Analysis of the motor behaviour of people without specific dance training in improvisation tasks: Influence of mirror and partner.

This study aims to analyse the influence of the mirror and/or partner constraints on the motor creativity of women without specific training in dance during improvisation tasks, in order to contribute to the knowledge of creativity in the field of sports science and movement-based practices. We studied the exploratory behaviour and emerging movement patterns of 12 women who performed four improvisations under the following situations: individual without mirror; individual with mirror; partner without mirror; and partner with mirror. The dynamic overlap qd(t) was calculated to identify the exploratory dynamics composed of the exploratory amplitude and the rate of change between movement configurations. To determine emerging movement patterns, a principal component analysis was carried out by ad hoc routines prepared. A mixed linear model was performed to find out the influence of the different constraints on the exploratory behaviour. The results indicate that the presence of the mirror seems to provoke a decrease in the exploratory behaviour. In addition, partner improvisation favoured coupling and imitation dynamics among the participants. Likewise, the most recurrent emergent movement pattern was walking while moving the arms. It would be advisable to take the influence of these constraints into consideration depending on the improvisation purpose and the experience level of female participants.

The ecological dynamics of trumpet improvisation.

The nature of music improvisation continues to provide an interesting showcase of the multifaceted and skilful ways we engage with and act within our environments. Improvising musicians are somehow able to generate musical material in real time that adaptively navigates musical situations. In this article I explore the broader aspects of improvised activity-such as our bodily interactions with the instrument and environment-as they relate to improvised music-making. I do so by drawing upon principles from the embodied cognitive sciences, namely ecological and dynamical systems approaches. Firstly, I introduce the concept of affordances to illustrate the bidirectional relationship between improvisor and environment. I then take a dynamical view, exploring the ways that a trumpet player coordinates their body with their instrument and engages with trumpet affordances in order to navigate musical situations. I continue this dynamical view, taking the improviser to be an adaptive system whose behaviours are self-organised responses to a set of constraints. To conclude, I situate my research within the wider 4E approach. I advocate that 'E' approaches, which take seriously the role of the body-instrument-environment relationship, provide an insightful perspective on the nature of improvisation.

Exploring improvisations in road safety in a low-income setting.

Road collision types repeat themselves, especially in low- and middle-income countries (LMICs), where countermeasures are often improvised and implemented with little planning. At the Shahbag intersection in Dhaka, Bangladesh, speed bumps were quickly constructed at the exit of the intersection as an improvised road safety measure following the occurrence of a fatal collision, which eventually contributed to another collision between a truck and a car. The events influencing the improvisation decision, and that action's consequences, have been analysed using the Impromap methodology, a variation of the Accimap approach that focusses specifically on improvisation. The applicability of the Impromap as a systems-based approach to the road safety domain is assessed using the predictions described in Rasmussen's risk management framework, and corresponding countermeasures are proposed. The analysis shows that improvisation in the road safety domain is undesirable irrespective of the economic setting as it is likely to eventually contribute to secondary collisions.Practitioner summary: In this paper, the events influencing the improvisation decision following a road crash, and that action's consequences, have been analysed using the Impromap methodology. The applicability of Impromap as a systems-based approach in road safety domain is assessed using the Rasmussen's risk management framework-based predictions, and corresponding countermeasures are proposed.

State-of-the-art review of medical improvisation curricula to teach health professional learners communication.

Medical improvisation (improv) applies theater principles and techniques to improve communication and teamwork with health professionals (HP). Improv curricula have increased over time, but little is known about best practices in curricula development, implementation, and assessment. We sought to complete a state-of-the-art review of medical improv curricula to teach HP learners communication skills. A literature search of MEDLINE and 8 other databases on HP medical education and medical improv communication curricula occurred. We screened 1869 articles published from 2012 to 2022. Seventeen articles were selected for extraction and synthesis. Common curricular goals included improving interprofessional, interpersonal, and empathetic communication. Curricula often lacked alignment between learning objectives and improv exercises. Sessions occurred once (65%) or were longitudinal (35%). Only 24% reported a full description of their intervention. Few reported details on the content of curricula. Evaluations often focused on feasibility and acceptability. Heterogeneity exists in the development, implementation, and assessment of improv curricula. Low-quality evidence was provided to support the use of medical improv to teach communication skills to HP learners. Improv curricula were feasible, and acceptable to learners. We offer recommendations to guide future medical improv curricula development.

