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  • Disputation: 2019-12-13 13:00 Örebro universitet, Hörsalen, Musikhögskolan, Örebro
    Ullsten, Alexandra
    Örebro universitet, Musikhögskolan.
    Singing, sharing, soothing: Family-centred music therapy during painful procedures in neonatal care2019Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    To sing is to communicate. The soothing, comforting and emotional regulating properties of a lullaby are well-known cross-culturally and historically. This doctoral thesis addresses neonatal pain management from a novel and groundbreaking perspective, studying the efficacy of live music therapy on infants’ pain responses during venepuncture. New research is needed to advance the non-pharmacological interventions in neonatal pain care, and neonatal music therapy (NICU MT) offers active methods to involve the parents in pain management. The doctoral thesis includes two empirical and two theoretical articles. In paper I, preterm and term infants (n=38) were subjected to venepuncture with and without live lullaby singing, in a randomised order with a crossover design. Parent-preferred lullabies were performed live by a music therapy student and standard care was provided for all infants. The results did not show any significant pain-alleviating effects, however, the live singing was not stressful for the infants.

    In paper II, the microanalysis disclosed that live lullaby singing is a communicative reciprocal intervention that also applies to premature infants during painful procedures. Live lullaby singing is a tool suitable as a means to optimise the homeostatic mechanisms. The results from the theoretical papers III and IV are further developed and synthesised in the thesis into a theoretical strategy; The Nordic NICU MT pain management strategy, featuring the parents and their singing voices as mediators for pain relief. The role of the music therapist in neonatal pain management is as a facilitator and an educator for the parents. Coaching parents to better meet their infant’s attachment needs during a painful procedure may lead to more efficacious interventions. The biopsychosocial parental infant-directed singing is presumably an applicable parent-driven non-pharmacological intervention, which promotes pain relief and attachment formation during painful procedures. Neonatal music therapy is still in its infancy in the Nordic countries, but the societal and healthcare contexts afford important prerequisites to further develop NICU MT as a truly family-centred approach. This doctoral thesis will hopefully contribute to the important interdisciplinary endeavour worldwide of involving and integrating parents in neonatal pain management.

    Delarbeten
    1. Efficacy of Live Lullaby Singing During Procedural Pain in Preterm and Term Neonates
    Öppna denna publikation i ny flik eller fönster >>Efficacy of Live Lullaby Singing During Procedural Pain in Preterm and Term Neonates
    Visa övriga...
    2017 (Engelska)Ingår i: Music and Medicine, ISSN 1943-8621, Vol. 9, nr 2, s. 73-85Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    This clinical trial tested the pain relieving effect of live lullaby singing on behavioral and physiological pain responses during venepuncture in 38 preterm and full term neonates. Acute and repeated pain, as well as the use of analgesic drugs, may have long-term negative impact on infants’ development and future behaviour. This emphasizes the need for complementary approaches to pain management such as music therapy.

    Parent-preferred lullabies were performed live and standard care was provided for all neonates. Behavioral responses with regard to pain were assessed with Premature Infant Pain Profile-Revised (PIPP-R) and Behavioral Indicators of Infant Pain (BIIP). Heart rate, respiratory rate and oxygen saturation were measured each tenth second.

    Although the live lullaby singing did not show a statistically significant effect on the infants’ pain score, there was a significantly calmer breathing pattern in the lullaby intervention versus the control condition in the pre-needle stage, showing a non-significant trend towards higher oxygen saturation levels and calmer heart rate in the lullaby intervention versus the control condition in the pre-needle stage. There were non-significant indications of fewer and shorter skin punctures with lullaby singing. More research is needed to explore such positive trends in the data.

