• Which behavioural and exercise interventions targeting fatigue show the most promise in multiple sclerosis? A systematic review with narrative synthesis and meta-analysis

      Harrison, Dr Anthony M.; Safari, Dr Reza; Norton, Dr Sam; Marietta L van der Linden, Dr; Picariello, Dr Federica; Thomas, Dr Sarah; White, Dr Claire; Mercer, Tom; Moss-Morris, Rona; University of Derby (Elsevier, 2019-08-28)
      Fatigue is a common and highly debilitating symptom of multiple sclerosis (MS). This meta-analytic systematic review with detailed narrative synthesis examined randomised-controlled (RCTs) and controlled trials of behavioural and exercise interventions targeting fatigue in adults with MS to assess which treatments offer the most promise in reducing fatigue severity/impact. Medline, EMBASE and PsycInfo electronic databases, amongst others, were searched through to August 2018. Thirty-four trials (12 exercise, 16 behavioural and 6 combined; n = 2,434 participants) met inclusion criteria. Data from 31 studies (n = 1,991 participants) contributed to the meta-analysis. Risk of bias (using the Cochrane tool) and study quality (GRADE) were assessed. The pooled (SMD) end-of-treatment effects on self-reported fatigue were: exercise interventions (n = 13) -.84 (95% CI -1.20 to -.47); behavioural interventions (n = 16) -.37 (95% CI -.53 to -.22); combined interventions (n = 5) -.16 (95% CI: -.36 to .04). Heterogeneity was high overall. Study quality was very low for exercise interventions and moderate for behavioural and combined interventions. Considering health care professional time, subgroup results suggest web-based cognitive behavioural therapy for fatigue, balance and/or multicomponent exercise interventions may be the cost-efficient therapies. These need testing in large RCTs with long-term follow-up to help define an implementable fatigue management pathway in MS.
    • Nurses' knowledge and practice of pressure ulcer prevention and treatment: an observational study

      Saleh, Mohammad; Papanikolaou, Panos; Nassar, Omayyah; Shaheen, Abeer; Anthony, Denis; The University of Jordan; University of Leeds (Elsevier, 2019-10-25)
      To assess nurses’ knowledge on pressure ulcer (PU) prevention and treatment in Jordan, and the frequency of and factors influencing nurses’ implementation of PU prevention and treatment interventions. Highly educated and experienced nurses can provide effective PU care; however, previous studies highlighted poor knowledge and implementation of PU care. Design: A correlational study examining nurses’ knowledge of PU prevention and frequency of PU preventive actions in Jordanian hospitals. Participants were 377 nurses and 318 patients from 11 hospitals. Data were collected to quantify the frequency of nurses’ implementation of pressure ulcer prevention and treatment interventions for patients suffering from PUs and/or at risk of PU development using a self-reported cross-sectional survey and prospective 8-hour observation. For observed PU prevention while type of hospital and number of beds in units were significant it is not known without further work if this is replicable. For observed PU treatment, linear regression analysis revealed significant negative beta values for more than 50 beds in clinical unit (β=-2.49). The study addressed new factors, facilitating the provision of prevention and treatment strategies to PU development, including type of clinical institution and number of beds in clinical unit.
    • Using figured worlds to explore parents' attitudes and influences for choosing the content of primary school packed lunches