Use of theatresports to promote positive education among youth participants.

BACKGROUND: Due to the scarcity of research on the benefits of theatresports for youth, this study examined the outcomes of theatresports as a means to implement positive education in youth work settings. METHODS: To this end, qualitative research was conducted with 92 participants in a theatresports program. Thematic analysis was applied to analyze the participants' experiences of the program, using the framework of positive education. RESULTS: Results showed that the processes and practices of the theatresports program helped the participants achieved well-being in terms of various domains namely positive emotions, positive health, positive relationships, positive engagement, positive accomplishment, and positive meaning. These capabilities and qualities acquired helped them achieve well-being, and the learning acquired from the program could even be applied to daily life situations and deal with the challenges. CONCLUSIONS: This shows that the theatresports program manifests the benefits of positive education. Corresponding implications were discussed.

Novel concepts and improvisation for treating postpartum haemorrhage: a narrative review of emerging techniques.

BACKGROUND: Most treatments for postpartum haemorrhage (PPH) lack evidence of effectiveness. New innovations are ubiquitous but have not been synthesized for ready access. NARRATIVE REVIEW: Pubmed 2020 to 2021 was searched on 'postpartum haemorrhage treatment', and novel reports among 755 citations were catalogued. New health care strategies included early diagnosis with a bundled first response and home-based treatment of PPH. A calibrated postpartum blood monitoring tray has been described. Oxytocin is more effective than misoprostol; addition of misoprostol to oxytocin does not improve treatment. Heat stable carbetocin has not been assessed for treatment. A thermostable microneedle oxytocin patch has been developed. Intravenous tranexamic acid reduces mortality but deaths have been reported from inadvertent intrathecal injection. New transvaginal uterine artery clamps have been described. Novel approaches to uterine balloon tamponade include improvised and purpose-designed free-flow (as opposed to fixed volume) devices and vaginal balloon tamponade. Uterine suction tamponade methods include purpose-designed and improvised devices. Restrictive fluid resuscitation, massive transfusion protocols, fibrinogen use, early cryopreciptate transfusion and point-of-care viscoelastic haemostatic assay-guided blood product transfusion have been reported. Pelvic artery embolization and endovascular balloon occlusion of the aorta and pelvic arteries are used where available. External aortic compression and direct compression of the aorta during laparotomy or aortic clamping (such as with the Paily clamp) are alternatives. Transvaginal haemostatic ligation and compression sutures, placental site sutures and a variety of novel compression sutures have been reported. These include Esike's technique, three vertical compression sutures, vertical plus horizontal compression sutures, parallel loop binding compression sutures, uterine isthmus vertical compression sutures, isthmic circumferential suture, circumferential compression sutures with intrauterine balloon, King's combined uterine suture and removable retropubic uterine compression suture. Innovative measures for placenta accreta spectrum include a lower uterine folding suture, a modified cervical inversion technique, bilateral uterine artery ligation with myometrial excision of the adherent placenta and cervico-isthmic sutures or a T-shaped lower segment repair. Technological advances include cell salvage, high frequency focussed ultrasound for placenta increta and extra-corporeal membrane oxygenation. CONCLUSIONS: Knowledge of innovative methods can equip clinicians with last-resort options when faced with haemorrhage unresponsive to conventional methods.

Unborn babies are nourished by the mother's blood supply to the afterbirth (placenta). After a baby's birth, contractions of the muscles of the womb (uterus) shear the placenta from its attachment and clamp off the mother's blood vessels. This process is assisted by giving an injection which contracts the womb, and pulling gently on the cord to remove the afterbirth. Usually, blood loss is minimal. Occasionally the womb fails to contract effectively or there is bleeding from tears of the birth canal. Bleeding in excess of 500 ml is called postpartum haemorrhage, which can be life-threatening. Excessive bleeding may be treated with medicines to contract the womb or help the blood to clot, rubbing or squeezing the womb, a 'drip' with fluids or blood replacement, placing a balloon or suction device in the womb, and operations to stop the bleeding or remove of the womb (hysterectomy). There is very little hard evidence for the effectiveness of each method. This review highlights recent innovations including approaches to quick diagnosis and rapid treatment, suturing the lower part of the womb via the vagina, improvements in balloon and suction methods, new designs of clamps to apply through the vagina and to clamp the aorta (the main artery of the body), new approaches to giving blood clotting factors, many new types of stitches to compress the uterus, and advanced technology such as ultrasound treatment and artificial oxygenation of the mother's blood. We call for more research to show which methods really work.

