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Implementing music therapy through telehealth: considerations for military populations

VAUDREUIL, Rebecca
LANGSTON, Diane G
MAGEE, Wendy L
BETTS, Donna
KASS, Sara
LEVY, Charles
2020

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Purpose

Telehealth provides psychotherapeutic interventions and psychoeducation for remote populations with limited access to in-person behavioural health and/or rehabilitation treatment. The United States Department of Défense and the Veterans Health Administration use telehealth to deliver primary care, medication management, and services including physical, occupational, and speech-language therapies for service members, veterans, and eligible dependents. While creative arts therapies are included in telehealth programming, the existing evidence base focuses on art therapy and dance/movement therapy, with a paucity of information on music therapy.

 

Methods

Discussion of didactic and applied music experiences, clinical, ethical, and technological considerations, and research pertaining to music therapy telehealth addresses this gap through presentation of three case examples. These programmes highlight music therapy telehealth with military-connected populations on a continuum of clinical and community engagement: 1) collaboration between Berklee College of Music in Boston, MA and the Acoke Rural Development Initiative in Lira, Uganda; 2) the Semper Sound Cyber Health programme in San Diego, CA; and 3) the integration of music therapy telehealth into Creative Forces®, an initiative of the National Endowment for the Arts.

 

Results

These examples illustrate that participants were found to positively respond to music therapy and community music engagement through telehealth, and reported decrease in pain, anxiety, and depression; they endorsed that telehealth was not a deterrent to continued music engagement, requested continued music therapy telehealth sessions, and recommended it to their peers.

 

Conclusions

Knowledge gaps and evolving models of creative arts therapies telehealth for military-connected populations are elucidated, with emphasis on clinical and ethical considerations.

A comparison of disability rights in employment: Exploring the potential of the UNCRPD in Uganda and the United States

OJOK, Patrick
GOULD, Robert
2019

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The disability employment policy systems in the US and Uganda are compared, and areas identified to improve implementation by examining the broader socio-cultural contexts that have shaped disability policy and practices of the two countries over time. Using the United Nations Conventions on the Rights of Persons with Disabilities (UNCRPD) as the overarching analytical framework, the analysis is framed within the discussion of the right to employment, as both countries are recognized for policy advances in this domain, but continue to experience low labor market participation for persons with disabilities. It identifies three critical areas that impact the realisation of disability rights in each context: ideological frameworks; hiring and retention initiatives; and state level supports. Ultimately, it considers the limitations of the rights based framework for actualising employment rights in the context of limited state and individual resources. 

 

Disability and the Global South, 2019, Vol.6, No. 2

 

The long-term impact of wheelchair delivery on the lives of people with disabilities in three countries of the world

SHORE, Susan
2017

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Background: Lack of access to mobility for people with disabilities, particularly in less- resourced settings, continues to be widespread. Despite challenges to wheelchair delivery, the benefits to health, employment, social integration and life satisfaction are apparent.


Objectives: Previous studies have explored the impact of receiving a wheelchair on the lives of the users through cross-sectional or short-term longitudinal analysis. The current study was undertaken to evaluate whether previously reported changes were sustained after 30 months of use, and whether results varied between two differing models of a wheelchair.


Method: One hundred and ninety-one subjects from Peru, Uganda and Vietnam received one of two models of wheelchair provided by the Free Wheelchair Mission. Using interviews to record survey results, data were collected at the time the wheelchair was received and following 12 and 30 months of use. Variables of overall health, employment, income and travel were explored through non-parametric analysis.


Results: There was a significant improvement in overall health and distance travelled after 12 months, but these changes were no longer significant by 30 months (Friedman test for overall change, p = 0.000). Employment status showed a small but significant increase at 12 and 30 months (Cochran’s Q, p = 0.000). Reported income increased slowly, becoming significantly different at 30 months (Friedman test, p = 0.033). There was no association between the model of wheelchair received and the incidence of pressure ulcers, pain or maintenance required. There was higher satisfaction with the GEN_2 wheelchair at 12 months (p = 0.004), but this difference was not apparent by 30 months. Overall wheelchair satisfaction and maintenance levels were favourable.


Conclusion: While overall health status, and distance travelled into the community fluctuated over time, receipt of one of two models of a wheelchair in less-resourced settings of the world appears to have a positive sustained impact on employment and income. Further investigations should be carried out to confirm these results and explore the factors responsible for fluctuating variables. This study affirms the importance of long-term follow-up of outcomes associated with wheelchair distribution in less-resourced environments.

