Investigating the Relationship Between Childhood Music Practice and Pitch-Naming Ability in Professional Musicians and a Population-Based Twin Sample.

The relationship between pitch-naming ability and childhood onset of music training is well established and thought to reflect both genetic predisposition and music training during a critical period. However, the importance of the amount of practice during this period has not been investigated. In a population sample of twins (N = 1447, 39% male, 367 complete twin pairs) and a sample of 290 professional musicians (51% male), we investigated the role of genes, age of onset of playing music and accumulated childhood practice on pitch-naming ability. A significant correlation between pitch-naming scores for monozygotic (r = .27, p < .001) but not dizygotic twin pairs (r = -.04, p = .63) supported the role of genetic factors. In professional musicians, the amount of practice accumulated between ages 6 and 11 predicted pitch-naming accuracy (p = .025). In twins, age of onset was no longer a significant predictor once practice was considered. Combined, these findings are in line with the notion that pitch-naming ability is associated with both genetic factors and amount of early practice, rather than just age of onset per se. This may reflect a dose-response relation between practice and pitch-naming ability in genetically predisposed individuals. Alternatively, children who excel at pitch-naming may have an increased tendency to practice.

The scholarship of application: recognizing and promoting nurses' contribution to knowledge development.

The generation of knowledge is fundamental to the practice of nursing and occurs through various forms of scholarship. Boyer recognized this and described knowledge production through research, integration, teaching, and application. The focus of this article is on the scholarship of application and its role in the development of nursing knowledge. Examples of achievement in the scholarship of application are provided with outcomes of work between community and education partners and innovative clinical practice changes. The scholarship of application is of particular importance to nursing as it bridges research, practice, and education, and documents and disseminates nursing knowledge to enable peer critique. Approaches for developing a climate of scholarship are discussed, including differentiating scholarly practice from clinical scholarship and how the scholarship of application is situated in practice arenas. The role of clinical scholars and clinical leaders and the continuing development of future scholars are proposed.

Music performance anxiety: the role of early parenting experiences and cognitive schemas.

Music Performance Anxiety (MPA) is a common challenge for classical musicians, however its etiology has received minimal research, particularly in regards to caregiver experiences during childhood and adolescence. The aim of this research was to explore the impact of childhood experiences with parents along with patterns of dysfunctional cognitive schemas that develop through childhood ('Early Maladaptive Schemas'; EMSs) on the manifestation and severity of MPA in adulthood. Study 1 employed 100 adult professional, amateur, and tertiary student classical musicians from across Australia. Participants completed the Young Schema Questionnaire (YSQ) and the Kenny Music Performance Anxiety Inventory (K-MPAI). Study 2 included eight participants from Study 1, five of whom scored 1.5 standard deviations or more above the mean K-MPAI score and three of whom scored 1.5 standard deviations or more below the mean K-MPAI score. Participants were interviewed about experiences of parenting during childhood and adolescence, along with their experiences of MPA and musical training. Interpretative phenomenological analysis was used to explore themes in the interview data. Study 1 factor analysis revealed four higher-order EMS factors, F(4, 95) = 13.74, p < 0.001, one of which was a significant predictor of MPA, t(99) = 3.06, p = 0.003. This factor comprised themes of failure, catastrophising, and incompetence/dependence. Study 2 qualitative analysis revealed various key parenting themes experienced in childhood that differentiated low- and high-MPA scorers in adulthood. Findings from both studies are discussed in light of clinical applications and interventions, and implications for both parents and music educators.

Understanding racial-ethnic differences in patient-centered care (PCC) in oncology through a critical race theory lens: A qualitative comparison of PCC among Black, Hispanic, and White cancer patients.

OBJECTIVES: Patient-centered care (PCC) experiences can vary by race and ethnicity and likely contribute to cancer care disparities. We compared PCC concepts between Non-Hispanic White (White), Hispanic, and Non-Hispanic Black (Black) cancer patients utilizing Critical Race Theory (CRT) to understand the relationships between racial-ethnic identity and PCC. METHODS: A thematic analysis and in-depth CRT-informed analysis of individual interviews exploring patient values, unmet needs, preferences, and priorities were performed. RESULTS: Participants were aged> 25 yrs old, 53% male, and included 5 Hispanic, 4 Black and 6 White cancer patients. Unmet needs for time to make decisions, and provider interaction between visits and the value for finding meaning in the illness emerged among Blacks and Whites. The unmet need for a long-term treatment plan emerged among Blacks, and the preference of research participation among Whites. A value for optimism was observed among Hispanics and Whites. Racial-ethnic variations in patient descriptions and experiences of their values, unmet needs, preferences, and priorities were identified. CONCLUSIONS: Underrepresented groups face subtle but significant challenges in feeling cared for and understood, voicing concerns, and obtaining quality care. PRACTICE IMPLICATIONS: Increased mutual understanding and provider knowledge of unique PCC experiences among underrepresented cancer patients are needed.