Medical improvisation-based motivational interviewing for internal medicine residents: Mixed-methods evaluation of a novel course.

PURPOSE: Develop and assess a novel medical improvisation-based motivational interviewing (MI) curriculum for residents. MATERIALS AND METHODS: A 6-h medical improv-based MI curriculum occurred in 2022 for internal medicine residents. A mixed-methods evaluation included: pre- and post-role plays using the Motivational Interviewing Treatment Integrity Score (MITI) to assess MI competency, a post-course survey assessing confidence, and focus groups to understand learning through improvisation. RESULTS: Participants increased their confidence in applying MI skills after the curriculum in responding to a patient's argument against change (29% pre vs. 72% post, p < 0.001), eliciting change talk (21% vs. 86%, p < 0.001), and providing information in an MI-centric way (39% vs. 86%, p < 0.001). All role-play participants achieved at least beginning proficiency on MITI technical and relational global summary scores post-course. MI-adherent behaviors increased, and MI-non-adherent behaviors decreased in post-course role plays. Themes on learning through improvisation included: (1) improvisation can enhance the learning of MI skills, (2) using non-medical scenarios in improvisation exercises has benefits, and (3) trying improvisation had positive effects on the learning environment. DISCUSSION: A medical improvisation-based course is a promising, engaging way to teach residents MI skills and can improve competence and confidence with MI.

It's never too late to improvise: The impact of theatre improvisation on elderly population.

Despite the availability of improvisational theater training in different settings, studies that assess its effectiveness as a means for enhancing cognitive training for older adults are scarce. This study examines the influence of short theater improvisation exercises on the cognitive flexibility of cognitively-healthy older adults, and their influence on the four core components of improvisation (i.e., spontaneity, flow, creativity, playfulness). The study also examines the correlation between an improvement in these four key agents and an improvement in cognitive flexibility among older adults. This quantitative empirical study was conducted in retirement homes and daycare centers in Israel. A total of 45 participants took part in this study, all in good physical health and with age-appropriate cognitive abilities. The participants were divided into five research groups; each group met twice a week for a one-hour improvisation session over a six-week period. The data was collected through five questionnaires that were completed at four points of time (before, during, and after the workshop). The findings did not indicate a significant effect of the improvisation exercises on the participants' cognitive flexibility, yet they did show improvement in three components of improvisation: spontaneity, flow, playfulness. As such, the findings of this study indicate that despite a normal decline in basic cognitive functioning among older adults, the beneficial effect of improvisation on cognitive flexibility might still occur through spontaneity, playfulness, and flow. In conclusion, short theater improvisation exercises could contribute to various indicators of healthy aging in various settings.

Safe and Sound: An Improvisational Theater-Based Curriculum and Behavioral Intervention to Address Violence in the Emergency Department.

BACKGROUND: Emergency department (ED) workplace violence has become increasingly prevalent in the United States, warranting the development of legislation, policy, and advocacy to protect health care workers. Solutions to address ED violence remain limited, and staff-oriented trainings often exist as short, one-time didactic sessions, which are not practical nor often applicable to the ED setting. There is a paucity of evidence-based interventions that incorporate behavioral-based training to adequately prepare staff for the complicated, multifactorial presentation of violence in the ED. OBJECTIVE: This pilot study sought to assess the feasibility of an improvisational theater-based, simulation intervention for health care professionals to address ED violence. METHODS: A longitudinal curriculum for ED violence was developed in collaboration with a committee of emergency medicine (EM) faculty, EM simulation experts, hospital security and police personnel, professional theater and improvisational performers, resident physicians, and medical students. This pilot intervention was tailored to new EM residents (n = 25) at a large, urban, academic medical center. Sessions were led by facilitators trained in group facilitation, simulation, and improvisation. RESULTS: Participants felt the curriculum was helpful (82.6%), engaging (91.3%), applicable (73.9%), and enjoyable (82.6%). Participation primarily by residents identifying as female and people of color suggested the efficacy of creative expression and nontraditional modalities in engaging diverse learners. Ninety-five percent of participants expressed interest in future sessions. CONCLUSIONS: A multidisciplinary workplace violence intervention leveraging principles of improvisational theater, health equity, organizational psychology, and EM simulation may prove useful in preparing health care professionals for violence in the ED.

