Melbourne Conservatorium of Music - Research Publications

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    Comparing health gains, costs and cost-effectiveness of 100s of interventions in Australia and New Zealand: an online interactive league table
    Carvalho, N ; Sousa, TV ; Mizdrak, A ; Jones, A ; Wilson, N ; Blakely, T (BMC, 2022-07-27)
    BACKGROUND: This study compares the health gains, costs, and cost-effectiveness of hundreds of Australian and New Zealand (NZ) health interventions conducted with comparable methods in an online interactive league table designed to inform policy. METHODS: A literature review was conducted to identify peer-reviewed evaluations (2010 to 2018) arising from the Australia Cost-Effectiveness research and NZ Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programmes, or using similar methodology, with: health gains quantified as health-adjusted life years (HALYs); net health system costs and/or incremental cost-effectiveness ratio; time horizon of at least 10 years; and 3% to 5% discount rates. RESULTS: We identified 384 evaluations that met the inclusion criteria, covering 14 intervention domains: alcohol; cancer; cannabis; communicable disease; cardiovascular disease; diabetes; diet; injury; mental illness; other non-communicable diseases; overweight and obesity; physical inactivity; salt; and tobacco. There were large variations in health gain across evaluations: 33.9% gained less than 0.1 HALYs per 1000 people in the total population over the remainder of their lifespan, through to 13.0% gaining > 10 HALYs per 1000 people. Over a third (38.8%) of evaluations were cost-saving. CONCLUSIONS: League tables of comparably conducted evaluations illustrate the large health gain (and cost) variations per capita between interventions, in addition to cost-effectiveness. Further work can test the utility of this league table with policy-makers and researchers.
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    Editorial: Cognition and Music Performance
    Herrero, L ; Lopez-Iniguez, G ; Casanova, O ; Zarza-Azulgaray, FJ ; McPherson, GE (FRONTIERS MEDIA SA, 2022-06-09)
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    What Young People Think About Music, Rhythm and Trauma: An Action Research Study
    McFerran, K ; Crooke, A ; Kalenderidis, Z ; Stokes, H ; Teggelove, K (FRONTIERS MEDIA SA, 2022-06-14)
    A number of popular theories about trauma have suggested rhythm has potential as a mechanism for regulating arousal levels. However, there is very little literature examining this proposal from the perspective of the young people who might benefit. This action research project addresses this gap by collaborating with four groups of children in the out-of-home-care system to discover what they wanted from music therapists who brought a strong focus on rhythm-based activities. The four music therapy groups took place over a 12 month period and each cycle of action and reflection led to adjustments in what activities were offered, as well as exploring different levels of structure and ways of building relationships in the groups. The initial group incorporated a strong emphasis on highly structured rhythm-based activities, but young people found the format difficult to engage with. The second cycle included more opportunities for creativity and self-direction within semi-structured activities which children reported enjoying, but too much freedom also became overwhelming at times. The two groups in the third cycle seemed to balance structure and responsiveness successfully but were also influenced by the introduction of individual sessions prior to group commencement, which was designed to contribute to safety and trust building. Final reflections on the role of rhythm in supporting young people who have had adverse experiences were centred around the ideas of co-regulation. This was qualitatively different to our expectations that practicing rhythm-based activities would lead to an expanded window of tolerance that resulted in less time being spent in either hypo-arousal or hyper-arousal. Instead of entraining to an external rhythm, young people felt safe when their rhythms were matched, even if they were irregular, out of time and unpredictable. The small moments of co-regulation resulted in pleasure, comfort, satisfaction and peace and these moments were highly valued by the young people, who described just wanting to be relaxed and happy. Although not as rhythm-specific as the literature might suggest, music making with trusted adults helped the young people in this study feel more content.
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    Feedback in Music Performance Teaching.
    McPherson, GE ; Blackwell, J ; Hattie, J (Frontiers Media SA, 2022)
    The purpose of this article is to provide one prominent perspective from the research literature on a conception of feedback in educational psychology as proposed by John Hattie and colleagues, and to then adapt these concepts to develop a framework that can be applied in music performance teaching at a variety of levels. The article confronts what we see as a lack of understanding about the importance of this topic in music education and provides suggestions that will help music teachers refocus how they use feedback within their teaching. Throughout the article, we draw heavily on the work of John Hattie and his colleagues whose explanations on all facets of feedback, but especially those forms of feedback that are focused on ensuring students understand "where to next"-have had a huge impact on school education through various publications.
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    Positive Psychology in Therapeutic Songwriting for People Living with Late-Life Depression-An Intervention Protocol
    Eickholt, J ; Baker, FA ; Clark, IN (MDPI, 2022-05-01)
    (1) Background: An increasing number of people are living with late-life depression, yet non-pharmacological treatments to help manage symptoms are limited. Two interventions, positive psychology and music therapeutic songwriting, have independently led to decreased depressive symptoms and an improved wellbeing in older people over 65 years old. (2) Methods: This article describes the development of a therapeutic songwriting program for people living with late-life depression. Knowledge from positive psychology and therapeutic songwriting was combined to maximize the potential benefits. (3) Results: The intervention program has ten weekly 45 min sessions that incorporate elements from positive psychology into therapeutic songwriting. Using a three-song approach encompassing ongoing musical practices, different positive psychology interventions were incorporated to support the experiences associated with a flourishing life. The intervention protocol for older people presented here is distinct from previous deficit-orientated approaches in that it shifts the focus to positive experiences, resources, and the individual's ability to decrease their own depressive symptoms and improve their wellbeing. (4) Discussion: This protocol presenting a therapeutic songwriting program meets the need to develop new non-pharmacological treatment options. However, further studies are needed to examine the feasibility and impact of the intervention program on late-life depression and wellbeing in older people.