      Jackson, Jessica; Giles, David; Gerrard, Clarabelle; University of Derby (MAG Online Library, 2019-09-30)
      This study aimed to explore parents' attitudes toward the content of their child's packed lunch, school healthy eating policies, and their child's wishes. Furthermore, in this context, it also aimed to explore perceptions of health promotional materials and how these interventions interplayed with issues parents felt were important. The ideology of ‘figured worlds’ was used as a stance to consider the relationship between bounding structures within society and the individual positional identity. Focus groups interviews obtained qualitative data of parents' multiple viewpoints. Iterative categorisation was employed as a method of analysis to observed findings in the data in relation to the individuals as intersubjective beings and their behaviour influenced by environmental conditions. A cross selection of local schools and parenting network were approached. Snowballing techniques were implemented highlighting the inclusion criteria. Participants were required to have a child attending primary school who they provided a packed lunch for on a regular basis. Three umbrella themes were identified: ‘The parents ideal’, ‘The child's desires’, and ‘Inconsistencies of the governing school’. A fourth theme, ‘The health promotional intrusion’ provides insight into the parents' reality when being presented with health promotional materials. This study has highlighted the complex, conflicting interplay between parents' ideal for their child's diet, their child's desires and the governing approaches to encouraging healthier choices. This understanding is vital when designing specific interventions to meet the needs of individuals, which prevent, protect and promote a healthy lifestyle for children and their families.
    • A systematic review on the effects of group singing on persistent pain in people with long‐term health conditions

      Irons, J. Yoon; Sheffield, David; Ballington, Freddie; Stewart, Donald E; Health and Social Care Research Centre, University of Derby (Wiley, 2019-09-23)
      Singing can have a range of health benefits; this paper reviews the evidence of the effects of group singing for chronic pain in people with long‐term health conditions. We searched for published peer‐reviewed singing studies reporting pain measures (intensity, interference and depression) using major electronic databases (last search date 31 July 2018). After screening 123 full texts, 13 studies met the inclusion criteria: five randomized controlled trials (RCTs), seven non‐RCTs and one qualitative study. Included studies were appraised using Downs and Black and the Critical Appraisals Skills Programme quality assessments. Included studies reported differences in the type of singing intervention, long‐term condition and pain measures. Due to the high heterogeneity, we conducted a narrative review. Singing interventions were found to reduce pain intensity in most studies, but there was more equivocal support for reducing pain interference and depression. Additionally, qualitative data synthesis identified three key linked and complementary themes: physical, psychological and social benefits. Group singing appears to have the potential to reduce pain intensity, pain interference and depression; however, we conclude that there is only partial support for singing on some pain outcomes based on the limited available evidence of varied quality. Given the positive findings of qualitative studies, this review recommends that practitioners are encouraged to continue this work. More studies of better quality are needed. Future studies should adopt more robust methodology and report their singing intervention in details. Group singing may be an effective and safe approach for reducing persistent pain and depression in people with long‐term health conditions.
    • Student pro-sociality: measuring institutional and individual factors that predict pro-social behaviour at university

      Stiff, Chris; Rosenthal-Stott, Harriet E. S.; Wake, Stephanie; Woodward, Amelia; Keele University; Durham University; York University, Toronto (Springer, 2019-04-18)
      Students operate within a bounded social context and often face decisions regarding whether to pursue selfish or group-level benefit. Yet little work has examined what predicts their behaviour towards fellow students. This work addresses this gap by investigating what factors may predict students’ performance of pro-social actions at university, and how an institution may maximise such behaviour. Study 1 created the student pro-sociality scale, used to measure these tendencies in students. In study 2, 428 students from 25 UK universities took part in an online survey study using this scale ,and several other pre-existing measures of possible predictors. Analysis suggested that of those factors examined, role clarity, affective commitment, empathy, and perspective-taking emerged as the most influential. This first foray into this area can now inspire further research in finding the effective ways of fostering pro-social behaviour in students.
    • Group singing has multiple benefits in the context of chronic pain: an exploratory pilot study

      Irons, J. Yoon; Kuipers, Pim; Wan, Aston; Stewart, Donald E; Health and Social Care Research Centre, University of Derby (Elsevier, 2019-09-05)
      This paper reports findings of a pilot singing intervention to assist people living with chronic pain. Pain Management Clinic out-patients participated in 10 weekly group singing sessions. Benefits of the intervention and its impact on participants’ (N=4) experience of pain were explored qualitatively. Three main themes comprising over 20 separate codes indicated physical, psychological and social dimensions associated with the intervention. People with chronic pain identify multiple benefits from participating in a group singing program. Group singing in chronic pain settings has multiple benefits; and can be a beneficial adjunct to conventional pain management care and nursing, which may positively complement clinical outcomes.
    • The eye of the beholder

