Home-based family caregiver-delivered music and reading interventions for people living with dementia (HOMESIDE trial): an international randomised controlled trial.

Background: Music interventions provided by qualified therapists within residential aged care are effective at attenuating behavioural and psychological symptoms (BPSD) of people with dementia (PwD). The impact of music interventions on dementia symptom management when provided by family caregivers is unclear. Methods: We implemented a community-based, large, pragmatic, international, superiority, single-masked randomised controlled trial to evaluate if caregiver-delivered music was superior to usual care alone (UC) on reducing BPSD of PwD measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q). The study included an active control (reading). People with dementia (NPI-Q score ≥6) and their caregiver (dyads) from one of five countries were randomly allocated to caregiver-delivered music, reading, or UC with a 1:1:1 allocation stratified by site. Caregivers received three online protocolised music or reading training sessions delivered by therapists and were recommended to provide five 30-min reading or music activities per week (minimum twice weekly) over 90-days. The NPI-Q severity assessment of PwD was completed online by masked assessors at baseline, 90- (primary) and 180-days post-randomisation and analysed on an intention-to-treat basis using a likelihood-based longitudinal data analysis model. ACTRN12618001799246; ClinicalTrials.govNCT03907748. Findings: Between 27th November 2019 and 7th July 2022, we randomised 432 eligible of 805 screened dyads (music n = 143, reading n = 144, UC n = 145). There was no statistical or clinically important difference in the change from baseline BPSD between caregiver-delivered music (-0.15, 95% CI -1.41 to 1.10, p = 0.81) or reading (-1.12, 95% CI -2.38 to 0.14, p = 0.082) and UC alone at 90-days. No related adverse events occurred. Interpretation: Our findings suggested that music interventions and reading interventions delivered by trained caregivers in community contexts do not decrease enduring BPSD symptoms. Funding: Our funding was provided by National Health and Medical Research Council, Australia; The Research Council of Norway; Federal Ministry of Education and Research, Germany; National Centre for Research and Development, Poland; Alzheimer's Society, UK, as part of the Joint Programme for Neurodegenerative Diseases consortia scheme.

Content development and validation for a mobile application designed to train family caregivers in the use of music to support care of people living with dementia.

Background: Music therapy is increasingly recognized as an effective support for people living with dementia. However, with incidences of dementia increasing, and limited availability of music therapists, there is a need for affordable and accessible ways that caregivers can learn to use music-therapy based strategies to support the people they care for. The MATCH project aims to address this by creating a mobile application that can train family caregivers in the use of music to support people living with dementia. Methods: This study details the development and validation of training material for the MATCH mobile application. Training modules developed based on existing research were assessed by 10 experienced music therapist clinician-researchers, and seven family caregivers who had previously completed personalized training in music therapy strategies via the HOMESIDE project. Participants reviewed the content and scored each training module based on content (music therapists) and face (caregivers) validity scales. Descriptive statistics were used to calculate scores on the scales, while thematic analysis was used to analyze short-answer feedback. Results: Participants scored the content as valid and relevant, however, they provided additional suggestions for improvement via short-answer feedback. Conclusion: The content developed for the MATCH application is valid and will be trailed by family caregivers and people living with dementia in a future study.

Recruitment approaches and profiles of consenting family caregivers and people living with dementia: A recruitment study within a trial.

Background: While studies have identified strategies that are useful for recruiting people living with dementia, none have focused on psychosocial interventions involving arts therapies, or have examined the profiles of older people living in the community who consent or decline participation, particularly during a global pandemic. We aimed to identify the most effective recruitment strategies according to participant characteristics and transnational differences and develop a profile of consenting and non-consenting participants. Methods: Recruitment teams in Australia, Norway, Germany, Poland, and the United Kingdom, recorded participants' source of study awareness and characteristics of consenting and non-consenting participants. Distributions of participants 'consenting to participate' were compared and logistic regressions were used to estimate the odds ratios. Results: Consenting female caregivers were disproportionally represented. Study awareness differed between countries but overall, most expressions of interest to participate were derived from referrals from professionals or organisations, or from databases of people wanting to participate in research. Troughs in recruitment rates occurred during Northern Hemisphere summer vacation periods, and during Christmas periods. Conclusions: This study found that recruiting for a trial with community-dwelling family caregivers and people living with dementia is challenging, especially during a global pandemic. While spousal caregivers comprised the highest proportion of dyads recruited, overall spousal caregivers were more reluctant to consent to participate than adult child caregivers. More targeted recruitment strategies designed for minority groups are also needed to ensure broader representation in dementia treatment studies.

Music and Psychology & Social Connections Program: Protocol for a Novel Intervention for Dyads Affected by Younger-Onset Dementia.

