The World Health Organization (WHO), at the United Nations International Day of Older Persons (September 30), organised an event to support this year’s theme ‘Take a stand against ageism’. Cochrane Global Ageing, represented by Sue Marcus and Tracey Howe, participated in the event and made the following statement:
‘We’re delighted to be here on this significant day to celebrate the international day of older persons and the launch of Cochrane Global Ageing.
For those of you who may not be aware, Cochrane has been producing systematic reviews about health and health care for over 20 years and has had an official relationship with WHO for the past 5 years.
Cochrane Global Ageing will build on this relationship and continue to work with WHO to address the need for age appropriate systematic reviews and evidence synthesis methods that reflect both the multidisciplinary nature and diversity of ageing worldwide.
In setting up Cochrane Global Ageing, our first question was: to what extent do ageist attitudes impact on research in general and Cochrane Reviews in particular?
Our preliminary search of the Cochrane Library found only 45 reviews and 14 protocols from about 10000 records - that’s less than 1% of all reviews – and the term “ageing” showed no hits at all.
So we have to ask ourselves…. Is this evidence that ageism is present in our organization and policy practices? Or, does it indicate a problem of indexing and evolving terminology, making evidence difficult to find? We know for example that older people are under-represented in clinical trials. Clearly we need to look at this more closely.
In addition to this we’ll also be working with WHO on priority setting, to better reflect the needs and rights of older people. Ensuring wider dissemination, knowledge exchange and including older people in the process will be key.
We’re looking forward to creating a new era of evidence that doesn’t discriminate against older people and accords them the respect and dignity they truly deserve.’
Tracey Howe (Cochrane Global Ageing), Sylvia de Haan (Cochrane), Sue Marcus (Cochrane Global Ageing) and Ritu Sadana (WHO) meeting in front of WHO Executive Board room
In response to the statement, John Beard, WHO Director of Ageing and Life Course, said:
‘Many trials preferentially recruit younger adults excluding older people with multiple comorbidities and polypharmacy even though their physiology is quite different. Something like 80% of clinical trials exclude older people as subjects. It is absolutely crucial we move forward on this and it is great to see Cochrane leading the way.’
We all need to be able to make sense of evidence, whether we’re making decisions about treatments, or weighing up the latest health story to hit the headlines. Cochrane UK, in partnership with Students 4 Best Evidence, are putting the spotlight on common errors and misunderstandings with our new campaign, Understanding Evidence.
This series brings together the ideas that underpin the way we think about evidence. It shares resources and initiatives that can help with making sense of evidence, and highlights opportunities to get involved with others with an interest in evidence.
Please join us on social media (#UnderstandingEvidence), share your ideas, and help us make sure that we challenge claims and think critically.
So far this year, 90% of the 2016 WHO guidelines contain Cochrane Evidence
Cochrane exists so that healthcare decisions get better. During the past 20 years, Cochrane has helped to transform the way health decisions are made. Cochrane contributors - 37,000 from more than 130 countries - work together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Many of our contributors are world leaders in their fields - medicine, health policy, research methodology, or consumer advocacy - and our groups are situated in some of the world's most respected academic and medical institutions. Our work is recognized as representing an international gold standard for high quality, trusted information.
Cochrane has been a non-governmental organization in official relations with the World Health Organization (WHO) since 2011. WHO develops global health guidelines, which are of a high methodological quality and are developed through a transparent, evidence-based decision-making process. Ensuring there is an appropriate use of evidence within these guidelines, represents one of the core functions of WHO.
The percentage of Cochrane Reviews used in WHO guidelines have been steadily raising. So far for 2016, Cochrane Reviews have been included in 90% of the WHO guidelines, which surpasses last year’s 75% inclusion rate. As of 26 September 2016, 474 reviews from Cochrane Review Groups have been used to inform 160 World Health Organization accredited guidelines and other evidence-based recommendations published between 2008 and 2016. Of the 160 WHO guidelines and other evidence-based recommendations that have used Cochrane reviews to inform their guidance, 14 have used over 10 reviews in any one guideline.