    Ort, förlag, år, upplaga, sidor
    PKP Publishing Services, 2017
    Nyckelord
    newborn infant, preterm infant, pain, music therapy, lullaby
    Nationell ämneskategori
    Pediatrik
    Forskningsämne
    Musikvetenskap
    Identifikatorer
    urn:nbn:se:oru:diva-68308 (URN)
    Tillgänglig från: 2018-07-31 Skapad: 2018-07-31 Senast uppdaterad: 2019-11-19Bibliografiskt granskad
    2. Live music therapy with lullaby singing as affective support during painful procedures: a case study with microanalysis
    Öppna denna publikation i ny flik eller fönster >>Live music therapy with lullaby singing as affective support during painful procedures: a case study with microanalysis
    2017 (Engelska)Ingår i: Nordic Journal of Music Therapy, ISSN 0809-8131, Vol. 26, nr 2, s. 142-166Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    During the most vulnerable period in a child’s life, preterm and sick infants are exposed to a high number of painful procedures, sometimes without the comfort and affection of their parents. Since repeated pain and frequent use of analgesic drugs may have consequences for the neurological and behaviour-oriented development of the infant, it is vital to identify effective non-pharmacological interventions with regard to procedural pain. This paper reviews the use of live lullaby singing as an adjuvant to the control of premature infant pain. The objectives of this case study were to analyse the live lullaby singing for two premature infants during venipuncture in comparison to standard care only, and the infants’ physiological and affective responses emerging before, during and after this procedure. The empirical data stem from a quantitative clinical study. From this larger study, two premature infants were selected. Through microanalysis, with in-depth analysis of video footage, and pain assessment with Behavioral Indicators of Infant Pain (BIIP), painful standard care procedures with and without live lullaby singing, were analysed. The results show that live lullaby singing with premature infants is a communicative interaction which may optimize the homeostatic mechanisms of the infant during painful procedures. This case study shows the importance of predictability of the affective support, right from the start of the live singing intervention. It is important in a painful context that vocal interactions provide regular and comforting intensity, shape and temporal structures.

    Ort, förlag, år, upplaga, sidor
    Oxon, United Kingdom: Routledge, 2017
    Nyckelord
    Pain management, premature infants, music therapy, infant directed singing, lullaby
    Nationell ämneskategori
    Musikvetenskap
    Forskningsämne
    Hälso- och sjukvårdsforskning
    Identifikatorer
    urn:nbn:se:oru:diva-49326 (URN)10.1080/08098131.2015.1131187 (DOI)000394440800004 ()2-s2.0-84988566335 (Scopus ID)
    Anmärkning

    Funding Agencies:

    Värmland County Council, Sweden

    Queen Silvia's Jubilee Fund, Sweden

    Karin and Erik Gerdens Foundation, Sweden

    Berit and Carl-Johan Wettergrens Foundation, Sweden

    Tillgänglig från: 2016-03-13 Skapad: 2016-03-13 Senast uppdaterad: 2019-11-19Bibliografiskt granskad
    3. Singing, sharing, soothing: Biopsychosocial rationales for parental infant directed singing in neonatal pain management: A theoretical approach
    Öppna denna publikation i ny flik eller fönster >>Singing, sharing, soothing: Biopsychosocial rationales for parental infant directed singing in neonatal pain management: A theoretical approach
    2018 (Engelska)Ingår i: Music & Science, ISSN 2059-2043, Vol. 1, s. 1-13Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Infant-directed singing is a medium for parents and infants to communicate in a mutual relationship. Parental infant-directed singing is a multisensory, biopsychosocial communication that applies to ill and vulnerable hospitalised infants. The primary musical features of infant-directed singing are ideal for emotional coordination and sharing between parent and infant without the risk of over-stimulation. In this article, we suggest that parental infant-directed singing is regarded as a nonpharmacological emotion regulation intervention, which may modify the painful experience for both the infant and the parent before, during and after painful procedures in the neonatal intensive care context. Parents have the biopsychosocial resources to alleviate their infant’s pain through infant-directed singing, if they are empowered to do so and coached in this process. A music therapist specialised in neonatal music therapy methods can mentor parents in how to use entrained and attuned live lullaby singing in connection to painful procedures. Pain and the vast amount of painful procedures early in infancy, combined with early parent–infant separation and lack of parental participation in the care of the infant during neonatal intensive care, place arduous strain on the new family’s attachment process and on the infant’s and parents’ mental health, both from a short and long-term perspective. Therefore, we argue with biopsychosocial rationales, that live parental infant-directed singing should be promoted in neonatal pain care worldwide. Consequently, parents should be welcomed round the clock and invited as prescribed pain management for their infant.

