Index. The severity sum score of BMLs in the midfoot was greater in patients with midfoot pain and no signs ofOA on radiography compared to controls (P= 0.007), with a pattern of involvement in the cuneiform–metatarsal jointssimilar to that in patients with midfoot OA. In univariable models, BMLs (ρ= 0.307), JSN (ρ= 0.423), and subchondralcysts (ρ= 0.302) were positively associated with pain (P< 0.01). In multivariable models, MRI abnormalities were notassociated with pain and disability when adjusted for covariates. In individuals with persistent midfoot pain but no signs of OA on radiography, MRIfindings suggestedan underrecognized prevalence of OA, particularly in the second and third cuneiform–metatarsal joints, where BMLpatterns were consistent with previously recognized sites of elevated mechanical loading. Joint abnormalities werenot strongly associated with pain or foot-related disability

Return to Learn ECHO: Telementoring for School Personnel to Help Children Return to School and Learning After Mild Traumatic Brain Injury

BACKGROUND: Return to learn (RTL) after mild traumatic brain injury (mTBI) presents unique challenges for school professionals. A multidisciplinary team approach is necessary yet training school professionals is logistically difficult. This paper describes an innovative pilot RTL program and its evaluation. METHODS: Utilizing the telehealth/telementoring program Project ECHO®(Extension for Community Healthcare Outcomes), this study utilized a multidisciplinary team of subject matter experts to deliver five 1-hour sessions across 5 cohorts of school-based professionals (total of 133 participants). The evaluation used a mixed-methods approach of post-session and post-program participant surveys and post-program participant focus groups. RESULTS: Participants who completed a post-program survey reported statistically significant improvements in essential aspects of RTL knowledge and self-efficacy. This included improvements in how to manage a student with an mTBI (44.8% to86.9%), benefits of early return to school for students following mTBI (31.8% to 86.9%), and the importance of written RTL policies/procedures (55.1% to 97.1%). CONCLUSIONS: This study demonstrates that RTL training via a telementoring approach may be a positive and effective way to train school-based professionals and improve knowledge and self-efficacy, especially when attending face-to-face trainings are difficult. This model has the potential to produce programmatic and systematic improvements for RTL education

Identification of molecular subphenotypes in two cohorts of paediatric ARDS

BACKGROUND: Two subphenotypes of acute respiratory distress syndrome (ARDS), hypoinflammatory and hyperinflammatory, have been reported in adults and in a single paediatric cohort. The relevance of these subphenotypes in paediatrics requires further investigation. We aimed to identify subphenotypes in two large observational cohorts of paediatric ARDS and assess their congruence with prior descriptions. METHODS: We performed latent class analysis (LCA) separately on two cohorts using biomarkers as inputs. Subphenotypes were compared on clinical characteristics and outcomes. Finally, we assessed overlap with adult cohorts using parsimonious classifiers. FINDINGS: In two cohorts from the Children\u27s Hospital of Philadelphia (n=333) and from a multicentre study based at the University of California San Francisco (n=293), LCA identified two subphenotypes defined by differential elevation of biomarkers reflecting inflammation and endotheliopathy. In both cohorts, hyperinflammatory subjects had greater illness severity, more sepsis and higher mortality (41% and 28% in hyperinflammatory vs 11% and 7% in hypoinflammatory). Both cohorts demonstrated overlap with adult subphenotypes when assessed using parsimonious classifiers. INTERPRETATION: We identified hypoinflammatory and hyperinflammatory subphenotypes of paediatric ARDS from two separate cohorts with utility for prognostic and potentially predictive, enrichment. Future paediatric ARDS trials should identify and leverage biomarker-defined subphenotypes in their analysis

Diagnosis and management in Rubinstein-Taybi syndrome:first international consensus statement

Rubinstein-Taybi syndrome (RTS) is an archetypical genetic syndrome that is characterised by intellectual disability, well-defined facial features, distal limb anomalies and atypical growth, among numerous other signs and symptoms. It is caused by variants in either of two genes (CREBBP, EP300) which encode for the proteins CBP and p300, which both have a function in transcription regulation and histone acetylation. As a group of international experts and national support groups dedicated to the syndrome, we realised that marked heterogeneity currently exists in clinical and molecular diagnostic approaches and care practices in various parts of the world. Here, we outline a series of recommendations that document the consensus of a group of international experts on clinical diagnostic criteria for types of RTS (RTS1: CREBBP; RTS2: EP300), molecular investigations, long-term management of various particular physical and behavioural issues and care planning. The recommendations as presented here will need to be evaluated for improvements to allow for continued optimisation of diagnostics and care.</p