Symjepi Epinephrine Injection Device Deconstruction and Residual Medication Retrieval in an Austere Environment.

Epinephrine is the primary therapy in the treatment of anaphylaxis. Epinephrine delivery devices are commonplace in out-of-hospital care of anaphylaxis because they administer a standardized dose of epinephrine, limit human error, and allow for ease of use by the operator. However, a major limitation of these devices is the single-use nature of the products. In an austere setting, the ability to obtain additional doses from an autoinjector may prevent further progression of anaphylaxis. Previous articles have demonstrated the deconstruction of spring-loaded epinephrine autoinjectors to extract additional medication doses. This article provides instruction and videography, outlining the process of deconstructing and obtaining additional doses of epinephrine from the Symjepi prefilled syringe.

Pop Music Singing in Education with Modern Innovative Technologies: How the Chinese Language Shapes the Creation of Popular Singing.

The purpose of this study is to investigate the uniqueness of the pop singing genre by determining the role of the Chinese language in the creation of popular singing in education with modern innovative technologies. The paper began by determining which types of popular music were the most popular among respondents and the influence of modern innovative technologies on music education. The results showed that popular folk music (25%) and popular music (23%) are the most popular genres. This is because they are based on improvisational elements and combine modern and ethnic musical elements with the use of modern innovative technologies. Pentatonic preservation (94.3), modern innovative technologies (91.2), expressive performance (85.6), sound fluidity and mobility (82) and instrumental accompaniment have been identified as the most defining characteristics of contemporary Chinese popular music (78.1). Taking into account how pure and expressive Chinese music is, the study found that singing should take into account the following aspects of the Chinese language: the tonality of vowels, the influence of consonant sounds, the use of sound imitations, the performance of words with different levels of complexity, and the relationship between speech and musical intonation. It has been proven that students in group 1 who studied vocals and were taught the rules for combining phonetic features of language when singing had better results in terms of quality performance (0.83) and expressive performance (0.91). The non-professional singers in group 2 attained scores of 0.62 and 0.85, respectively.

Sailing through the storm: Improvising paradox navigation during a pandemic.

Despite rich depictions of paradox navigation strategies, and the recognition that they are fraught with uncertainty, research reveals relatively little about how leaders navigate paradoxical tensions when improvising in the face of highly unpredictable and quickly evolving events. We conducted a narrative study of how French President Macron navigated the tension between the paradoxical poles of "saving lives" and "preserving life as usual" during the pandemic. Our article surfaces three central elements that form a model of improvised paradox navigation in stormy conditions: turning points, fog of uncertainty, and chaotic learning. Our model contributes to paradox theorizing by shedding light on paradox navigation in highly turbulent environments and has implications for management learning and improvisation.

Character-enabled improvisation and the new normal: A paradox perspective.

The COVID-19 pandemic has amplified and exacerbated organizational paradoxes felt by individuals largely because of the nostalgia individuals feel for the "old" normal while facing the need to let go in order to create a "new" normal. We position improvisation as a synthesis-type approach to working through the paradoxes of the pandemic. Furthermore, we look at individual differences that underpin the ability to improvise, and identify that it is the strength of character and character-based judgment of the individual that enables the enactment of a focal context, the choice to improvise, and the act of effectively improvising to work through paradoxes. Linking character to improvisation, and, vice versa, improvisation to the development of character, reveals the importance of dimensions such as courage, humility, temperance, transcendence, humanity, and collaboration in the practice of improvisation.

Pandemic, power and paradox: Improvising as the New Normal during the COVID-19 crisis.

