Medical ethnomusicology is a subfield of ethnomusicology, which according to UCLA professor Timothy Rice is "the study of how and why humans are musical." [1] Medical ethnomusicology, similar to medical anthropology, uses music-making, musical sound, and noise to study human health, wellness, healing and disease prevention including, but not limited to, music as violence. [2]
In 2008, scholars from the Society for Ethnomusicology [3] defined medical ethnomusicology as "a new field of integrative research and applied practice that explores holistically the roles of music and sound phenomena and related praxes in any cultural and clinical context of health and healing." [4] Medical ethnomusicology often focuses specifically on music and its effect on the biological, psychological, social, emotional, and spiritual realms of health. In this regard, medical ethnomusicologists have found applications of music to combat a broad range of health issues including the treatment of autism, Asperger syndrome, dementia, and HIV/AIDS. Other interventions are found in social and spiritual contexts where music and sound contribute to the restoration of community or play a role in prayer and meditation. Studies have also shown how music can help to alter mood and serve as cognitive therapy. [4]
Medical ethnomusicology can involve a "blend of anthropological and ethnological, historical and literary techniques in eliciting its data" and challenge Western notions of medicine with alternatives such as ethnomedicine found in non-elite cultures or settings. [5]
Theresa Allison served at a nursing home in 2006–2007, studying the effects of music on the residents of the home. "The Home," as she refers to it in her publications, was rather unusual in that music was of utmost priority: the Home has over 60 hours of music and performing arts activities scheduled weekly, and dozens of residents actively participate in songwriting groups. The Home has produced a professional CD, Island on a Hill, and an award-winning documentary, A 'Specially Wonderful Affair, both in 2002. With such emphasis placed in the arts, Allison concludes that the creation and performance of music has increased the residents' quality of life by allowing them to remain active in their society through songwriting. Songwriting in the Home has fostered a sense of community among the residents and a means of transcending the institution by bringing in memories and experiences from outside their physical space. [6]
Koen's research has also extended into the realm of the spiritual; he analyzed the role of music in maddâh , a form of prayer. Koen believed in music-prayer dynamics, which modeled the dynamic relationship between music, prayer, and healing. Maddâh is unique in that it encompasses all three elements of music-prayer dynamics over the course of a ceremony. Koen describes a maddâh ceremony as such: "during a maddâh ceremony, one experiences music alone, prayer alone, music and prayer combined, and unified music-prayer". In particular, Koen focused on the restorative properties of maddâh as it was utilized in Badakhshan, Tajikistan. Being the economically poorest region of Tajikistan, Badakhshan's culture of health care is precarious at best; there is no running water or plumbing in homes, satisfactory nutrition is hard to come by, and the psychological distress that comes with these factors leads to an abundance of health issues. As a result, maddâh is utilized to maintain health and prevent illness. Koen conducted an experiment of 40 participants from Badakhshan, in which Koen assessed the stress levels of those who participated in a maddâh ceremony using physical indicators of stress such as blood pressure and heart rate. In conclusion, Koen observed an overarching de-stressing effect in those who participated in maddâh, regardless of the role they assumed in the ceremony. Koen attributes this to familiarity: "there was enough familiarity to engage a cultural aesthetic and dynamic that allowed a person's consciousness to approach a flexible state, which here facilitated a state of lower stress". Koen also noted that participants had positive feelings regarding maddâh; many of the participants commented that maddâh relieves them of their emotional burdens. [7]
Treatment of Alzheimer's was historically centered around a biomedical, classically mechanistic model of the disease, but doctors have increasingly taken on a "person-centered" approach, a model through which multiple academic disciplines can contribute to an increased quality of life. Biology, psychology, spirituality, sociology, and most recently, ethnomusicology have all been combined to find the most effective, integrative, complementary, and native interventions for dementia. Carol Prickett provides an overview of the current state of research into music therapy for dementia: [8]
In 2008, Kenneth Brummel-Smith studied the state of care for those with Alzheimer's disease (AD) and found care to be largely unsatisfactory. Rather, Brummel-Smith looks toward music as the cure to Alzheimer's disease; he observes that nursing home residents with AD are capable of participating in structured music activities late into the disease, and that music can be used to enhance social, emotional, and cognitive skills in those with AD. Brummel-Smith calls for a more interdisciplinary approach to combatting AD, which may include music therapy if it may be suitable for a given AD patient. [9]