Use of explicit priming to phenotype absolute pitch ability.

Musicians with absolute pitch (AP) can name the pitch of a musical note in isolation. Expression of this unusual ability is thought to be influenced by heritability, early music training and current practice. However, our understanding of factors shaping its expression is hampered by testing and scoring methods that treat AP as dichotomous. These fail to capture the observed variability in pitch-naming accuracy among reported AP possessors. The aim of this study was to trial a novel explicit priming paradigm to explore phenotypic variability of AP. Thirty-five musically experienced individuals (Mage = 29 years, range 18-68; 14 males) with varying AP ability completed a standard AP task and the explicit priming AP task. Results showed: 1) phenotypic variability of AP ability, including high-accuracy AP, heterogeneous intermediate performers, and chance-level performers; 2) intermediate performance profiles that were either reliant on or independent of relative pitch strategies, as identified by the priming task; and 3) the emergence of a bimodal distribution of AP performance when adopting scoring criteria that assign credit to semitone errors. These findings show the importance of methods in studying behavioural traits, and are a key step towards identifying AP phenotypes. Replication of our results in larger samples will further establish the usefulness of this priming paradigm in AP research.

A journey of critical consciousness: an educational strategy for health care leaders.

Healthcare leaders who develop a critical perspective of the relationship between culture and health; value respect for differences, inclusiveness, equity, and social justice; and use their power to enact these values in their spheres of influence, both professionally and personally, are better able to improve care for a diversity of clients. Graduate students can be assisted to develop such a critical perspective through a course designed as a journey of critical consciousness. We describe this journey that takes students through phases of awareness, reflection, and action in which they come to understand the concepts of critical theory and discourse analysis and begin to use these to create changes in their work settings in the direction of equity and social justice. We suggest broader implications for programs and invite readers to begin their own journeys of critical consciousness.

Emotion Goals in Music Performance Anxiety.

Performance anxiety can be debilitating, and so researchers and laypeople alike tend to assume that it is desirable to downregulate this emotion. Yet emerging perspectives in the emotion literature suggest that people sometimes aim to upregulate anxiety to aid performance. The present research investigated the emotion goals that musicians hold when performing. Drawing on a novel framework of emotion goals, the findings suggest that how people want to feel and how they want to appear to feel are determinants of performance anxiety. In Study 1 (N = 44), musicians mostly reported wanting to neither feel nor show anxiety during a performance, although a meaningful subset reported wanting to feel but not show anxiety during a performance. In Study 2 (N = 32), musicians who enacted an emotion goal to neither feel nor show anxiety reported less state unease and greater satisfaction with their performance than musicians who enacted a goal to feel but not show anxiety. This research yields insight into the emotion goals that musicians hold and how these goals influence desired performance outcomes.

Examining a Group Acceptance and Commitment Therapy Intervention for Music Performance Anxiety in Student Vocalists.

Music performance anxiety (MPA) is a distressing and persistent anxious apprehension related to musical performance. The experience of MPA forces many musicians to give up performing or develop maladaptive coping mechanisms (e.g., avoidance or substance use), which can impact their career and wellbeing. High levels of MPA in students and vocalists are reported in the literature. Vocalists present a unique challenge for clinicians in that vocal and breathing mechanisms, required for performance, are negatively impacted when anxious. Acceptance and commitment therapy (ACT) has demonstrated efficacy for the treatment of a range of psychological problems including social anxiety disorder (of which MPA may be indicated as a subtype). This study sought to investigate whether group-based ACT may be a feasible and effective intervention for MPA in Australian student vocalists and aimed to design an intervention that could be adopted by music education providers. Potential participants (N = 31) completed an online survey including demographic questions and outcome measures. Six vocal students (four females; two males; aged M = 20.33 years) with elevated MPA scores participated in the ACT for MPA group program and 3-month follow-up. Group sessions were 2 h each week for six consecutive weeks. Participants were followed up 3 months post-intervention via online survey. There was a significant increase in psychological flexibility and significant decreases in MPA and psychological inflexibility. Gains were maintained at 3-month follow-up. The current study offers preliminary evidence for the feasibility and effectiveness of a group-based ACT protocol for musicians with performance anxiety which may be incorporated into tertiary performance training curricula.