      Bird, Jamie; University of Derby (Routledge, 2019-07-30)
      This chapter addresses issues that arose from being a male researcher and art therapist conducting arts-based research with women who had experienced domestic violence and abuse. Engaging in such research required that I critically engage with issues of gender within the context of conducting research. Through the lens of one particular vignette taken from a larger study, this paper will engage with broader ideas about gender and the conducting of arts-based research and art therapy. Whilst this chapter will have relevance for those men engaged in research or art therapy that involves aspects of domestic violence and abuse, it will also have relevance to those who are interested in wider discussions to be had about the influence of gender upon relationships within therapy and research. This has always been a topic worthy of sustained investigation, but the contemporary emergence within public discourse about abuses of male privilege within various professions make this an especially important subject to attend to. Drawing upon the work of Sandra Harding (1998, 2004), Jeff Hearn (1998) and Ann Murphy (2012), I will explore how feminist standpoint theory and reflexivity helped to manage, and make sense of, the concerns and anxieties that arose whilst conducting research into violence against women. Anxieties about research becoming therapy merged with anxieties about being a male researcher working with women who had experienced domestic violence and abuse. Whilst this chapter does not aim to outline in depth what an arts-based research methodology looks like within the context of studying domestic violence and abuse, it begins by describing the methodology in enough detail to provide a context within which the nature of the research process can be appreciated. The findings of the research are presented in sufficient detail to allow the overall findings of the research to be understood. There then follows examples of words and images produced by one woman, who used her participation as a way of ensuring that she was seen clearly by myself and by other research participants. This aspect of wanting to be seen became an embodiment of the need to acknowledge my own standpoint and reflexive position as a male researcher. Evaluative comments about participation made by other women are used to show how vulnerability was a feature of taking part in this research for both participants and for me. The concept of vulnerability is examined with reference made to ideas about imagination and empathy from the perspective of feminist philosophy, which in turn helps to shape a discussion about the place of gender within research, art therapy, and the boundary between them. In keeping with the principles of feminist standpoint theory and strong objectivity, as set forth by Harding (1998), this chapter is written from a first-person perspective.
    • Parental and health professional evaluations of a support service for parents of excessively crying infants

      Bamber, Deborah; Powell, Charlotte; Long, Jaqui; Garratt, Rosie; Brown, Jayne; Rudge, Sally; Morris, Tom; Bhupendra Jaicim, Nishal; Plachcinski, Rachel; Dyson, Sue E.; et al. (Springer Nature/ BMC, 2019-08-22)
      The ‘Surviving Crying’ study was designed to develop and provisionally evaluate a support service for parents of excessively crying babies, including its suitability for use in the United Kingdom (UK) National Health Service (NHS). The resulting service includes three materials: a website, a printed booklet, and a Cognitive Behaviour Therapy (CBT) programme delivered to parents by a qualified professional. This study aimed to measure whether parents used the materials and to obtain parents’ and NHS professionals’ evaluations of whether they are fit for purpose. Parents were asked about participating in a randomised controlled trial (RCT) to evaluate the materials fully in health service use. Methods: Participants were 57 parents with babies they judged to be crying excessively and 96 NHS Health Visitors (HVs). Parental use and parents’ and HVs’ ratings of the Surviving Crying materials were measured. Results: Thirty four parents reported using the website, 24 the printed booklet and 24 the CBT sessions. Parents mostly accessed the website on mobile phones or tablets and use was substantial. All the parents and almost all HVs who provided data judged the materials to be helpful for parents and suitable for NHS use. If offered a waiting list control group, 85% of parents said they would have been willing to take part in a full RCT evaluation of the Surviving Crying package. Discussion and conclusions: The findings identify the need for materials to support parents of excessively crying babies within national health services in the UK. The Surviving Crying support package appears suitable for this purpose and a full community-level RCT of the package is feasible and likely to be worthwhile. Limitations to the study and barriers to delivery of the services were identified, indicating improvements needed in future research.
    • Singing as an adjunct therapy for children and adults with cystic fibrosis.