Psychosocial interventions targeting the specific needs of people affected by younger-onset dementia are lacking. Younger-onset dementia refers to dementia where symptom onset occurs at less than 65 years old. Because of its occurrence in middle age, the impact on spouses is particularly marked and dyadic-based interventions are recommended. Music And Psychology & Social Connections (MAPS) is a novel online intervention, informed by the theory of adaptive coping by Bannon et al. (2021) for dyads affected by younger-onset dementia. MAPS combines therapeutic songwriting, cognitive behaviour therapy, and a private social networking group that focuses on the dyads. This will be a randomised controlled trial with a waitlist control. The primary aims are to assess whether MAPS improves depressive, anxiety, and stress symptoms in caregivers, with secondary aims to assess whether MAPS improves depressive symptoms in people with younger-onset dementia. The trial also aims to assess dyadic social connectedness; caregiver coping skills; and neuropsychiatric symptoms in people with younger-onset dementia. We will recruit 60 dyads to participate in a group-based weekly online program for 8 weeks facilitated by a credentialed music therapist and psychologist. Sessions 1 and 8 will include both caregivers and people with younger-onset dementia and Sessions 2-7 will involve separate group sessions for caregivers and those with dementia. There will be focus groups for qualitative feedback. Due to its online administration, MAPS has the potential to reach many dyads affected by younger-onset dementia.

Neural activation during emotional interference corresponds to emotion dysregulation in stressed teachers.

Teacher stress and burnout has been associated with low job satisfaction, reduced emotional wellbeing, and poor student learning outcomes. Prolonged stress is associated with emotion dysregulation and has thus become a focus of stress interventions. This study examines emotional interference effects in a group of teachers suffering from high stress and to explore how individual differences in cognitive control, emotion dysregulation, and emotion recognition related to patterns of neural activation. Forty-nine teachers suffering moderate-high stress participated in an emotional counting Stroop task while their brain activity was imaged using functional magnetic resonance imaging. Participants viewed general or teacher specific words of either negative or neutral valence and were required to count the number of words on screen. Behavioural and neuroimaging results suggest that teachers are able to control emotional responses to negative stimuli, as no evidence of emotional interference was detected. However, patterns of neural activation revealed early shared engagement of regions involved in cognitive reappraisal during negative task conditions and unique late engagement of the hippocampus only while counting teacher-specific negative words. Further, we identified that greater emotion dysregulation was associated with increased activation of regions involved in cognitive control processes during neutral word trials. Teachers who showed slower emotion recognition performance were also found to have greater activation in regions associated with visual and word processing, specifically during the teacher specific negative word condition of the task. Future research should explore emotion regulation strategy use in teachers and utilise temporally sensitive neuroimaging techniques to further understand these findings.

Teacher stress and burnout in Australia: examining the role of intrapersonal and environmental factors.

Concerns regarding high rates of teacher stress and burnout are present globally. Yet there is limited current data regarding the severity of stress, or the role of intrapersonal and environmental factors in relation to teacher stress and burnout within the Australian context. The present study, conducted over an 18-month period, prior to the COVID pandemic, surveyed 749 Australian teachers to explore their experience of work-related stress and burnout; differences in stress and burnout across different demographic groups within the profession; as well as the contributing role of intrapersonal and environmental factors, particularly, emotion regulation, subjective well-being, and workload. Results showed over half of the sample reported being very or extremely stressed and were considering leaving the profession, with early career teachers, primary teachers, and teachers working in rural and remote areas reporting the highest stress and burnout levels. Conditional process analyses highlighted the importance of emotion regulation, workload and subjective well-being in the development of teacher stress and some forms of burnout. Implications for educational practice are discussed.

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.

The Downstream Effects of Teacher Well-Being Programs: Improvements in Teachers' Stress, Cognition and Well-Being Benefit Their Students.

Quality interventions addressing the important issue of teacher stress and burnout have shown promising outcomes for participating teachers in terms of decreased distress, improved well-being and increased commitment to their jobs. Less is known however about whether such interventions also benefit students. The present study investigated the downstream effects for a completer sample of 226 primary and high school students after their teachers (n = 17) completed one of two 8-week stress reduction interventions. The relationships between change in teacher self-reported distress and burnout after completing the interventions, and change in students' self-reported well-being, academic self-perceptions, and perceptions of classroom environment were explored. A secondary aim of this study was to assess whether changes in teachers' cognitive flexibility mediated the relationship between teacher and student self-report outcomes. Results of correlational and multi-level mediation analyses showed that changes to teachers' self-reported distress and burnout affected multiple facets of students' well-being and the academic environment. Specifically, reductions in teachers' self-reported distress and burnout were related to students' improved perceptions of their teachers' support in the classroom. Reductions in teachers' personal and work-related burnout correlated with greater increases of academic self-perception in students. Contrary to predictions, cognitive flexibility in teachers did not mediate the relationship between these student and teacher measures. These findings indicate important downstream benefits for students and highlight the broader value of stress-reduction and well-being programs for teachers.

Beliefs and Values About Music in Early Childhood Education and Care: Perspectives From Practitioners.

This paper reports the findings of a study that aimed to identify the music beliefs and values of educators in early childhood education and care settings in Australia. The aims of the study were 2-fold: to adapt and pilot a survey of music beliefs and values which might be implemented subsequently nationally in childcare settings; and, secondly, to identify the music beliefs and values held by early childhood and care educators concerning music in children's learning. The research questions that guided this component of the study were: What is the profile of early childhood and care educators? What beliefs and values for music engagement are held by early childhood and care educators? What shapes early childhood and care educators' music beliefs and values? Findings indicated that educators' beliefs and values on all items are above the mid-point indicating overall positive attitudes toward music despite the majority having no formal qualifications in music or a history of instrumental performance and/or singing. Given the overall positive attitudes toward music we suggest there is enormous potential within this population for further professional learning and development targeted at music and its potential wider benefits in young children's learning and lives.