Melbourne Conservatorium of Music - Research Publications

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    The dynamics of musical participation
    Schiavio, A ; Maes, P-J ; Schyff, DVD (SAGE Publications, 2021)
    In this paper we argue that our comprehension of musical participation—the complex network of interactive dynamics involved in collaborative musical experience—can benefit from an analysis inspired by the existing frameworks of dynamical systems theory and coordination dynamics. These approaches can offer novel theoretical tools to help music researchers describe a number of central aspects of joint musical experience in greater detail, such as prediction, adaptivity, social cohesion, reciprocity, and reward. While most musicians involved in collective forms of musicking already have some familiarity with these terms and their associated experiences, we currently lack an analytical vocabulary to approach them in a more targeted way. To fill this gap, we adopt insights from these frameworks to suggest that musical participation may be advantageously characterized as an open, non-equilibrium, dynamical system. In particular, we suggest that research informed by dynamical systems theory might stimulate new interdisciplinary scholarship at the crossroads of musicology, psychology, philosophy, and cognitive (neuro)science, pointing toward new understandings of the core features of musical participation.
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    Music interventions for dementia and depression in elderly care (MIDDEL): The Australian part of an international cluster randomised controlled trial
    Baker, F ; Lee, YEC ; Sousa, T ; Stretton-Smith, P ; Clark, I ; Sveinsdottir, V ; Geretsegger, M ; Gold, C (Wiley, 2021-12-01)
    BACKGROUND: Dementia and depression are highly prevalent, comorbid conditions in older adults residing in care homes and are associated with individual distress and associated challenges for care staff. Music-based interventions are widely used and potentially effective nonpharmacological interventions, due to the relative preservation of the ability of people with dementia to respond to music even with disease progression. However, there is a lack of large-scale studies evaluating the effectiveness of music-based interventions in dementia care. Music Interventions for Dementia and Depression in the Elderly (MIDDEL) is the first large-scale international cluster-randomised controlled trial to investigate the effectiveness of small group music therapy (GMT), recreational choir singing (RCS) and their combination on levels of depression in residents with dementia. The trial is currently being conducted across six countries, and this presentation will outline the study outcomes from the Australian arm of the trial. METHOD: Between June 2018 and November 2019, 20 care home units were randomised to music interventions (GMT, RCS, GMT and RCS) or standard care delivered over 6 months. The primary outcome was level of depression as measured by the Montgomery-Asberg Depression Rating Scale (MADRS). Secondary outcomes included neuropsychiatric symptoms, quality of life, care staff burden and adverse events collected at baseline, 3-months, 6-months and 12-months post-randomisation. Outcomes were analysed as intention-to-treat, per-protocol, and with exploratory predictor analyses. RESULTS: 318 participants (215 female; 103 male) aged 65 years or more with diagnoses of dementia and at least mild depressive symptoms (as defined by score of 8 or above on MADRS) residing in care homes were recruited. In addition, 131 care staff (108 female; 23 male) answered questions regarding perceived care burden to search for potential ripple effects of the music interventions. We will present the main findings of the study including the predictive effects of clinical characteristics on efficacy. CONCLUSION: The presentation will include discussion of contextual factors and conditions that support efficacy, and clinical implications for safety and quality of life for people with dementia living in care homes.
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    HOMESIDE-A home-based family caregiver-delivered music and reading intervention for people living with dementia: A randomised controlled trial.
    Baker, F ; Odell-Miller, H ; Wosch, T ; Stensaeth, K ; Bukowska, A ; Clark, I (Wiley, 2021-12)
    BACKGROUND: Pharmacological interventions to address behavioural and psychological symptoms of dementia (BPSD) can have undesirable side effects, therefore non-pharmacological approaches to managing symptoms may be preferable. Past studies show that music therapy can reduce BPSD, and other studies have explored how formal caregivers use music in their caring roles. However, no studies have examined the effects on BPSD of music interventions delivered by informal caregivers (CGs) in the home setting. Our project addresses the need for improved informal care by training cohabiting family CGs to implement music interventions that target BPSD, and the quality of life (QoL) and well-being of people with dementia and CGs. METHODS: An international three-arm parallel-group randomised controlled trial has so far randomised 130 of the target 495 dyads from Australia, Germany, UK, Poland and Norway. Dyads are randomised equally to standard care (SC), a home-based music programme plus SC, or a home-based reading programme plus SC for 12 weeks. The primary outcome is BPSD of people with dementia (measured using the Neuropsychiatric Inventory-Questionnaire). Secondary outcomes examine relationship quality between CG and people with dementia, depression, resilience, competence, QoL for CG and QoL for people with dementia. Outcomes are collected at baseline, at the end of the 12-week intervention and at 6 months post randomisation. Resource Utilisation in Dementia captures economic data across the life of the intervention and at 6-month follow-up. Our presentation will briefly outline the study protocol and describe the caregiver training protocol and interventions in detail with video footage illustrating how the intervention looks in practice.