    Ort, förlag, år, upplaga, sidor
    Sage Publications, 2018
    Nyckelord
    Affect attunement, biopsychosocial, infant, infant-directed singing, music therapy, pain management, parent, vitality affects
    Nationell ämneskategori
    Musikvetenskap
    Forskningsämne
    Hälso- och sjukvårdsforskning
    Identifikatorer
    urn:nbn:se:oru:diva-67535 (URN)10.1177/2059204318780841 (DOI)
    Tillgänglig från: 2018-06-27 Skapad: 2018-06-27 Senast uppdaterad: 2019-11-19Bibliografiskt granskad
    4. Development of family-centred care informing Nordic neonatal music therapy
    Öppna denna publikation i ny flik eller fönster >>Development of family-centred care informing Nordic neonatal music therapy
    2019 (Engelska)Ingår i: Music in paediatric hospitals – Nordic perspectives / [ed] Lars Ole Bonde, Kjersti Johansson, Oslo: CREMAH, Norwegian Academy of Music , 2019, s. 1-25Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Since the 1990s, the concept of family-centred care, where the family and healthcare staff share responsibility for the infant’s hospital care, has been part of an ongoing paradigm shift in neonatal care globally. The public health care system with family-friendly parental leave policies might be one of the reasons that the Nordic countries today are at the forefront of welcoming and including parents and partners in the care of their infant round the clock. When implementing neonatal music therapy (NICU MT) in the context of Nordic health care, music therapy models of practice as well as research ought to be defined and shaped by the family-centred care model, which today is considered best practice. The Nordic context also offers favourable conditions for further developing NICU MT approaches in line with family-centred care. NICU MT was first developed in the USA in the 1980s and the interventions were infantfocused, emphasising the infant’s physical and medical needs, which was the existing care focus in neonatal care at that time. Neonatal music therapy and research in the Nordic countries is still in its infancy. Systematic implementation work was first initiated in Karlstad, Sweden in 2010 and in Akershus and Oslo, Norway in 2017. 

    This essay provides the international music therapy field as well as other professionals in paediatric and neonatal health care an insight into the evolving Nordic approach of NICU MT. The conclusion of this essay is that the familycentred care approach in the Nordic NICUs, combined with the progressive family politics in the Nordic countries with generous parental leave schemes and gender equality in childcare, afford important prerequisites to further develop NICU MT as a truly family-centred approach.

    Ort, förlag, år, upplaga, sidor
    Oslo: CREMAH, Norwegian Academy of Music, 2019
    Serie
    CREMAH Anthology ; 11
    Nyckelord
    neonatal music therapy, Nordic perspective, family-centred care, infants, pain management
    Nationell ämneskategori
    Musikvetenskap
    Forskningsämne
    Musikvetenskap
    Identifikatorer
    urn:nbn:se:oru:diva-77701 (URN)
    Anmärkning

    Funding Agency:

    Centre for Clinical Research, Region Värmland, Karlstad, Sweden

    Tillgänglig från: 2019-11-03 Skapad: 2019-11-03 Senast uppdaterad: 2019-11-19Bibliografiskt granskad
  • Disputation: 2019-12-20 13:00 Örebro universitet, Konsertsalen, Musikhögskolan, Örebro
    Larsson, Christina
    Örebro universitet, Musikhögskolan.
    Att lära genom improvisation: en didaktisk studie i grundskolans musikundervisning2019Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    In the growing field of research on improvisation, it is argued that improvisation should be at the core of music education, and in many curricula improvisation is in fact emphasized. However, in general music education, as well as research, improvisation is still overlooked. There seem to be a discursive gap between ‘everyday’ and artistic perceptions of improvisation and the way it is perceived didactically. Improvisation is also a creative music activity form and as such it cannot have prescribed outcomes. Yet, the current goal- and result driven schooling system focuses on achieving prescribed knowledge requirements. This situation constitutes an educational paradox. Through a systematic literature review, interviews with teachers and a practice-based study, this thesis explores the conditions and the role of improvisation in general music education. The theoretical perspective is based on Dewey’s pragmatist philosophy, and his concepts of aesthetic experience and transaction. Results show that improvisation is conceptualised in a continuum between structure and freedom and that teachers’ didactical approaches to improvisation can be oriented towards the process, the subject or Bildung. However, teachers’ perceptions of improvisation as related to jazz and blues sometimes present a hindrance. Combining a practical epistemology analysis with Dewey´s concept of the esthetic event (Dewey´s spelling) provides new insights into the process and content of aesthetic meaning-making. Improvising pupils who have an aesthetic experience can develop expressivity, agency and responsivity (EAR) as well as aspects of embodied, cognitive and ethical knowledge. The transactional perspective and 5 concepts developed here provide new insights in how to understand improvisation in education: as ethically co-creative action, co-learning action, explorative action, a space for imagination and emotional engagement and finally a room for subjectification. This implies a negotiated role for the teacher as co-player. A practical aesthetic analysis (PESA) is suggested which emphasises the specific nature of the aesthetic experience.

