A trio of music therapy reviews featured in last year’s Australian top 100 Cochrane Library downloads, with Music Therapy for depression coming in at number 7, Music Therapy for people with spectrum disorder at number 40 and Music Therapy for people with dementia at 76. Recently a new update of Music interventions for cancer patients took centre stage and made headlines around the world, finding that music may have beneficial effects on anxiety, pain, fatigue, depression and quality of life for people with cancer.
‘It’s great to see these reviews are the subject of so much interest and discussion,’ says Emma Donoghue, resident music therapist and evidence officer with Cochrane Australia. ‘Sometimes we find that people confuse music therapy with music education or entertainment, or perhaps think it involves mysterious crystals and incense. But these reviews help us highlight that music therapy is a well-established, research-based profession that supports the health and well-being of children and adults of every age, often at very difficult times in their lives. It’s an amazing profession to be a part of.’
Emma graduated from the University of Melbourne’s Masters of Music Therapy program two years ago, gaining the theoretical grounding and practical clinical placement experience necessary to pursue a career in the field. ‘Music therapists are trained to use music to support people to improve their health, functioning and wellbeing. You need to cover a lot of complex theoretical and practical territory to become accredited’ Emma explains. ‘But in simple terms, you look at particular age groups, conditions and settings and the different types of interventions that can meet the needs of individuals. In a session, a music therapist chooses and adapts music experiences to meet the needs, preferences and ability levels of the people that they are working with. Some of these music experiences include listening to music, singing familiar songs, playing instruments, improvising music on instruments or voice, song writing, moving to music, or discussing someone’s emotional reaction or meaning attached to a particular song or improvisation.’
‘The music is just one part of the equation though, as music therapy happens within the context of a therapeutic relationship. So you need to have essential skills to build these relationships, like rapport-building, empathy and counselling skills. What a person needs can change from session to session, or even within a single session, so the idea is to build a toolkit of music therapy techniques that you can draw on to meet the client’s changing needs in the moment. Throughout the training, your theoretical knowledge and practical skills are put into practice in various clinical placements within hospitals, schools, aged and palliative care, and community settings. These really give you a sense of the challenges and rewards of working with different populations, and sometimes they’re not what you’d expect.’
‘One of my early placements was at a respite care facility for people with progressive neurological conditions like MS and Motor Neurone Disease. I anticipated that this might be a sad or depressing experience, but despite the emotional challenges, it turned out be really rewarding to go in and do something positive to help each person in some way. And not with the usual interventions like feeding, medication and hygiene, but with something that recognised and connected with them as a person and enabled them to be something other than a long-term patient. This is so important given people can feel their identities are reduced to just this person in a hospital bed. The Australian Music Therapy Association just launched a campaign called RMTS change lives, which features six short animations highlighting the kind of work that we do with different populations. The first two focus on babies and children with disabilities, with more to follow in areas like mental health, aged care and palliative care. This is a great way to see how music therapists make a difference to individual patients and families alike.’
This focus on individual, personalised and responsive treatment is what differentiates the field of music therapy from music medicine, which is another area of increasing interest to researchers. The latter focuses more on the physiological impacts of music and does not involve a therapist. So for example a recent review in The Lancet looked at 7,000 patients who listened to pre-recorded music before, during and after surgery and found the experience of listening to music could actually lower the activity of the nervous system and reduce pulse rate, breathing and blood pressure. They also found pain, anxiety and even the need for pain medication were reduced.
Interestingly, the latest update of the Cochrane review of Music interventions for cancer patients includes and compares both music medicine and music therapy studies. It suggest that music therapy interventions lead to more consistent results across studies than music medicine studies, which is likely due to the fact that music therapists are trained to meet the patient’s in-the-moment needs when offering live music, rather than offering a limited selection of pre-recorded music which mightn’t be suitable for all patients. The review also found that participants overwhelmingly preferred the music therapy sessions because of the personal attention and care, the creativity of the interactive music making, and the opportunity for emotional expression through singing and playing instruments.
This resonates with Emma and her experiences of music therapy to date. ‘I worked with an older lady with MS, who was weak, in pain, and had a lot of trouble sleeping. Each week I’d visit and she would request different music – be it bright and sparky or something romantic. Sometimes she would fall asleep while I played and sang her preferred songs, which was great as she was so tired yet had trouble sleeping. She would say to me ‘Even if I’m asleep, just keep playing dear. When you’re here I just feel better.’’