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    By myself but not alone: Agency, creativity, and extended musical historicity
    Schiavio, A ; Ryan, K ; Moran, N ; van der Schyff, D ; Gallagher, S (Routledge, 2022-11)
    In this paper we offer a preliminary framework that highlights the relational nature of solo music-making, and its associated capacity to influence the constellation of habits and experiences one develops through acts of musicking. To do so, we introduce the notion of extended musical historicity and suggest that when novice and expert performers engage in individual musical practices, they often rely on an extended sense of agency which permeates their musical experience and shapes their creative outcomes. To support this view, we report on an exploratory, qualitative study conducted with novice and expert musicians. This was designed to elicit a range of responses, beliefs, experiences and meanings concerning the main categories of agency and creativity. Our data provide rich descriptions of solitary musical practices by both novice and expert performers, and reveal ways in which these experiences involve social contingencies that appear to generate or transform creative musical activity. We argue that recognition of the interactive components of individual musicking may shed new light on the cognition of solo and joint music performance, and should inspire the development of novel conceptual and empirical tools for future research and theory.
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    Push and Pull: Creative Practice and Creating Technologies
    Rose, S (Birmingham Centre for Media and Cultural Research, 2020)
    The lures of technologically enhanced performance are numerous but present challenges. This paper discusses the interplay of creative practice and embodied technology design as I experienced it through the co-development and construction of a set of data-gloves for use in performance. The project grew from the desire to engage with technology in an intuitive and visually exciting way. Using an embodied technology to interact with the voice radically changed my experience when performing. It led to feeling immersed in the sound and performance in contrast to disconcerted (with sampling) or nonplussed (with effects pedals). The gloves encouraged specificity in performance techniques and the use of movement cues. Audio manipulation via embodied interactive technology was startlingly empowering. The gloves connected to Ableton via MAX/MSP. MAX/MSP monitored the movement of flex sensors and buttons and communicated this by Musical Interface Digital Instrument (MIDI) to Ableton. Data triggered samples and audio effects in Ableton that affected the audio output of two microphones. Making, evaluating, troubleshooting, and curating sonic effects led to the creation of the piece, Tāwhirimātea (Rose 2018a), the adaptation of Te Karanga (Rose 2018b), and use in These Would Be Other (Burke & Mann 2019). This is an ongoing project, which will build upon the initial iteration discussed in this paper, to explore using embodied interactive technology to manipulate, alter and spatialise sound in surround sound and Ambisonic environments. There is further work to be explored within the design and technical capabilities of these gloves, including how it changes the user experience and what effects the types of interactions have on composition and performative outcomes.
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    Exploring Shared Musical Experiences in Dementia Care: A Worked Example of a Qualitative Systematic Review and Thematic Synthesis
    McMahon, K ; Clark, IN ; Stensaeth, K ; Odell-Miller, H ; Wosch, T ; Bukowska, A ; Baker, FA (SAGE PUBLICATIONS INC, 2022-09)
    Qualitative systematic reviews, or qualitative evidence syntheses (QES), are increasingly used in health settings to guide the development of practice and policy. Thematic synthesis is one of the most well-developed approaches used for QES, however there are limited worked examples describing how to apply the steps of analysis in the literature. This paper describes the processes and decisions undertaken in a qualitative systematic review and thematic synthesis from the perspective of a novice researcher. The described review aimed to explore the shared musical experiences of people living with dementia and their family care partners across a range of settings. We found that shared musical activities fostered experiences of connection and wellbeing for people living with dementia and their family care partners. This was demonstrated with moderate-high confidence through six themes, and our findings informed the development of the Contextual Connection Model of Health Musicking. In presenting a worked example of our review, this paper introduces a systematic approach to coding and discusses the complexities of developing and reporting on analytical themes. We identify the need for a specific thematic synthesis reporting tool, and the need to embed reflexive practices into QES tools more broadly.
