Laughter and MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful): narrative synthesis

Effects of laughter yoga on health-related quality of life in cancer patients undergoing chemotherapy: a randomized clinical trial

BACKGROUND

Chemotherapy is associated with a wide range of physical and psychological side effects, so complementary and alternative therapies may be practiced as an independent treatment or combined with the standard ones to improve health-related quality of life of cancer patients. Laughter yoga has predominantly been used as a complementary therapy to enhance health and wellbeing of ordinary people and patients with chronic diseases. However, to date, few studies have evaluated the effects of this modern exercise on cancer patients undergoing chemotherapy in clinical settings, to the best of the authors' knowledge. the present study aimed to investigate the effects of Laughter Yoga on the health-related quality of life of cancer patients undergoing chemotherapy.

METHODS

This study was a two-group randomized clinical trial on 69 cancer patients undergoing chemotherapy at Reza Radiotherapy and Oncology Center, Iran in 2018. Patients were randomly divided into intervention and control groups. The intervention group received laughter yoga for four sessions at one-week intervals. Each session consists of one part and lasts for 20-30 min. Patients' health-related quality of life was assessed before and after the laughter yoga sessions using Quality of Life Questionnaire European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) version 3.0. SPSS Statistics (v.20 software was used to conduct Chi-square, independent t-test, Mann-Whitney, Wilcoxon and paired t-tests analyses of the data.

RESULTS

The number of participants in intervention and control groups were 34 and 35, there was no significant difference of demographic and disease related characteristics and pre-intervention HRQOL between two groups. In the intervention group, there is significant difference between pre- and post-intervention scores (Mean ± Standard Deviation) of emotional functioning (12.99 ± 10.49), physical functioning (0.78 ± 6.08), role functioning (3.43 ± 7.97), fatigue (-8.82 ± 22.01), pain (-8.33 ± 11.78), sleep disturbance (-15.68 ± 18.77), and global health and quality of life (6.37 ± 5.04) (p < 0.05). There was no significant change in the control group. Participants reported no adverse events.

CONCLUSIONS

A structured laughter yoga intervention in a hospital setting effectively improved health-related quality of life for cancer patients undergoing chemotherapy. Benefits to many patients could be expected if this would become a part of routine care.

TRIAL REGISTRATION

This study was registered in the Iranian Registry of Clinical Trials (no. IRCT20180429039463N1) on 21/08/2018.

Lost in Translation: A Multilingual Survey of Interlinguistic Variations in Terms Used in Pharmacovigilance

INTRODUCTION

Although English is the universal language of science, it is nevertheless the first language of only about 6% of the world's population, and 75% of people do not speak English at all. It is therefore important that accurate translations of scientific information should be available, not only for professionals but also for the general public. This applies to pharmacovigilance as much as to any other discipline.

OBJECTIVE

The aim of this study was to determine how pharmacovigilance terms are translated into other languages, in order to judge the extent to which differences between languages might impair communication in pharmacovigilance.

METHODS

I surveyed the translation of 26 pharmacovigilance terms into 26 languages via a panel of 83 pharmacovigilance experts.

RESULTS

Three types of terms emerged: Type 1-those that are similar in form across all, or almost all, of the languages surveyed (e.g. 'signal' and 'risk'); Type 2-terms that are similar in form across some languages but not all (e.g. 'pharmacovigilance' and 'surveillance'); Type 3-terms for which there are major differences across languages (e.g. 'hazard').

CONCLUSION

Misconceptions in the communication of pharmacovigilance information may arise through difficulties in translation. Metaphorical expressions are best avoided in serious scientific publications, in order to reduce the difficulties of translation. A multilingual glossary of terms and definitions, which could be used to program a dedicated machine translator, would be of value. Published guidelines offer guidance to methods of translation, but they are complex and time-consuming and are mostly used in translating instruments for eliciting patient-reported outcomes.