    Delarbeten
    1. Improvisation in General Music Education: A literature review
    Öppna denna publikation i ny flik eller fönster >>Improvisation in General Music Education: A literature review
    2019 (Engelska)Ingår i: British Journal of Music Education, ISSN 0265-0517, E-ISSN 1469-2104, Vol. 36, nr 1, s. 49-67Artikel, forskningsöversikt (Refereegranskat) Published
    Abstract [en]

    The overall purpose of this article is to provide a convenient summary of empirical research on improvisation in general music education and thereby provide guidance to researchers and practitioners, using a systematic, narrative-review approach. By analysing 20 music education research articles, published from 2000–2015 in peer-reviewed journals,we firstly provide an overview of the key features and knowledge of existing research. Secondly we identify how improvisation has been characterized, conceptually before, thirdly, describing the implications of the literature for improvisation in practice. Our article reveals that improvisation tends to be an overlooked activity both in music education contexts and in music education research. Broadly speaking, music education research tends to characterise improvisation within two conceptual frameworks, which have different implications for implementation; ‘structured’, teacher-directed improvisation and ‘free’, child-directed improvisation. We conclude by arguing that music educational research on improvisation is an underdeveloped field and outline a number of questions to be addressed in future research.

    Ort, förlag, år, upplaga, sidor
    Cambridge University Press, 2019
    Nationell ämneskategori
    Musikvetenskap
    Forskningsämne
    Musikvetenskap
    Identifikatorer
    urn:nbn:se:oru:diva-52882 (URN)10.1017/S026505171800013X (DOI)000466759900005 ()2-s2.0-85048884464 (Scopus ID)
    Tillgänglig från: 2016-10-10 Skapad: 2016-10-10 Senast uppdaterad: 2019-11-26Bibliografiskt granskad
    2. Improvisation i musikundervisningen: tre lärares didaktiska förhållningssätt
    Öppna denna publikation i ny flik eller fönster >>Improvisation i musikundervisningen: tre lärares didaktiska förhållningssätt
    (Svenska)Manuskript (preprint) (Övrigt vetenskapligt)
    Nationell ämneskategori
    Musikvetenskap
    Identifikatorer
    urn:nbn:se:oru:diva-78148 (URN)
    Tillgänglig från: 2019-11-26 Skapad: 2019-11-26 Senast uppdaterad: 2019-11-26Bibliografiskt granskad
    3. A Deweyan take on improvisation as an experience: An example from a Swedish year 4 music class
    Öppna denna publikation i ny flik eller fönster >>A Deweyan take on improvisation as an experience: An example from a Swedish year 4 music class
    2019 (Engelska)Ingår i: Expanding the space for improvisation pedagogy in music: a transdisciplinary approach / [ed] G. G. Johansen, K. Holdhus, C. Larsson & U. MacGlone, London: Routledge, 2019, s. 61-81Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    In this chapter I argue that specific valuable educational qualities can be developed through free group improvisation in general music education. My claims are operationalised through a set of research questions to investigate students’ actions, and characteristics as well as implications of these actions in improvisation events. John Dewey’s theory of aesthetic experience, and more specifically an experience, is employed as analytical lens in analysis of children’s improvisations. I argue that an experience in improvisation occurs in and through a reciprocal interaction with the environment which means that when children improvise, they change due to their musical experiences but they also in turn change their musical environment. Crucially, I argue that having an experience in free group improvisation can cultivate Expressiveness, Agency and Responsiveness.