Cochrane’s partnership with WHO is helping to put our high quality evidence into guidelines that will have an impact upon health policies and clinical practise worldwide. It’s also a testament to the important and hard work that many in the Cochrane community are putting forward.
Specifications: Full Time
Salary: £24,000 - £28,000
Location: London, UK
Application Closing Date: 20/10/2016
Cochrane is a global independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making the vast amounts of evidence generated through research useful for informing decisions about health. We do this by identifying, appraising and synthesizing individual research findings to produce the best available evidence on what can work, what might harm and where more research is needed.
Our work is recognised as the international gold standard for high quality, trusted information. We want to be the leading advocate for evidence-informed health care across the world.
This is a new and exciting role for an individual passionate about finance and who would relish the challenge of creating new standard operating procedures to join our finance and core services team. The role will predominantly be the point of contact for colleagues in relation to payments and payment enquiries. This role will be 37.5 hours per week.
The successful candidate will need to be extremely well organized to manage a high workload. We are looking for an experienced Purchase Ledger with previous experience in a similar role with a proven collaborative approach to assist our internal and external customer needs with financial information.
For more information, please see the full job description.
If you would like to apply for this position, please send a CV along with a supporting statement to email@example.com with “Purchase Ledger Assistant” in the subject line. The supporting statement should indicate why you are applying for the post, and how far you meet the requirements for the post outlined in the job description using specific examples. List your experience, achievements, knowledge, personal qualities and skills which you feel are relevant to the post.
Sue Marcus joined Cochrane in 2010 as Managing Editor of Cochrane’s Dementia and Cognitive Improvement Group, after being a Researcher at the Oxford Institute of Population Ageing in the UK. She has a passion for demography and health.
Now, in conjunction with being a Cochrane Managing Editor, she is embracing an exciting new opportunity as Co-Director of the new Cochrane Field, Global Ageing, which launches on October 1st 2016.
How did Cochrane Ageing come about?
A group of us began discussions back in 2013 as part of a natural evolution of the Cochrane Healthcare of Older People Field (HCOP). My background is in demography and health and I had felt for a while that there was a need - or maybe ‘opportunity’ is a better word - to expand on what had been achieved by the HCOP. The result is the launch of Cochrane Global Ageing. Broadly, its aims are to promote the quality, dissemination, accessibility, applicability and impact of Cochrane systematic reviews and hopefully this will contribute towards better health and wellbeing of older people, everywhere. We want to connect people globally, within and outside Cochrane, and facilitate the sharing of knowledge and experiences related to global ageing and health so Cochrane can produce age appropriate reviews. Ageing is multidisciplinary by nature and we need reviews that reflect this so they are relevant and accessible to a wide audience - consumers, review editors, authors, specialists, policymakers, educators, commissioners and funders.
What do you plan to do?
We want to support and work with the Cochrane Review Groups who will produce these reviews. We also want to find ways to better disseminate them. We want to make this evidence more accessible by drawing on and extending our international network of users of Cochrane Reviews, and by extension support the collection and dissemination of global evidence about ageing and health. Knowledge exchange and translation will be key here.
Has the work of Global Ageing already started?
Yes, it has. We’re working closely with the World Health Organization. When we looked at the WHO’s action plan on ageing and health, we found it resonated well with the aims and objectives of Cochrane’s strategy to 2020. WHO have invited us to be part of their steering group for a priority setting exercise, which is to be developed this year. We have been invited to speak from the floor at the WHO meeting in Geneva on September 30th to celebrate the UN International Day of Older Persons. This coincides with the launch of CGA. We’re also holding a special session at the Seoul Colloquium, and we’re currently defining our scope by conducting a broad stakeholder engagement and prioritisation process with the advice and advocacy of our international Advisory Board. This will help us achieve our mission and objectives.
What impact would you like Global Ageing to have?
Ageing and health is not just about disease-focussed evidence, although this is very important.