The global COVID-19 pandemic made salient various paradoxical tensions, such as the trade-offs between individual freedom and collective safety, between short term and long-term consequences of adaptation to the new conditions, the power implications of sameness (COVID-19 was non-discriminatory in that all were affected in one way or another) and difference (yet not all were affected equally due to social differences), whereas most businesses became poorer under lockdown, others flourished; while significant numbers of workers were confined to home, some could not return home; some thrived while working from home as others were challenged by the erosion of barriers between their private and working lives. Rapid improvisational responding and learning at all levels of society presented itself as a naturally occurring research opportunity for improvisation scholars. This improvisation saw the arrival of a 'New Normal', eventually defined as 'learning to live with COVID-19'. The five articles in this special issue capture critical aspects of improvisation, paradoxes and power made salient by the COVID-19 pandemic in contexts ranging from higher-education, to leadership, to medical care and virtue ethics. In their own ways, each breaks new ground by contributing novel insights into improvisation scholarship.

Power, politics and improvisation: Learning during a prolonged crisis.

The COVID-19 pandemic has caught most organizations off guard. They have had to adapt their operations rapidly, and with the pandemic persisting, continuously improvise. While such an external jolt to organizations might unsettle operations, it does not remove the fact that organizations are sites of power relations and political activity. In this article, we examine the influence of power and politics on learning from improvisation, through a qualitative longitudinal case study of an Australian university during COVID-19. We trace improvisations with the use of the social media platform WeChat, which was eventually adopted, after several changes in forms of improvisation, as part of the response to the COVID-19 pandemic. Our study contributes to the literature on learning from improvisation, and explains how different forms of improvisation morph into one another under the simultaneous influence of power relations and learning.

A mixed-methods program evaluation of the Alda Healthcare Experience- a program to improve healthcare team communication.

BACKGROUND: Communication among interprofessional healthcare worker teams is critical to ensure a thriving and resilient workforce. We will evaluate the implementation and effectiveness of the Alda Healthcare Experience (AHE), a novel medical improvisation (improv) workshop designed to improve interprofessional communication skills among healthcare professionals. The AHE workshop includes a two-hour experiential training workshop led by an improv specialist and a clinical co-facilitator. In July 2022 we began implementing the AHE workshop by training 18 clinical co-facilitators who will co-facilitate the workshops for 550 healthcare workers from five hospital departments at Stony Brook University Hospital over the course of a year and a half. Using mixed-methods, we will conduct an Effectiveness-Implementation Hybrid Design project that includes an outcome evaluation (effectiveness) and a process evaluation (implementation). METHODS: Our outcome evaluation will assess the impact of the AHE workshop on short- and long-term improvement in interprofessional communication, stress, and professional fulfillment. The process evaluation component will examine programmatic, organizational, and individual facilitators or barriers to effective implementation of the AHE workshop. Qualitative methods will include dimensional analysis employing individual interviews of 20-40 AHE Project Participants, 5-10 Selected Informants, and all the clinical co-facilitators. Quantitative methods will use a quasi-experimental longitudinal design with an intervention group and surveillance of a control group (wait-list) and repeated assessments using validated instruments measuring communications skills, professional fulfillment, stress, burnout, uncertainty tolerance, and teamwork. DISCUSSION: Effective and efficient communication within healthcare teams is fundamental to building team cohesion that, in turn, supports individual resilience and builds positive organizational culture. The AHE program is an innovative approach to improve interprofessional healthcare communication and reduce healthcare worker burnout. In addition to institutional buy-in, rigorous evaluations of medical improv programs are necessary as a critical step in making such programs scalable. TRIAL REGISTRATION: N/A.

Brain oscillation recordings of the audience in a live concert-like setting.