      Irons, J. Yoon; Petocz, Peter; Kenny, Dianna T; Chang, Ann B.; University of Derby (2019-07-12)
      Cystic fibrosis is a genetically inherited, life‐threatening condition that affects major organs. The management of cystic fibrosis involves a multi‐faceted daily treatment regimen that includes airway clearance techniques, pancreatic enzymes and other medications. Previous studies have found that compliance with this intensive treatment is poor, especially among adolescents. Because of both the nature and consequences of the illness and the relentless demands of the treatment, many individuals with cystic fibrosis have a poor quality of life. Anecdotal reports suggest that singing may provide both appropriate exercise for the whole respiratory system and a means of emotional expression which may enhance quality of life. This is an update of a previously published review. To evaluate the effects of singing as an adjunct therapy to standard treatment on the quality of life, morbidity, respiratory muscle strength and pulmonary function of children and adults with cystic fibrosis. We searched the Group's Cystic Fibrosis Trials Register and the Cochrane Central Register of Controlled Trials. Date of latest search: 07 January 2019. We also searched major allied complementary data bases, and clinical trial registers. Additionally, we hand searched relevant conference proceedings and journals. Date of latest search: 28 March 2019. Randomised controlled trials in which singing (as an adjunct intervention) is compared with either a control intervention (for example, playing computer games or doing craft activities) or no singing in people with cystic fibrosis. Results of searches were reviewed against pre‐determined criteria for inclusion. Only one eligible trial was available for analysis. Since only one small study (n = 40) was included, no meta‐analysis could be performed. The included randomised controlled study was of parallel design and undertaken at two paediatric hospitals in Australia. The study evaluated the effects of a singing program on the quality of life and respiratory muscle strength of hospitalised children with cystic fibrosis (mean age 11.6 years, 35% male). While the singing group received eight individual singing sessions, the control group participated in preferred recreational activities, such as playing computer games or watching movies. This study was limited by a small sample size (51 participants) and a high drop‐out rate (21%). There were no differences between the groups at either post‐intervention or follow‐up; although by the end of treatment there were some improvements in some of the domains of the quality of life questionnaire Cystic Fibrosis Questionnaire‐Revised (e.g. emotional, social and vitality domains) for both singing and control groups. For the respiratory muscle strength indices, maximal expiratory pressure at follow‐up (six to eight weeks post‐intervention) was higher in the singing group, mean difference 25.80 (95% confidence interval 5.94 to 45.66). There was no difference between groups for any of the other respiratory function parameters (maximal inspiratory pressure, spirometry) at either post‐intervention or follow‐up. No adverse effects were observed in the singing group; adverse events for the control group were not reported in the paper. There is insufficient evidence to determine the effects of singing on quality of life or on the respiratory parameters in people with cystic fibrosis. However, there is growing interest in non‐medical treatments for cystic fibrosis and researchers may wish to investigate the impact of this inexpensive therapy on respiratory function and psychosocial well‐being further in the future.
    • Online research in health

      Anthony, Denis; University of Derby (Sage, 2019-04-30)
      This chapter shows some of the ways to use online resources in health research. It looks not only at internet-based data sources but also more widely at some of the clinical databases to illustrate the advantages and limitations of using these for research. In general, using internet-based resources can be make health research quicker and less labour intensive with rapid access to data and references. It can also provide tools to carry out data collection and analysis. However, researchers may have to learn how to use the tools available and not all health data are available. Some clinical databases are closed systems for reasons of patient confidentiality. These systems may be web-based but are on intranets rather than on the public internet with wider access – such as those that are part of hospital information and support systems (HISS).
    • Prevalence of pressure ulcers in long term care: A global review.