We want to make sure that Global Ageing builds and develops effective relationships and ensure communication flows between researchers and decision-makers and reaches knowledge users, funders, older people, families and caregivers, and professional organisations. Ideally, these endeavours will contribute to reliable, high-quality primary research that is prioritized to answer pertinent, ‘real world’ health questions that are age appropriate and that improve the evidence-base on which our work is built.
In addition to building international capacity to synthesize research, we’d like to see more involvement from older people themselves. We know for example they are under-represented in clinical trials so this could be a way to give them a ‘voice’. This could mean greater participation in research and helping identify research questions and the need for innovation - including the development of study designs, services, technologies etc. Older people are a very valuable and under used resource!
How do you feel about the launch of Global Ageing?
I think it’s a very exciting development - and it carries a good deal of responsibility too! I’m very fortunate to be working with two highly-respected colleagues, Tracey Howe and Vivian Welch who are Co-Directors. They bring a range of expertise and experience that’s crucial to our success. There’s a wealth of talent, expertise and passion throughout Cochrane, and we’d like to see this harnessed and expressed through a variety of contributions to Cochrane Global Ageing. The new and innovative ways to get involved, such as Task Exchange and Cochrane Crowd will be the perfect vehicles for such contributions. We hope to work in partnership with complementary initiatives both within and external to Cochrane. We dare to think that the activities of Cochrane Global Ageing will provide a new gateway to optimising the health and wellbeing of ageing populations everywhere.
We’d love to hear from anyone who wishes to be involved with us! Visit the Cochrane Global Ageing website or send us an email.
European Stroke Organisation in association with Cochrane Stroke seeks a Guidelines Development Support Person - flexible location
Specifications: Half time (0.5 FTE)
Salary: £20,000 to £25,000
Application closing date: Friday 14 October 2016
The European Stroke Organisation (ESO) is a non-for-profit organisation that aims to improve stroke care in Europe and worldwide. As part of this effort, the development of Guidelines by ESO is a major cornerstone. The Guideline Committee (GC) of ESO has a central role in this process and has recently published a standard operating procedure (SOP; available here), which ensures that each ESO Guideline Document is developed according to the highest standards.
ESO, in association with the Cochrane Stroke Group, is looking for a person who will provide multi-level support to the ESO working groups during the development of ESO Guideline Documents.
The successful candidate is expected to have expertise in:
• developing and performing complex and comprehensive systematic literature searches;
• importing data and performing meta-analyses using Cochrane’s Review Manager software;
• assisting with identifying and summarising all relevant evidence in evidence profiles using the GRADE Profiler software (as described in the SOP);
• assisting in the grading of available evidence (as described in the SOP);
• interdisciplinary communications with technical staff from different countries and backgrounds: all communication and work-related activities will be in English.
Ideally, the successful candidate will have expertise in all aforementioned points. However, ESO will also consider applications from interested candidates who do not have expertise in all these points.
For more information, please see the full job description.
To apply, please send applications, by Friday 14 October 2016, to firstname.lastname@example.org along with a detailed curriculum vitae. Your application should indicate to what extent you meet the requirements for the post outlined in the job description and provide specific examples. List your experience, achievements, knowledge, personal qualities, and skills which you feel are relevant to the post. Selected candidates may be required to attend for interview.
For many women with breast cancer, the use of post-operative radiotherapy will allow them to undergo less extensive surgery. In mid-July, Brisbane-based Radiation Oncologist Brigid Hickey and colleagues from Australia and New Zealand published two review updates that consider critical questions about the size of the doses in which radiation is given. Here, Brigid shares her thoughts on the important findings of both reviews.
‘So who gets breast cancer? Women with families, women with jobs, women with busy lives,’ says Brigid. ‘So from a patient perspective, our latest review updates consider really important questions about access to the most effective and convenient treatments that are the least disruptive to daily life. And from a more clinical perspective, they provide evidence to inform both the best patient outcomes and the most efficient use of our healthcare resources.’