Bringing you Cochrane evidence in 13 different languages
Making Cochrane evidence accessible to non-English speakers is a priority for us. More than 2,500 translations of Cochrane Review summaries have been published in the first half of 2016 alone. Translation activities are led by local Cochrane groups and their translator communities, the majority of which are volunteer based. Due to the length of Cochrane Reviews, our teams focus on the abstract and or the Plain Language Summary.
Find Cochrane evidence in different languages: Cochrane evidence is currently translated into 13 languages: Croatian, French, German, Japanese, Korean, Malay, Polish, Portuguese, Russian, Simplified Chinese, Spanish, Tamil and Traditional Chinese. Each language has its own version of cochrane.org; you can view translations by clicking on the languages that appear across the top of each page.
Cochrane Podcasts in different language: Cochrane podcasts offer a short summary of a recent Cochrane review and have been recorded in 33 languages.
Most translated Reviews: The links below will take you to the English language version of our most translated Reviews. Languages these Reviews have been translated into are listed across the top of the page. To read the Review in another language, simply click on the language and it will take you to the translation.
· Interventions for preventing obesity in children
· Electronic cigarettes for smoking cessation and reduction
· Vitamin C for preventing and treating the common cold
· Continuous support for women during childbirth
Our translation achievements for the first half of 2016:
Feature Review: Population-level interventions in government jurisdictions for dietary sodium reduction
National government initiatives have the potential to achieve population-wide reduction in salt intake
In almost all countries worldwide, most people eat too much salt. This can cause high blood pressure, which can lead to health problems, such as heart disease and stroke. To reduce the amount of salt eaten, governments in many countries have developed national salt reduction initiatives. These initiatives may be individually oriented, such as providing education about salt, or structurally oriented to improve or offset the deficiencies which prevent people from obtaining food with lower salt. As the number of population-based initiatives to reduce salt rise worldwide, it is important for policy-makers to identify which population-level intervention are impactful and cost-effective.
A team of Cochrane authors based in Australia and Canada worked with Cochrane Public Health to examine whether national salt reduction initiatives have been effective in reducing the amount of salt consumed in those populations. 15 national initiatives, including more than 260,0000 were included, with 10 initiatives providing sufficient date for quantitative analysis. These were mostly conducted in high income countries. The quality of the data was rated to be very low given the nature of the interventions does not lend to using controlled study design.
Population-level interventions in government jurisdictions for dietary sodium reduction have the potential to result in population-wide reductions in salt intake from pre-intervention to post-intervention, particularly if they have more than one intervention activity and incorporate interventions of a structural nature (e.g. large-scale efforts to lower the salt content of food products at the time of production), and particularly amongst men. Implementation of future initiatives should embed more effective means of evaluation to help us better understand the variation in the effects.
This Cochrane Review excluded a larger number of national salt reduction strategies because the data lacked pre and/or post data points which are needed to examine the impact of the intervention. There were 15 included initiatives the Review but with a wide variation in the elements they included, as well as the quality of evidence in their evaluation. For these reasons, it is difficult to interpret the current evidence and we warrants more research. This Review provides some evidence that national sodium reduction initiatives that are multi-component and include activities of a structural nature, such as policies to lower the salt levels in food in specific settings, appear to be more effective than single-component initiatives, such as information campaigns.
Read the full Cochrane Review
Visit the Cochrane Public Health website
Cochrane podcasts deliver the latest Cochrane evidence in an easy to access audio format, allowing you to stay up to date on newly published reviews wherever you are.
Each Cochrane podcast offers a short summary of a recent Cochrane review from the authors themselves. They have been recorded in 33 languages and are brief, allowing everyone from healthcare professionals to patients and families to hear the latest Cochrane evidence in under five minutes.
Whether you listen in your office, on your daily commute or even in the bath, Cochrane podcasts offer a quick and easy way to keep up with the latest evidence from the Cochrane Library.Wednesday, November 9, 2016
"What are systematic reviews?"
If you’re a Cochrane contributor and have ever attempted to explain Cochrane’s work to someone, chances are you’ve tried to answer this question. And if you’re reading this because you’re new to Cochrane and the work we do, you may be wondering about this too.