      Anthony, Denis Martin; Alosoumi, Dalyal; Safari, Reza; University of Derby (Mark Allen Healthcare, 2019)
      To identify the prevalence and incidence of pressure ulcers in people with long term conditions resident in care homes or nursing homes . We followed the PRISMA guideline for systematic reviews however due to funding constraints we do not claim this review to be systematic but it is a narrative review informed by PRISMA. We searched Embase, Medline and CINHAL for observational studies reporting incidence or prevalence data. Data reported relevant head to toe examination of the pressure ulcer in residence of care or nursing homes. Internat and external validity of the included studies were assessed using the checklist devised by Hoy et al (2012). Seventeen studies met the inclusion criteria an included in the study. Some studies gave a full breakdown by grade, some only gave overall figures and some excluded grade I pressure ulcers. However within those constraints certain patterns are clear. Prevalence rates varied from 3.4% to 32.4% and large differences in prevalence in different countries was not explained by methodological differences. While some countries such as Germany, the Netherlands and the USA had robust data some countries such as the UK had none. Pressure ulcers are a common problem in long term care. However there are substantial differences between countries and many countries have no published data.
    • Evaluating clinical placements in Saudi Arabia with the CLES+T scale

      Anthony, Denis; Al-Anazi, Norah; Alosaimi, Dalyal; Pandaan, Isabelita; Dyson, Sue; University of Derby (Elsevier, 2019-07-09)
      The clinical learning environment and supervision (CLES) tool has been enhanced with an additional sub-scale for measuring the quality of nurse teacher’s involvement to form the CLES+T scale. It has been widely used in many countries to evaluate clinical placements. Here we report data from Saudi Arabia. The CLES+T was employed to measure satisfaction among student nurses concerning their clinical learning environment. Linear regression was used to determine relationships of various variables to the outcomes of total CLES+T score and those of its subscales. Students were generally satisfied with their placements. For female students the number of visits of the nurse tutor was positively associated with most subscales and with the total score. For males, who had fewer visits of nurse tutor, there was no such association. Nurse tutor visits are positive in terms of clinical placement evaluation by female student nurses. Saudi nursing students are generally similar to students in other international studies in terms of their appraisal of clinical placements.
    • An agenda for best practice research on group singing, health, and well-being

      Dingle, Genevieve A.; Clift, Stephen; Finn, Saoirse; Gilbert, Rebekah; Groarke, Jenny M; Irons, J. Yoon; Jones-Bartoli, Alice; Lamont, Alexandra; Launay, Jacques; Martin, Eleanor S; et al. (Sage, 2019-07-10)
      Research on choirs and other forms of group singing has been conducted for several decades and there has been a recent focus on the potential health and wellbeing benefits, particularly in amateur singers. Experimental, quantitative and qualitative studies show evidence of a range of biopsychosocial and wellbeing benefits to singers; however, there are many challenges to rigour and replicability. To support the advances of research into group singing, the authors met and discussed theoretical and methodological issues to be addressed in future studies. The authors are from five countries and represent the following disciplinary perspectives: music psychology, music therapy, community music, clinical psychology, educational and developmental psychology, evolutionary psychology, health psychology, social psychology, and public health. This paper summarises our collective thoughts in relation to the priority questions for future group singing research, theoretical frameworks, potential solutions for design and ethical challenges, quantitative measures, qualitative methods, and whether there is scope for a benchmarking set of measures across singing projects. With eight key recommendations, the paper sets an agenda for best practice research on group singing.
    • The acceptability of iterative reconstruction algorithms in head CT: An assessment of sinogram affirmed iterative reconstruction (SAFIRE) vs. filtered back projection (FBP) using phantoms