The third update of Fraction size in radiation therapy for breast conservation in early breast cancer looked at nine studies involving 8,228 women. It asked if giving fewer radiation treatments using a higher radiation dose at each visit was as effective as the conventional 25 to 30 radiation treatments. ‘It’s very satisfying to be able to say that we now have high quality evidence for all sorts of outcomes, including local recurrence-free survival, breast appearance, toxicity, overall survival and breast cancer-specific survival. So in practical terms for example this means a patient may come for treatment 21 times instead of 30, and that’s meaningful for them because treatment can be incredibly disruptive. This is particularly the case for women in regional and rural areas, who we know may opt for mastectomy over the difficulties of travelling long distances to receive frequent treatments. We can now reassure patients with this precise data and robust evidence that fewer treatments are just as effective and the cosmetic outcome is just as good.’
‘And on the clinical side, if we can accommodate more people with fewer treatments we see an immediate benefit in terms of reducing waiting times for machines. These findings will also be incorporated into clinical guidelines, as with our earlier reviews that informed both NHS and Australian guidelines. These can be tightened up further now that we have this new evidence. It’s not always the case that we can be so absolute, but in this instance you could say that doing the Summary of Findings table was particularly satisfying as we really do have the evidence we needed.’
The second priority review update wasn’t as conclusive, as Brigid explains. ‘To some degree the jury is still out on Partial breast irradiation for early breast cancer and it’s more of a work in progress. In this case we looked at whether giving radiotherapy (RT) to part of the breast is as good as giving RT to the whole breast. Women with early breast cancer who choose to keep their breast need to have RT as well as surgery to remove the cancer to make sure it does not regrow in the breast. This usually means 25 to 30 visits to the RT department, five times a week. It’s not surprising that the idea of treating someone in five as opposed to 30 or 25 treatments is very appealing to patients and specialists alike. So this approach is already being used quite widely in some parts of the world, but we don’t really feel that the evidence is there yet. Our latest review update found that at the moment partial breast irradiation doesn’t give the same cancer control as treating the whole breast, and it may cause worse side effects. However, there are still four big ongoing studies that we are waiting to see results from. Ideally they will help us come to a more definitive conclusion in the next update of this review.’
For more details about both reviews and the implications of their findings, listen to Brigid discuss them on these Cochrane podcasts:
Specifications: Part-time, 17.5 hours per week
Salary: £30,738 to £32,600 per annum (pro rata)
Location: Oxford Road, Manchester, UK
Application Closing Date: 12 Oct 2016
Cochrane Wounds is looking for a dynamic and enthusiastic individual with excellent communication skills to support the production of systematic reviews in the field of wound care.
You will be a graduate with a strong health information background. A qualification in librarianship, information science or equivalent experience is essential.
Experience of designing and conducting online literature searches of databases such as MEDLINE, good computer literacy and a sound knowledge of medical terminology and systematic reviews are also essential.
You will have excellent interpersonal, time management and organisational skills and be able to work with considerable autonomy to regular deadlines.
As an equal opportunities employer we welcome applicants from all sections of the community regardless of gender, ethnicity, disability, sexual orientation and transgender status. All appointments are made on merit.
The Cochrane Library iPad edition presents the latest Cochrane evidence in a convenient mobile format. Monthly issues feature Cochrane Reviews selected by the Editor in Chief and abridged to optimize the iPad reading experience.
Use the Cochrane Library iPad app to easily access abstracts, read selected reviews, and view full-page Summary of Findings tables. With access to a range of topics each month, create reading lists tailored to your own interests. All content in the app is free, and new issues will download regularly to your Newsstand.
Monash University Mental Health and General Practice is seeking a Research Fellow (Evidence Review)
Job No: 552703
Faculty of Medicine, Nursing and Health Sciences
School of Primary Health Care
Department of General Practice
Location: Notting Hill
Employment Type: Part-time (0.8)
Duration: 12 month fixed-term appointment
Pro-rata of $62,271 - $84,513 pa Level A PhD
(plus 9.5% employer superannuation)
For complete information on the position and how to apply, please see the full posting on the Monash website.Friday, September 23, 2016 Category: Jobs
Cochrane is delighted to announce that we have received a grant of USD $1.15 million from the Bill & Melinda Gates Foundation. The grant will support the development of Cochrane's next generation evidence system, with a specific focus on maternal and child health. This system is a major component of Cochrane's wider technology development program designed to address the challenge of ever-increasing health data, often with conflicting research findings, and builds on Cochrane’s initial investment in projects including Linked Data and Project Transform. The next generation evidence system will develop new technology, ontology, structures, machine learning, and crowd engagement to change the ways health data are utilized and discover new solutions for global health.