Equal basis 2014 : access and rights in 33 countries

BURKE, Megan
PERSI VICENTIC, Loren
December 2014

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This report presents research about efforts to meet the needs and uphold the rights of persons with disabilities in four thematic areas: health care, rehabilitation, work and employment, and accessibility and enabling environments. Research findings are drawn from the experiences of landmine and cluster munition survivors and other persons with similar needs in 33 countries experiencing armed conflict or emerging from armed conflict or political or economic transition. Findings are placed within the context of relevant articles of the Convention on the Rights of Persons with Disabilities and the World Report on Disability

Fact sheet : refugees with disabilities

WOMEN’S REFUGEE COMMISSION
2014

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This factsheet highlights the issue of disabilities among refugees and conflict-affected population. It emphasizes actions undertaken by the Women’s Refugee Commission (WRC) and highlights their next steps in disability inclusion

Note: Also available in easy read format

Armed violence and disability : the untold story

THAPA, Rashmi
THALER, Kai
2012

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"This study aims to understand the links between armed violence and impairments that can lead to disabilities. It focuses on individuals who sustain impairments resulting from incidents of armed violence. The Disability Creation Process is adapted to analyse the combination of health problems, discrimination and socio- economic exclusion that can lead to disability for people who have sustained serious injury and/or lasting impairments as a result of armed violence...This report is written in a linear progression keeping the research project’s goals, objectives and approach as its backdrop. Chapter 1 (introduction) gives an overview of armed violence along with the justification of this research and its methods. Chapter 2 presents the findings from the four case study regions in countries, situated within its contextual analysis. Each case study draws on its discussion and summary of findings. Chapter 3 presents the discussion and lessons learned from this research, placing assistance and people at the centre of armed violence initiatives. Finally, a glossary, Annexes and references as endnotes are at the end of the report with notes at the end of every page"

The IMF, the global crisis and human resources for health : still constraining policy space

LEFRANÇOIS, Fabien
February 2010

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This report "...examines evidence from nine IMF country programmes, chosen based on their HIV prevalence rates, and finds that although the IMF has changed its tune and is talking about greater flexibility, these changes are not enough and are only temporary. "In 2006, the World Health Organisation (WHO) estimated that 57 countries were facing a severe health workforce crisis.... Addressing this shortage, and action alongside it to strengthen health systems around the world, requires substantial, concerted effort from both aid donors and recipient governments. The current global downturn threatens to undermine steps taken in this direction so far and jeopardise progress towards the health-related Millennium Development Goals. "...the IMF has adapted its rhetoric so that it now claims its programmes are more flexible on fiscal and monetary policies, which determine to what extent governments can maintain or increase spending - including of foreign aid - and stimulate economic activity"

Voices from the ground : landmine and explosive remnants of war survivors speak out on victim assistance

HANDICAP INTERNATIONAL
September 2009

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This report surveys landmine survivors’ opinions on assistance. The survey includes questionnaires and data from 1,645 survivors in 25 affected countries. The report finds that survivors are rarely included in decisions and activities destined to benefit them and subsequently more than two-thirds think that their needs are not taken into account when their governments makes plans to assist them. This document is useful for people interested in landmine survivor's opinions about governments supporting and reintegrating landmine survivors into society

Missing the target #5 : improving AIDS drug access and advancing health care for all

INTERNATIONAL TREATMENT PREPAREDNESS COALITION (ITPC)
December 2007

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This report documents how the mobilisation around AIDS is driving health systems advancement in China, Dominican Republic, Zimbabwe, Russia, Kenya, India, Cameroon, Zambia and Cambodia, and it highlights the need for improvements in broader systems of care and services to meet the needs of people living with HIV & AIDS and the communities in which they live. It also considers ARV procurement, registration and stock-outs in Argentina, Belize, Cambodia, China, Dominican Republic, India, Malawi, Morocco, Nigeria, Philippines, Russia, Uganda, Zambia, Zimbabwe

Another way to learn : case studies

UNITED NATIONS EDUCATIONAL, SCIENTIFIC AND CULTURAL ORGANIZATION
2007

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These case studies come from an initiative that supports non-formal education projects in Africa, South Asia, the Caribbean and Latin America. The long-term goal of these projects is to develop sustainable livelihoods for low-income, low-literate populations by addressing vulnerability to HIV and AIDS and drug misuse, a lack of education and social exclusion. Central to all of these projects are the creative and innovative methods used to communicate in a meaningful way, engage people and encourage their participation. The projects all focus on capacity building, empowerment, and creating learning opportunities. A DVD has been produced to accompany this publication