Reducing the stigma of mental illness.

A national report on mental health, produced by the Standing Senate Committee on Social Affairs, Science and Technology, indicates that Canada lags behind other developed countries in awareness of mental health and mental disorders. The report points out that health-care professionals are among the groups that perpetuate the stigma associated with mental illness. The authors, representing the Canadian Federation of Mental Health Nurses education committee, advocate psychiatric/mental health courses and clinical practicums in undergraduate nursing education. They call on students and nurses alike to reflect on attitudes and beliefs that might prevent them from intervening effectively with people living with mental illness.

Development and validation of a music performance anxiety inventory for gifted adolescent musicians.

Music performance anxiety (MPA) is a distressing experience for musicians of all ages, yet the empirical investigation of MPA in adolescents has received little attention to date. No measures specifically targeting MPA in adolescents have been empirically validated. This article presents findings of an initial study into the psychometric properties and validation of the Music Performance Anxiety Inventory for Adolescents (MPAI-A), a new self-report measure of MPA for this group. Data from 381 elite young musicians aged 12-19 years was used to investigate the factor structure, internal reliability, construct and divergent validity of the MPAI-A. Cronbach's alpha for the full measure was .91. Factor analysis identified three factors, which together accounted for 53% of the variance. Construct validity was demonstrated by significant positive relationships with social phobia (measured using the Social Phobia Anxiety Inventory [Beidel, D. C., Turner, S. M., & Morris, T. L. (1995). A new inventory to assess childhood social anxiety and phobia: The Social Phobia and Anxiety Inventory for Children. Psychological Assessment, 7(1), 73-79; Beidel, D. C., Turner, S. M., & Morris, T. L. (1998). Social Phobia and Anxiety Inventory for Children (SPAI-C). North Tonawanda, NY: Multi-Health Systems Inc.]) and trait anxiety (measured using the State Trait Anxiety Inventory [Spielberger, C. D. (1983). State-Trait Anxiety Inventory STAI (Form Y). Palo Alto, CA: Consulting Psychologists Press, Inc.]). The MPAI-A demonstrated convergent validity by a moderate to strong positive correlation with an adult measure of MPA. Discriminant validity was established by a weaker positive relationship with depression, and no relationship with externalizing behavior problems. It is hoped that the MPAI-A, as the first empirically validated measure of adolescent musicians' performance anxiety, will enhance and promote phenomenological and treatment research in this area.

Psychological intervention reduces self-reported performance anxiety in high school music students.

Music performance anxiety (MPA) can be distressing for many young people studying music, and may negatively impact upon their ability to cope with the demands and stressors of music education. It can also lead young people to give up music or to develop unhealthy coping habits in their adult music careers. Minimal research has examined the effectiveness of psychological programs to address MPA in young musicians. Sixty-two adolescents were pseudo-randomized to a cognitive behavioral (CB) group-delivered intervention or a waitlist condition. The intervention consisted of psychoeducation, cognitive restructuring and relaxation techniques, identification of strengths, goal-setting, imagery and visualization techniques to support three solo performances in front of judges. Significant reductions in self-rated MPA were found in both groups following the intervention and compared to their baseline MPA. This reduction was maintained at 2-months follow-up. There appeared to be inconsistent effects of the intervention upon judge-rated MPA, however the presence of floor effects precluded meaningful reductions in MPA. There appeared to be no effect of the intervention upon judge-rated performance quality. This study highlights the potential for group-based CB programs to be delivered within school music curricula to help young musicians develop skills to overcome the often debilitating effects of MPA.

How different can you be and still survive? Homogeneity and difference in clinical nursing education.

The article focuses on a component of a three-year institutional ethnography regarding the construction of cultural diversity in clinical education. Students in two Canadian schools of nursing described being a nursing student as bounded by unwritten and largely invisible expectations of homogeneity in the context of a predominant discourse of equality and cultural sensitivity. At the same time, they witnessed many incidents, both personally and those directed toward other individuals of the same culture, of clinical teachers problematizing difference and centering on difference as less than the expected norm. This complex and often contradictory experience of difference and homogeneity contributed to their construction of cultural diversity as a problem. The authors provide examples of how the perception of being different affected some students' learning in the clinical setting and their interactions with clinical teachers. They will illustrate that this occurred in the context of macro influences that shaped how both teachers and students experienced and perceived cultural diversity. The article concludes with a challenge to nurse educators to deconstruct their beliefs and assumptions about inclusivity in nursing education.