      Harris, Matine; Huckle, John; Anthiny, Denis; Charnock, Paul; University of Leeds (Elsevier, 2017-05-31)
      Computed tomography (CT) is the primary imaging investigation for many neurologic conditions with a proportion of patients incurring cumulative doses. Iterative reconstruction (IR) allows dose optimization, but head CT presents unique image quality complexities and may lead to strong reader preferences. OBJECTIVES: This study evaluates the relationships between image quality metrics, image texture, and applied radiation dose within the context of IR head CT protocol optimization in the simulated patient setting. A secondary objective was to determine the influence of optimized protocols on diagnostic confidence using a custom phantom. METHODS AND SETTING: A three-phase phantom study was performed to characterize reconstruction methods at the local reference standard and a range of exposures. CT numbers and pixel noise were quantified supplemented by noise uniformity, noise power spectrum, contrast-to-noise ratio (CNR), high- and low-contrast resolution. Reviewers scored optimized protocol images based on established reporting criteria. RESULTS: Increasing strengths of IR resulted in lower pixel noise, lower noise variance, and increased CNR. At the reference standard, the image noise was reduced by 1.5 standard deviation and CNR increased by 2.0. Image quality was maintained at </=24% relative dose reduction. With the exception of image sharpness, there were no significant differences between grading for IR and filtered back projection reconstructions. CONCLUSIONS: IR has the potential to influence pixel noise, CNR, and noise variance (image texture); however, systematically optimized IR protocols can maintain the image quality of filtered back projection. This work has guided local application and acceptance of lower dose head CT protocols.
    • A group singing program improves quality of life: An international study

      Irons, J. Yoon; Hancox, Grenville; Vella-Burrows, Trish; Han, E-Y; Chong, H-J; Sheffield, David; Stewart, Donald E; Health and Social Care Research Centre, University of Derby (University of Derby, 2019-06-05)
      People with Parkinson’s (PwPs) may experience stigma, isolation, stress and anxiety due to the chronic nature of Parkinson’s. Complementary therapies, including singing, have been reported to impact positively on quality of life (QoL) in PwPs. This paper reports on an international trial of Sing to Beat Parkinson’s®, a community group singing program, involving PwPs from Australia, the UK, and South Korea on QoL and mental well-being. PwPs (N=95; mean age=70.26; male 45%) participated in a standardized 6-month weekly group singing program, which included breathing exercises, vocal warm-ups and preferred song singing. PDQ39 and modified DASS21 were administered at baseline and follow-up to assess QoL and mental well-being, respectively. MANOVA and ANOVAs were performed with significance set as p<.05. MANOVA showed statistically significant multivariate effects of Time, Country, Time by Country and Time by Gender interactions on QoL. Follow-up univariate ANOVAs revealed main effects of Time on Stigma and Social Support domains of QoL; both improved. Further, MANOVA revealed a multivariate effect of Time on mental well-being; anxiety and stress significantly decreased from pre-test to post-test. This first international singing study with PwPs demonstrated that group singing enhanced some aspects of quality of life and mental well-being. Participating in a weekly group singing program for a 6-month period impacted positively on social support, and feeling stigmatized, as well as reductions in anxiety and stress. The findings are encouraging and warrant further research using more robust designs that include comparator groups.
    • Cochrane systematic review singing for people with parkinson’s: preliminary findings

      Irons, J. Yoon; coren, Esther; Young, Megan K; Gschwandtner, Manfred; Stewart, Donald E; Mellick, George D; Health and Social Care Research Centre, University of Derby (University of Derby, 2019-06-05)
      This is a Conference (5th World Parkinson's Congress) poster based on the on-going Cochrane Systematic review on the effects of singing for people with Parkinson's.
    • ‘Youth Working’ youth workers: Filling the student support void