Project work funded by this grant will run from September 2016 to late February 2017, and project funds will be dispersed among many Cochrane Groups including the Child Health Field and the Pregnancy and Childbirth and Neonatal Review Groups.
“We are delighted and honoured to receive this grant,” said Mark Wilson, Cochrane’s CEO. “We are proud that this award represents an endorsement of strategic investments we have been making in Linked Data and new ways of working.”Thursday, September 22, 2016
Cochrane Colloquia are our annual flagship events, bringing together Cochrane contributors from around the world to discuss, develop and promote Cochrane, and help shape its future.
The 2016 Cochrane Colloquium will be held in Seoul, South Korea from 23-27 October. For full information regarding the Colloquium, please visit the website.Key information:
Programme overview: colloquium.cochrane.org/programme-overview
Registration fees: colloquium.cochrane.org/registration-fees
Key dates: colloquium.cochrane.org/key-dates
Hashtag: #CochraneSeoulLatest news:Sign-up now open for the full Colloquium schedule
Sign-up for all the sessions you want to attend and create your own personal schedule for the Colloquium! You can also export the schedule to your online calendar. We'll be launching the Colloquium app in early October that will sync with your personal schedule. Details of the poster sessions are now available.
Don't miss out on a chance to learn more about Cochrane and evidence-based health care. Registration closes on 10 October. Click here for the registration rates.Plenaries, speakers and symposia:Plenary 1: Overdiagnosis and overtreatment in health care
In this session, the role of evidence-based health care and systematic reviews in limiting overdiagnosis and oversue will be discussed, including realignment of disease definition; quantification and monitoring of overdiagnosis; sensitisation of health professionals and patients; provision of balanced information on risk and benefits intervention; and the implications for Cochrane.
Alexandra Barratt, Professor of Public Health, School of Public Health, University of Sydney
Rita F. Redberg, Editor, JAMA Internal Medicine. Professor of Medicine, Division of Cardiology, University of California, San Francisco
Jenny Doust, Professor of Public Health, Faculty of Health Sciences and Medicine, Bond University
The speakers in the plenary session have been asked to describe their experiences in making challenging decisions regarding the quality and usability of Cochrane reviews. Different perspectives and lively debate will be sought with particular focus on potential initiatives that are being explored and are consistent with the CEU vision for high quality and timely Cochrane Reviews that meets the needs of end-users and informs clinical care and health policy.
James Thomas, Project Transform, Cochrane. Director of the EPPI-Centre’s Reviews Facility, Department of Health, England
Karla Soares-Weiser, Deputy Editor in Chief, Cochrane Library & Cochrane Innovations
Marguerite Koster, External Member, Cochrane Steering Group
Harriet MacLehose, Senior Editor, Cochrane Library
Claire Glenton, Director, Cochrane Norway
Pressure to increase transparency of data in clinical research is growing as scientific academies, regulatory agencies, funders and international organisations join the call for more data transparency. In this session, recent issues in the open data movement, data access policies and its impact on health care are discussed. Some examples of the impact of lack of transparency in East Asia will highlighted.
Kay Dickersin, Director, Cochrane United States. Director, Johns Hopkins Center for Clinical Trials & Evidence Synthesis
Byung Joo Park, Professor, Department of Preventive Medicine, Seoul National University College of Medicine
Lesley Stewart, Director, Centre for Reviews and Dissemination, University of York
Rintaro Mori, Director, Cochrane Japan. Head of Department National Center for Child Health and Department of Clinical Epidemiology
Since the term evidence based medicine (EBM) was coined over 20 years ago it has had a remarkable global influence. But EBM is not a static set of concepts, set in stone tablets in the 1990s; it is a young and evolving discipline. The fundamental concept of systematic reviews – providing a periodic summary of all controlled trials to aid clinical care – may have changed little since the birth of Cochrane. However, how to best provide and apply these in practice continues to develop.