Transitions in the early years : a learning opportunity [whole issue]

November 2006

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This issue of Early Childhood Matters presents a number of perspectives around children's transition from home environments to primary schooling and includes practical examples of initiatives in a number of countries, including the US, India, Uganda, Guatemala, Poland, Brazil and Israel. Articles look at transition and school readiness as a challenge and a learning opportunity rather than as a problem. In different contexts the emphasis of related early childhood programmes varies. The 'Parques Infantis' in Brazil focuses on children's rights, while in Guatemala and Uganda programmes reflect a need to promote local culture and support children learning the mainstream language. The Mississippi Delta Children's Partnership encourages interaction between pre-schools, primary schools and parents as a means to facilitate transition and supports school readiness through after-school programmes

Programming experiences in early childhood development

UNITED NATIONS CHILDREN'S FUND (UNICEF)
November 2006

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This document presents examples and case studies from 21 countries. They demonstrate the benefit of cross-sectoral programming to support early childhood development, some building on early child care or education programme

CSO capacity for policy engagement : lessons learned from the CSPP consultations in Africa, Asia and Latin America

CHOWDHURY, Naved
FINLAY-NOTMAN, Chelsie
HOVLAND, Ignie
August 2006

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This paper explore the views of Southern civil society organisations (CSOs) on the issues of evidence-based policy engagement and came out of the Civil Society Partnerships Programme (CSPP). "During its first phase the CSPP conducted a series of consultative seminars and workshops in Africa, Asia and Latin America. The aim was to provide a forum for representatives from policy research institutions and non-governmental organisations (NGOs), as well as other stakeholders, to come together. Participants discussed the opportunities and challenges for CSOs when using evidence to inform policy, presented lessons and best practice in this area, shared experiences about ongoing activities and identified opportunities for collaborative work"

Addressing violence against women in HIV testing and counselling

WORLD HEALTH ORGANIZATION (WHO)
2006

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This is a summary and recommendations from an international consultation co-convened by the WHO departments of Gender, Women and Health (GWH) and of HIV & AIDS to identify and review promising strategies or good practices to support women who may fear or experience violence as a consequence of HIV testing and/or HIV status disclosure; and develop recommendations to guide programmes and policies related to HIV testing and counselling, in light of current strategies to expand access to these and related services

USAID project profiles : children affected by HIV/AIDS

UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
January 2005

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This document presents profiles of 114 projects (90 country-specific, 12 regional, and 12 global) funded by USAID. It includes a section on USAID projects that support access to education in Africa. The project profiles include the names of implementing organisations, funding periods and amounts, objectives, strategies, key accomplishments, priority activities for the year ahead, and materials and tools available to other projects that can help meet the needs of children and youth affected by HIV and AIDS. The diversity of these projects demonstrates the US government's efforts to meet the wide variety of needs of children and youth affected by HIV and AIDS. Approaches vary in both strategy and scale. The vast majority of projects work with communities to identify opportunities that strengthen existing resources without undermining local ownership. In many places, communities are already mobilised and have systems in place to identify, protect, and provide basic necessities to the most vulnerable children. USAID supports the strengthening and monitoring of these existing activities

Processes and issues for improving access to medicines : willingness and ability to utilise TRIPS flexibilities in non-producing countries

BAKER, Brook K.
August 2004

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This paper addresses the varied ways by which a non-medicine producing country may lawfully utilise the agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS) flexibilities, primarily by importing. However, it also briefly discusses means for promoting local production through pharmaceutical capacity building and through both compulsory and voluntary licensing. To help decision-makers in understanding and evaluating the opportunities and constraints of each alternative, the paper briefly describes their respective advantages and disadvantages in terms of developing countries’ sustainable access to more affordable medicines, highlighting differing legal interpretations, political realities and pragmatic administrative and economic constraints

Emerging challenges and opportunities in drug registration and regulation in developing countries

HILL, Suzanne
JOHNSON, Kent
May 2004

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This study describes current drug regulation and registration processes in selected countries, in order to understand how they affect the quality and availability of medicines in developing countries. It puts forward policy recommendations as to how systems can more efficiently allow appropriate quality drugs to be marketed and examines the emerging challenges and requirements posed by compulsory licensing, drugs for neglected diseases, anti-retroviral (ARV) and anti-tuberculosis (TB) drugs

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