      Howell, T.J.; University of Derby (TAG, 2018-06-28)
      Initial findings from a replication of the the Krause and Coates (2008) study to examine the seven scales of student engagement. Recruitment to undergraduate youth work programmes are at risk, with programmes closing and many of those left struggling with unsustainably low numbers. However, numbers of younger applicants is growing. They are acquiring suitable experience from a range of sources, including the NCS model of recruiting from within, leaves school and college leavers with sufficient youth work experience to start a programme, albeit with limited life experience. Furthermore, there has been a spike of under graduate students who want to purse a career in youth work, after positive experiences of receiving youth work interventions, compounded by increasing numbers of applicants with support needs, including learning difficulties and a wide spectrum of mental health needs. Mature applicants still apply wihtout formal qualifications, and all students have to unlearn their experiences of schooling to maximise the transformational potential of undergraduate yoth work study. This session will explore the seven scales of engagement, loosely transition; peer to peer support; academic engagement; on line engagement; student to staff relationships and beyond class / social engagement. These were explored through the constant comparative method of qualitative analysis to explore the difference between the experience of the first year students , comparing those who identify as with support needs and those who do not after the first half of their first year of study. There are implications for living the values of the National Occupational Standard in the delivery of undergraduate programmes. There are implications for designing induction activities across the year, and qualitative feedback on a first year residential. Crucially there are implications for sustainable workloads of academics with significant time pressure to deliver teaching and learning and generating REF-able research. Join this session and hear the initial findings from this small-scale qualitative study, and work through the challenges nationally navigating the socially just commitment to social mobility, the range of support needs presenting at HEIs nationwide and propose how to generate best practice while remaining value driven and committed gatekeepers to the professional qualification. Is it acceptable to recruit students with limited resilience yet potential and maintain standards? How do we effectively promote engagement for first years? What are the implications for recruitment, programme delivery and workload planning?
    • Social media: blurred lines between personal and professional behaviour

      Jackson, Jessica; University of Derby (Medical Education Solutions, 2019-04-17)
      It is now over twenty years since the birth of social media and, according to Statista, the number of people engaged in these types of online networking platforms has reached over 39 million in the UK alone. These users include a generation who have grown up with such fast social interactions in a virtual world of posts for ‘likes’, ‘friends’ and ‘followers’. These young adults’ desire to engage in social media is often intertwined with their everyday lives.
    • Music, public health, and health promotion: Can music be a social determinant of health?

      Stewart, Donald E; Irons, J. Yoon; Queensland Conservatorium Research Centre, Griffith University (Palgrave Macmillan, 2018)
      This chapter explores the potentials of music as a social determinant of health and resource for psycho-social well-being. Music is encompassed within a socio-ecological definition of health, and from public health perspectives, music promotes well-being through its social participation and community engagement. This chapter offers two case studies, where qualitative and quantitative data attest that participating in music activities can increase well-being from public health perspectives.
    • Envy's pathology: Historical contexts.

      Minou, Lina; Independent Researcher (F1000Research, 2017-05-23)
      This article is concerned with the physicality of envy primarily in early -modern, but also in eighteenth-century health contexts. The discussion brings together descriptions of the effects of envy on the body of the envier, mainly from works of physiology and health preservation, but also from literary and spiritual writings. These depictions of envy are studied beyond their symbolism and with a view to establish whether they are meaningful according to the medical theories of the time in which they occur. The discussion begins by acknowledging the status of envy as a 'disease' and looks to the specific ways in which the discourse of envy conveys this sense. I find that in the early modern discourse envy is always pathological, that is, it is experienced as disease and signifies disease in general and several diseases in particular. Moreover, envy is uniquely placed to convey pathology on account of its being connected to inherently pathogenic elements of the humoural theory. Specifically, envy is physiologically connected to melancholy, and the way it is presented comes close to attributes assigned to black bile. In addition, envy realizes pathology, the occurrence of disease in the body, by impairing the vital process of digestion and thus depriving the person from proper nourishment and sustenance. The analysis further considers how this impairment of the body fits with the physiological manifestation of envy as 'corrosion' and 'consumption'. Finding commonalities with other maladies mediated by these physiological signs the article concludes by considering the function of pathology in the conception of early modern envy.