Thanks to a team of creative colleagues from Cochrane Consumers and Communication, we’re pleased to share a video resource which answers this question clearly and simply for people who may not be familiar with the concept of systematic reviews: what they are, how researchers prepare them, and why they’re an important part of making informed decisions about health - for everyone. You can find this video on Cochrane’s YouTube channel, and we hope you’ll share and spread the word about the importance of evidence!Tuesday, April 4, 2017
Supervised regular use of fluoride mouthwash by children and adolescents is associated with a large reduction in tooth decay in permanent teeth
Tooth decay is a health problem worldwide, affecting the vast majority of adults and children. Repair and replacement of decayed teeth is costly in terms of time and money, and is a major drain on the resources of healthcare systems. Preventing tooth decay in children and adolescents is regarded as a priority for dental services and is considered more cost-effective than treatment. Use of fluoride, a mineral that prevents tooth decay, is widespread. As well as occurring naturally, fluoride is added to the water supply in some areas, and is used in most toothpastes and in other products that are available to varying degrees worldwide. As an extra preventive measure, fluoride can be applied directly to teeth as mouthrinses, lozenges, varnishes, and gels.
Fluoride mouthrinse has frequently been used under supervision in school-based programmes to prevent tooth decay. Supervised (depending on the age of the child) or unsupervised fluoride mouthrinse needs to be used regularly to have an effect. Recommended procedure involves rinsing the mouth one to two minutes per day with a less concentrated solution containing fluoride, or once a week or once every two weeks with a more concentrated solution. Because of the risk of swallowing too much fluoride, fluoride mouthrinses are not recommended for children younger than six years of age.
A team of Cochrane authors based in the United Kingdom worked with Cochrane Oral Health to investigate how effective and safe the use of fluoride mouthrinse are for preventing tooth decay in children and adolescents compared with placebo (a mouthrinse without the active ingredient fluoride) or no treatment. The team included 37 randomized controlled trials with 15,813 children from age six to 14. The evidence was rated to be of moderate quality.
The review found that supervised regular use of fluoride mouthrinse by children and adolescents is associated with a large reduction in caries increment in permanent teeth. Most of the evidence evaluated use of fluoride mouthrinse supervised in a school setting, but the findings may be applicable to children in other settings with supervised or unsupervised rinsing, although the size of the preventive effect is less clear. Very little evidence is available to assess adverse effects.
- Read the full Cochrane Review
- Visit the Cochrane Oral Health Website
- Read the Plain Language Summary
- Listen to the podcast
- ‘Rinse and repeat: fluoride mouthrinses can prevent tooth decay in children’: blog post on Evidently Cochrane
- ‘Supervised use of fluoride mouthrinse results in large reductions in decay in children’s permanent teeth’: blog post on Cochrane Oral Health Editorial base blog
- 'Fluoride mouthrinse: regular supervised use reduces tooth decay in children': blog post on The Dental Elf
Thursday, September 15, 2016
Browse through our Tumblr account and get a visual dose of Cochrane evidence!
Tumblr is a microblogging social networking website – a place where people post images and animated graphics. On our Cochrane Tumblr account, you can view visual summaries of Cochrane evidence.
If you have a Tumblr account, you can follow us to add Cochrane evidence to your feed. If you don’t have a Tumblr account, just stop by and browse by health area or language – we have posts in seven different languages!
Cochrane Tumblr: https://cochraneblogshots.tumblr.com/
International Clinical Trials' Day is celebrated around the world each year on or close to 20 May, commemorating the day in 1747 on which James Lind began the first known controlled trial, comparing different treatments for scurvy then in common use among sailors in the British Royal Navy. (Watch a video explaining the trial to see history in the making.) International Clinical Trials' Day seeks to raise awareness of the importance of research to health care, and draw attention to ways in which the research can become more relevant to practice.
The European Clinical Research Infrastructures Network (ECRIN)helps to co-ordinate the annual commemoration, providing a focal point for international events, meetings, debates, and other celebrations of clinical research. The highlight of each year is a series of public lectures and discussions, held in a different European city. The 2017 celebrations are taking place on May 19th in Lisbon, Portugal. A range of speakers will present a variety of relevant topics, including ‘Data sharing and reuse: attitudes and practices in multinational clinical research’, with healthcare professionals and researchers from across Europe in attendance.
Learn about Cochrane systematic reviews and how clinical trials are used:
As part of our own commemoration of International Clinical Trials’ Day, Cochrane is highlighting a series of recent reviews using clinical study data and regulatory reports, as well as published reports in peer-reviewed journals:
Additional plerixafor to granulocyte colony-stimulating factors for haematopoietic stem cell mobilisation for autologous transplantation in people with malignant lymphoma or multiple myeloma
Blood pressure lowering efficacy of renin inhibitors for primary hypertension
And learn more about the issues relevant to clinical research in the latest of our commemorating the event.
Post and find other relevant information and resources on Twitter by using the hashtag #ICTD2017.Friday, May 19, 2017