In this year’s Cochrane Lecture, Paul Glasziou will propose four areas requiring renewed or ongoing attention:
- Improve dialogue between “evidologists” and clinicians
- Treatment is the patient’s decision: support and promote shared decision making
- Take non-drug interventions as seriously as pharmaceuticals
- Sustain investment in automating evidence synthesis
Paul Glasziou, Professor, Evidence-Based Medicine at Bond University; Chair, International Society for Evidence-Based Health Care
Cochrane’s technological innovations are set to transform the way evidence for health is created and used. Join us at the #CochraneTech Symposium in Seoul to discover first-hand the emerging Cochrane ecosystem for evidence synthesis.
We’re preparing an exciting morning of talks and discussion centred around how Cochrane is using its technology to help both prepare systematic reviews more efficiently but also better deliver outputs to our end-users. The #CochraneTech Symposium is the premier event for those interested in the application and integration of existing and emerging technologies in the production of Cochrane systematic reviews and evidence synthesis in health care.
Since the inaugural #CochraneTech Symposium in Québec City in 2013 several ambitious technological strategies have been pursued by Cochrane, and we welcome you to join us in exploring this new ecosystem for evidence synthesis.Methods Symposium: Living Systematic Reviews: Methods, Opportunities and Challenges
Living systematic reviews, as online summaries of healthcare research that are updated as new research becomes available, offer exciting possibilities in the new evidence ecosystem. Momentum is building around the living systematic review concept: a number of approaches are being piloted and Cochrane is at the forefront of these efforts. Living systematic reviews differ from traditional systematic reviews in several ways that have important implications for review methods and processes, affecting authors, editors and publishers.
At this interactive symposium, we will explore what living systematic reviews actually are and their implications for Cochrane. Participants will hear from those who have been piloting living systematic review methods and will be invited to contribute their expertise as we explore the implications of LSRs for review methods and review production processes, plus the enablers within Cochrane to support their introduction.Knowledge Translation (KT) Symposium
In 2016 Cochrane is embarking on the development of a Knowledge Translation (KT) Strategy, which will inform, facilitate and coordinate KT activities within Cochrane. We hope this strategy will scope knowledge translation activities for Cochrane, build on the Strategy to 2020 goals and provide a framework and co-ordination to support those who are undertaking knowledge translation activities in Cochrane. This framework will guide our knowledge translation work and ensure quality of outputs. We hope to establish mechanisms for better coordination of knowledge translation work within Cochrane so that organisational learning in this area flows through Cochrane.
In this symposium we will be presenting the current draft of Cochrane’s KT strategy. There will be brief presentations on the work around the strategy, an opportunity for discussion and input into further development of the strategy and the implementation plans accompanying it and what it will mean for knowledge translation in Cochrane.
Looking forward to seeing you in Seoul in October!Thursday, September 22, 2016
Extra-pulmonary tuberculosis (EPTB) accounts for about one-fifth of all cases of tuberculosis and is a major health burden in India - one that had previously had uncertainty surrounding diagnosis and management. In August India released INDEX-TB guidelines for diagnosis and management of extra-pulmonary tuberculosis (EPTB). This extensively peer-reviewed document gives health providers at primary and secondary care institutions better guidance for systematic management of EPTB.
INDEX-TB guidelines were developed over one and a half years, with involvement of a large number of experts from different organ system sub-specialties. The methodology support team comprised members from the Cochrane Infectious Diseases Group and Cochrane South Asia. "The rigorous, systematic methods, and the transparent and participatory approach used in developing the INDEX-TB guidelines has provided a template that future guideline-developers in India could use," says Dr. Prathap Tharyan, Director of Cochrane South Asia. "The enthusiasm among the participants during the guideline development process was encouraging and augers well for the future of guideline development in India."
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!
Wednesday, November 7, 2018
"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