There are only a few previous EEG studies that were conducted while the audience is listening to live music. However, in laboratory settings using music recordings, EEG frequency bands theta and alpha are connected to music improvisation and creativity. Here, we measured EEG of the audience in a concert-like setting outside the laboratory and compared the theta and alpha power evoked by partly improvised versus regularly performed familiar versus unfamiliar live classical music. To this end, partly improvised and regular versions of pieces by Bach (familiar) and Melartin (unfamiliar) were performed live by a chamber trio. EEG data from left and right frontal and central regions of interest were analysed to define theta and alpha power during each performance. After the performances, the participants rated how improvised and attractive each of the performances were. They also gave their affective ratings before and after each performance. We found that theta power was enhanced during the familiar improvised Bach piece and the unfamiliar improvised Melartin piece when compared with the performance of the same piece performed in a regular manner. Alpha power was not modulated by manner of performance or by familiarity of the piece. Listeners rated partly improvised performances of a familiar Bach and unfamiliar Melartin piece as more improvisatory and innovative than the regular performances. They also indicated more joy and less sadness after listening to the unfamiliar improvised piece of Melartin and less fearful and more enthusiastic after listening to the regular version of Melartin than before listening. Thus, according to our results, it is possible to study listeners' brain functions with EEG during live music performances outside the laboratory, with theta activity reflecting the presence of improvisation in the performances.

Spatiospectral brain networks reflective of improvisational experience.

Musical improvisers are trained to categorize certain musical structures into functional classes, which is thought to facilitate improvisation. Using a novel auditory oddball paradigm (Goldman et al., 2020) which enables us to disassociate a deviant (i.e. musical chord inversion) from a consistent functional class, we recorded scalp EEG from a group of musicians who spanned a range of improvisational and classically trained experience. Using a spatiospectral based inter and intra network connectivity analysis, we found that improvisers showed a variety of differences in connectivity within and between large-scale cortical networks compared to classically trained musicians, as a function of deviant type. Inter-network connectivity in the alpha band, for a time window leading up to the behavioural response, was strongly linked to improvisation experience, with the default mode network acting as a hub. Spatiospectral networks post response were substantially different between improvisers and classically trained musicians, with greater inter-network connectivity (specific to the alpha and beta bands) seen in improvisers whereas those with more classical training had largely reduced inter-network activity (mostly in the gamma band). More generally, we interpret our findings in the context of network-level correlates of expectation violation as a function of subject expertise, and we discuss how these may generalize to other and more ecologically valid scenarios.

Purpose-driven improvisation during organisational shocks: case narrative of three critical organisations and Typhoon Haiyan.

Disasters often produce elements of shock that may render pre-established plans for action limited or otherwise inapplicable to the current situation. Improvisation is considered to be a common response among organisations that operate in such turbulent environments. Despite the prevalence of such plans for action, existing research is reticent with regard to the processes concerning how improvisation relates to pre-established organisational goals. This study explores how improvisation can be employed by organisations to attain specific objectives, amidst the emergent nature of the initiative. Using case study narratives of three small organisations that were critical to the response after Typhoon Haiyan struck Leyte, Philippines, in November 2013, the paper demonstrates that improvisation can be absorbed as a conscious mechanism that can aid the attainment of pre-established goals. Furthermore, it conceptualises the buffering effect of improvisation to elucidate the process via which it purposefully directs an organisation to preserve and fulfil its aims.

Impact of music-based intervention on verbal memory: an experimental behavioral study with older adults.

Normal age-related declines have been reported in different cognitive functions, such as episodic memory. Some environmental factors have the potential to reduce cognitive decline and promote healthy aging. In this research, we employed musical improvisation as a focal music-based intervention to explore its effects as a modulator of verbal memory. We evaluated two types of verbal memory: a neutral one, employing the Rey Auditory Verbal Learning Test (Study 1), and an emotional one, implementing the Spanish version of Affective Norms for English Words (Study 2) in a volunteer group of older adults. After the acquisition of neutral (Study 1) or emotional (Study 2) verbal information, the participants were exposed to musical improvisation (experimental condition) or two control conditions (rhythmic reproduction as a musically active control condition or a rest condition as a passive control condition) for 3 min. Then, memory was evaluated through two memory tasks (immediate and deferred free-recall and recognition tests). In both studies, we compared memory performance among musicians (with five or more years of music training) and non-musicians. We found a significant improvement in neutral verbal memory among participants involved in musical improvisation, who remembered more words than those in the control conditions. Differences were also found according to the musical experience of the sample, with musicians outperforming non-musicians. The current research supports the late-life cognitive benefits of music-based intervention and music training.