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    Music Interventions and Delirium in Adults: A Systematic Literature Review and Meta-Analysis
    Golubovic, J ; Neerland, BE ; Aune, D ; Baker, FA (MDPI, 2022-05-01)
    Delirium is a neuropsychiatric syndrome represented by an acute disturbance in attention, awareness and cognition, highly prevalent in older, and critically ill patients, and associated with poor outcomes. This review synthesized existing evidence on the effectiveness of music interventions on delirium in adults, and music interventions (MIs), psychometric assessments and outcome measures used. We searched MEDLINE, PsychINFO, SCOPUS, Clinical Trials and CENTRAL for quantitative designs comparing any MIs to standard care or another intervention. From 1150 studies 12 met the inclusion criteria, and 6 were included in the meta-analysis. Narrative synthesis showed that most studies focused on prevention, few assessed delirium severity, with the majority of studies reporting beneficial effects. The summary relative risk for incident delirium comparing music vs. no music in postsurgical and critically ill older patients was 0.52 (95% confidential interval (CI): 0.20-1.35, I2 = 79.1%, heterogeneity <0.0001) for the random effects model and 0.47 (95% CI: 0.34-0.66) using the fixed effects model. Music listening interventions were more commonly applied than music therapy delivered by credentialed music therapists, and delirium assessments methods were heterogeneous, including both standardized tools and systematic observations. Better designed studies are needed addressing effectiveness of MIs in specific patient subgroups, exploring the correlations between intervention-types/dosages and delirium symptoms.
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    Music and Psychology & Social Connections Program: Protocol for a Novel Intervention for Dyads Affected by Younger-Onset Dementia
    Loi, SM ; Flynn, L ; Cadwallader, C ; Stretton-Smith, P ; Bryant, C ; Baker, FA (MDPI, 2022-04-01)
    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.
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    Neural activation during emotional interference corresponds to emotion dysregulation in stressed teachers.
    Fynes-Clinton, S ; Sherwell, C ; Ziaei, M ; York, A ; O'Connor, ES ; Forrest, K ; Flynn, L ; Bower, J ; Reutens, D ; Carroll, A (Springer Science and Business Media LLC, 2022-04-20)
    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.
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    Teacher stress and burnout in Australia: examining the role of intrapersonal and environmental factors.
    Carroll, A ; Forrest, K ; Sanders-O'Connor, E ; Flynn, L ; Bower, JM ; Fynes-Clinton, S ; York, A ; Ziaei, M (Springer Science and Business Media LLC, 2022)
    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.
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    The role of artistic creative activities in navigating the COVID-19 pandemic in Australia
    Kiernan, F ; Chmiel, A ; GARRIDO, S ; Hickey, M ; Davidson, J ; Hansen, NC ; Wald-Fuhrmann, M ; Davidson, J (Frontiers Media, 2022)
    During the COVID-19 pandemic some Australians turned to artistic creative activities (ACAs) as a way of managing their own mental health and well-being. This study examined the role of ACAs in regulating emotion and supporting mental health and well-being during the COVID-19 pandemic, and also attempted to identify at-risk populations. We proposed that (1) participants would use ACAs as avoidance-based emotion regulation strategies; and (2) music engagement would be used for emotion regulation. Australian participants (N = 653) recruited from the general public completed an online survey, which included scales targeting anxiety (GAD7 scale), depression (PHQ9 scale) and loneliness (two UCLA Loneliness Scales, referring to “Before” and “Since” COVID-19). Participants reported which ACAs they had undertaken and ceased during the pandemic using an established list and ranked their undertaken ACAs in terms of effectiveness at making them “feel better.” For their top-ranked ACA, participantsthen completed the Emot on Regulation Scale for Artistic Creative Activities (ERS-ACA), and if participants had undertaken any musical ACAs, also the Musical Engagement Questionnaire (MusEQ). The results supported both hypotheses. ANOVAs indicated that participants ranked significantly higher on the “avoidance” ERS-ACA subscale than the other subscales, and that participants ranked significantly higher on the emotion regulation and musical preference MusEQ subscales than the other subscales. Additionally, while ACAs such as “Watching films or TV shows” and “Cookery or baking” were common, they ranked poorly as effective methods of emotion regulation, whereas “Listening to music” was the second-most frequently undertaken ACA and also the most effective. “Singing” and “Dancing” were among the most ceased ACAs but also ranked among the most effective for emotion regulation, suggesting that support for developing pandemic-safe approaches to these ACAs may provide well-being benefits in future crises. Additionally, correlation analyses howed that younger participants, those who took less exercise during the pandemic, and those with the highest musical engagement reported the poorest well-being.We conclude that ACAs provided an important resource for supporting mental health and well-being during the COVID-19 pandemic in Australia and could potentially support mental health and well-being in future crises.