    Ort, förlag, år, upplaga, sidor
    London: Routledge, 2019
    Nyckelord
    improvisation, general music education, aesthetic experience, an experience
    Nationell ämneskategori
    Musikvetenskap
    Identifikatorer
    urn:nbn:se:oru:diva-78149 (URN)9780815392101 (ISBN)9781351199957 (ISBN)
    Tillgänglig från: 2019-11-26 Skapad: 2019-11-26 Senast uppdaterad: 2019-11-27Bibliografiskt granskad
    4. Music improvisation as an aesthetic event: Towards a transactional approach to meaning-making
    Öppna denna publikation i ny flik eller fönster >>Music improvisation as an aesthetic event: Towards a transactional approach to meaning-making
    2018 (Engelska)Ingår i: European Journal of Philosophy in Arts Education, ISSN 2002-4665, Vol. 3, nr 1, s. 121-181Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Improvisation in general music education is still a somewhat underdeveloped practice. Moreover, attempts to justify its place in the curriculum have often focused solely on its (measurable) outcomes. In this article, we claim that a deeper understanding of students' meaning-making processes in experiences of improvisation is necessary in order to develop improvisation practice and research. The purpose of this article is to offer a music education perspective on improvisation based on John Dewey's transactional perspective on aesthetic experience and meaning-making. Related to this, we suggest and illustrate a Practical Epistemology Analysis (PEA) as a way of analysing meaning-making in music improvisation within general music education. The method of analysis is illustrated by vignettes from video analyses of music lessons in two Swedish schools with pupils aged 9-10 and their free improvisations. The vignettes show how PEA enables analyses of situated meaning-making in the progress of the pupils' improvisation activities. Further, the transactional perspective makes educational values of improvisation visible, such as musical and personal agency, and elucidates cognitive, embodied and ethical aspects of musical meaning-making.

    Ort, förlag, år, upplaga, sidor
    Stockholms Musikpedagogiska Institut / Stockholm University College of Music Education, 2018
    Nationell ämneskategori
    Samhällsvetenskap Musikvetenskap
    Forskningsämne
    Musikvetenskap med musikpedagogisk inriktning
    Identifikatorer
    urn:nbn:se:oru:diva-70322 (URN)
    Tillgänglig från: 2018-11-25 Skapad: 2018-11-25 Senast uppdaterad: 2019-11-26Bibliografiskt granskad
  • Disputation: 2020-01-17 09:00 Örebro universitet, Campus USÖ, hörsal C1, Örebro
    Holster, Savanne
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Faecal Microbiota Transfer in Irritable Bowel Syndrome and Collagenous Colitis: Clinical outcomes and host-microbe interactions2020Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
  • Disputation: 2020-01-17 13:15 Örebro universitet, Prismahuset, Hörsal P1, Örebro
    Hort, Sofia
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Skrivprocesser på högskolan. Text, plats och materialitet i uppsatsskrivandet2020Doktorsavhandling, monografi (Övrigt vetenskapligt)
  • Disputation: 2020-01-31 13:00 Örebro universitet, Forumhuset, Hörsal F1, Örebro
    Lakew, Yuliya
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Matter of public connection: The role of mediated and interpersonal communication in young people's environmental engagement2020Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
  • Disputation: 2020-02-14 09:00 Örebro universitet, Campus USÖ, hörsal C3, Örebro
    Joelson, Anders
    Örebro universitet, Institutionen för medicinska vetenskaper.
    High-grade spondylolisthesis in young patients: Long-term results of in situ fusion2020Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
  • Disputation: 2020-05-29 13:15 Örebro universitet, Forumhuset, Hörsal F, Örebro
    Sandström, Lina
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Seeking Asylum - Finding a Home?: A qualitative study on asylum seekers' integration in two different housing contexts2020Doktorsavhandling, monografi (Övrigt vetenskapligt)