Consequences of Laughter Upon Trunk Compression and Cortical Activation: Linear and Polynomial Relations

Results from two studies of biological consequences of laughter are reported. A proposed inhibitory brain mechanism was tested in Study 1. It aims to protect against trunk compression that can cause health hazards during vigorous laughter. Compression may be maximal during moderate durations and, for protective reasons, moderate in enduring vigorous laughs. Twenty-five university students volunteered to see a candid camera film. Laughter responses (LR) and the superimposed ha-responses were operationally assessed by mercury-filled strain gauges strapped around the trunk. On average, the thorax compression amplitudes exceeded those of the abdomen, and greater amplitudes were seen in the males than in the females after correction for resting trunk circumference. Regression analyses supported polynomial relations because medium LR durations were associated with particularly high thorax amplitudes. In Study 2, power changes were computed in the beta and alpha EEG frequency bands of the parietal cortex from before to after exposure to the comedy “Dinner for one” in 56 university students. Highly significant linear relations were calculated between the number of laughs and post-exposure cortical activation (increase of beta, decrease of alpha) due to high activation after frequent laughter. The results from Study 1 supported the hypothesis of a protective brain mechanism that is activated during long LRs to reduce the risk of harm to vital organs in the trunk cavity. The results in Study 2 supported a linear cortical activation and, thus, provided evidence for a biological correlate to the subjective experience of mental refreshment after laughter.

A 15-Year Follow-Up Study of Sense of Humor and Causes of Mortality: The Nord-Trøndelag Health Study

BACKGROUND

Associations between the sense of humor and survival in relation to specific diseases has so far never been studied.

METHODS

We conducted a 15-year follow-up study of 53,556 participants in the population-based Nord-Trøndelag Health Study, Norway. Cognitive, social, and affective components of the sense of humor were obtained, and associations with all-cause mortality, mortality due to cardiovascular diseases (CVD), infections, cancer, and chronic obstructive pulmonary diseases were estimated by hazard ratios (HRs).

RESULTS

After multivariate adjustments, high scores on the cognitive component of the sense of humor were significantly associated with lower all-cause mortality in women (HR = 0.52, 95% confidence interval [CI] = 0.33-0.81), but not in men (HR = 0.88, 95% CI = 0.59-1.32). Mortality due to CVD was significantly lower in women with high scores on the cognitive component (HR = 0.27, 95% CI = 0.15-0.47), and so was mortality due to infections both in men (HR = 0.26, 95% CI = 0.09-0.74) and women (HR = 0.17, 95% CI = 0.04-0.76). The social and affective components of the sense of humor were not associated with mortality. In the total population, the positive association between the cognitive component of sense of humor and survival was present until the age of 85 years.

CONCLUSIONS

The cognitive component of the sense of humor is positively associated with survival from mortality related to CVD and infections in women and with infection-related mortality in men. The findings indicate that sense of humor is a health-protecting cognitive coping resource.

Does comedy kill? A retrospective, longitudinal cohort, nested case-control study of humour and longevity in 53 British comedians

OBJECTIVES

This work aims to test the hypothesis that the funniest comedians are most at risk of a premature death and reduced longevity compared to their relatively less funny counterparts.

METHODS

A retrospective longitudinal cohort study with a nested case-control analysis of longevity of 53 male British comedians born between 1900 and 1954 was conducted. All comedians were given a subjective score from 1 (relatively funny) to 10 (hilariously funny) by the study investigators. The survival profile of all comedians was then examined adjusting for decade of birth, whether they worked in a comedy team and their comedy score. A nested case-control analysis examined the longevity of those comedians working in teams according to their pre-specified status within the team (straight/less funny versus funny team member).

RESULTS

On an adjusted basis, there was no correlation between the decade of birth (HR 0.94, 95% 0.65 to 1.38 per incremental decade; p=0.763) and comedy team status (HR 1.13, 95% 0.51 to 2.48 versus independent comedian; p=0.761) with longevity. However, an increasingly funny comedy score was associated with increased mortality (HR 1.24, 95% CI 1.06 to 1.44 per unit funny score; p=0.006). Of the 23 comedians adjudged to be very funny (score 8-10), 18 (78%) had died versus 12 (40%) of the rest; mean age at death 63.3±12.2 versus 72.3±14.7 (p=0.079). Within comedy teams, those identified as the funnier member(s) of the partnership were, on an adjusted basis, more than three times more likely to die prematurely when compared to their more serious comedy partners (HR 3.52, 95% CI 1.22, 10.1; p=0.020).

CONCLUSIONS

These data suggest that elite comedians are at increased risk of premature death compared to their less funny counterparts. Mental health issues and personality characteristics that help shape their comedic talent and success may well explain their reduced longevity and raises serious issues for identifying and mitigating their risk of a premature death.