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    Demographic and clinical profile of residents living with dementia and depressive symptoms in Australian private residential aged care: Data from the Music Interventions for Dementia and Depression in ELderly care (MIDDEL) cluster-randomised controlled trial
    Lee, Y-EC ; Sousa, TV ; Stretton-Smith, PA ; Gold, C ; Geretsegger, M ; Baker, FA (WILEY, 2022-12)
    OBJECTIVES: 1) To describe the demographic and clinical characteristics of residents with dementia and depressive symptoms in the Australian private residential aged care (RAC) context; and 2) to investigate the association between neuropsychiatric symptoms, depression and quality of life and their interactions with dementia severity. METHODS: This study examined the baseline demographic and clinical data from the Australian arm of the Music Interventions for Dementia and Depression in ELderly care (MIDDEL) study, a multinational, cluster-randomised controlled trial. Demographic characteristics, neuropsychiatric symptoms, depression, quality of life and dementia severity were collected in 330 residents of 12 private RAC facilities across Melbourne, Australia. Descriptive statistics, the Kruskal-Wallis test and the Pearson Χ2 test were used to describe and compare the demographic and clinical characteristics according to dementia severity. The association between clinical characteristics and dementia severity was examined using linear regression analyses. RESULTS: Residents' mean age was 86.5 years, 69% were female, and 44.2% had severe dementia. There were no significant differences between the dementia severity groups on age, sex and education. Residents with severe dementia were more likely to have a diagnosis of Alzheimer's disease (40.3%) and be born overseas (46.8%). Higher levels of neuropsychiatric symptoms, distress and depressive symptoms, and lower quality of life were associated with more severe dementia. CONCLUSIONS: The findings from our study highlight the diverse and complex care needs of people living with dementia in the Australian private RAC setting, which can be used to inform targeted, person-centred dementia care planning, staff training and allocation of resources.
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    Exploring self-concept, wellbeing and distress in therapeutic songwriting participants following acquired brain injury: A case series analysis
    Roddy, C ; Rickard, N ; Tamplin, J ; Lee, YEC ; Baker, FA (Taylor & Francis, 2020-02-07)
    Acquired brain injury (ABI) presents a significant threat to sense of self and necessitates a complex process of psychosocial adjustment. Self-concept changes remain understudied in the early stages of inpatient rehabilitation. The aim of the current study was to examine changes in self-concept, distress, wellbeing and functional skills for five inpatients undertaking a music therapy intervention within a subacute rehabilitation centre in Victoria, Australia. Participants completed a six-week, 12-session therapeutic songwriting programme to produce past-, current- and future-self-focused songs. A range of self-concept, subjective wellbeing and distress measures were completed pre-, mid- and post-intervention. A descriptive case series approach was applied to determine trends in pre-post scores for five individual cases. Participants showing the greatest gains across self-concept and subjective wellbeing indices also showed the greatest functional gains on the Functional Independence Measure (FIM) from admission to discharge. The current study highlights the importance of examining early changes in self-concept, wellbeing and distress in subacute rehabilitation, and suggests that individualised songwriting programmes warrant further research attention in neurological populations.
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    The HOMESIDE Music Intervention: A Training Protocol for Family Carers of People Living with Dementia
    Odell-Miller, H ; Blauth, L ; Bloska, J ; Bukowska, AA ; Clark, IN ; Crabtree, S ; Engen, RB ; Knardal, S ; Kvamme, TK ; McMahon, K ; Petrowitz, C ; Smrokowska-Reichmann, A ; Stensaeth, K ; Tamplin, J ; Wosch, T ; Wollersberger, N ; Baker, FA (MDPI, 2022-12)
    Background: The number of people living with dementia (PwD) worldwide is expected to double every 20 years. Many continue living at home, receiving support from family caregivers who may experience significant stress, simultaneously to that of the PwD. Meaningful and effective home-based interventions to support PwD and their caregivers are needed. The development of a theory- and practice-driven online home-based music intervention (MI) is delivered by credentialed music therapists, nested within the HOMESIDE RCT trial. Methods: Dyads including the PwD and their family carer are randomised to MI, reading (RI) or standard care (SC). MI aims to support health wellbeing and quality of life by training caregivers to intentionally use music (singing, instrument playing, movement/dancing, and music listening) with their family member (PwD) in daily routines. MI is underpinned by cognitive, relational, social, and psychological theories of mechanisms of change. Results: Preliminary sub-cohort results analyses show MI can be delivered and is accepted well by participants and music-therapist interventionists across five countries. Conclusions: The specialist skills of a music therapist through MI enable carers to access music when music therapists are not present, to meet carer and PwD needs. Music therapists embrace this changing professional role, observing therapeutic change for members of the dyads.