In 2017, Bill Ahessy presented a music therapy case study about a 94-year-old woman with AD who participated in improvisation and song writing for 18 months, suggesting that person-centered therapy and music therapy theory and practice share valuable links and identifying song-writing as a powerful therapeutic technique for AD treatment. For the patient in the case study, music therapy helped with reminiscence and emotional self-expression, and assisted the client with experiencing herself in new ways to process her condition. Specifically, music helped her strengthen and validate her identify, verbalize her emotions, and reflect on her experience with AD. [10]
Kathleen Van Buren conducted fieldwork in Nairobi and Sheffield with the purpose of enacting positive change in the context of HIV and AIDS in each environment. Van Buren speaks about utilizing music as an agent of social change; in Nairobi, she witnessed individuals and organizing drawing upon music and the arts to promote social change within their respective communities. In Sheffield, Van Buren offered a new class on "Music and Health" at the University of Sheffield as well as World AIDS Day event with the theme "Hope through the Arts". After the conclusion of these events, Van Buren published her findings and offered a to-do list for the ethnomusicology of HIV and AIDS. Namely, she urged ethnomusicologists to research and engage with the music community in order to facilitate the development of educational and therapy programs to further the fight against AIDS. [11]
Gregory Barz also investigates the usage of music in healing individuals with HIV/AIDS in Sub-saharan African communities like Uganda, where only 10% of the population has access to medical facilities, and there is only one doctor for every 20,000 people. In Uganda, less than 2% of those who need antiretroviral drugs can afford them. He concludes that music's contributions to HIV/AIDS intervention and palliative care are a valuable, human, and imperative option to shaping the treatment landscape for these individuals. Through participation in music, socioeconomic effects of illness are reduced by supporting caregivers, controlling pain, and providing counseling to caretakers and sick individuals. [12]
Barz notes that one of the primary ways that music can play a role in the treatment of HIV/AIDS is through performances that help educate the listeners about the disease and make it easier for them to understand, interact with, and reconcile the role that HIV/AIDS plays in their lives. For example, Walya Sulaiman is a musical activist who lives with HIV; since his diagnosis, he has dedicated his life to educating and counseling other Igangan Muslims. There is often a communication barrier between doctors who understand the biological mechanisms behind HIV/AIDS and village people, who might not have as firm of a grasp on the implications of the disease. Therefore, in musical performances meant to educate his target groups about the affliction, Sulaiman uses the term kayovu, which is an insect that eats bananas from the inside out, to depict AIDS, and ene, which is jackfruit, to facilitate an understanding about how one can get stuck in the syrupy fruit, unable to wash or scrape HIV away. Thus, these linguistic localizations help facilitate a deeper, culturally relevant understanding of HIV/AIDS. [12]
Michael Bakan, professor of ethnomusicology and Florida State University, has spearheaded research efforts to apply ethnomusicology to autism, and conceptually sees the practice as a form of applied ethnomusicology. He sees the ethnomusicology of autism as in the same realm as other similar epistemological frameworks related to the condition, including the autistic self-advocacy and neurodiversity movements, disability studies, and the anthropology of autism. In his research and publications, he utilizes a polyvocal narrative approach by splicing his words and ideas with the children on the autism spectrum who he plays and listens to music with. He also integrates the ideologies of spokespeople from the autistic self-advocacy movement, and scholars, scientists, and disability rights advocates who represent a broad range of positions and epistemic schools of thought. He ultimately proposes an ethnographic model of disability as a complementary alternative to existing socio-medical models, further arguing that the ethnographic and relativistic principles of applied ethnomusicology can effectively promote neurodiversity and autism acceptance. [13]
An example of music used in the treatment of autism is the Music-Play Project (MPP). The MPP was inspired by an interaction in which Benjamin Koen and Michael Bakan invited their families to eat dinner together. After dinner, Koen and Bakan took out some drums and started playing music together. Mark, a 3-year-old member of the Bakan family who has Asperger's syndrome, began engaging with the music in a way that Koen describes as "miraculous". Bakan describes Mark's experience as a "remarkable and positive behavioral/emotional transformation in him". [14] After that moment, Koen and Bakan began hosting a six-week program in which three children, accompanied by their parents, engage in freeform improvisational music creation alongside Koen and Bakan. Participants play on gamelan gongs, metallophones, and drums, which are chosen for providing rewarding sounds with minimal technique and effort from the participants. Koen and Bakan recount that the Music-Play Project has proven successful in providing children with key experiences that are particularly important in development, including forming new friendships among participants and facilitating fresh interactions between children and their parents. [15]
The Flexibility Hypothesis
The flexibility hypothesis posits that the mechanism behind many forms of healing and psychotherapy is the induction of positive psychological states marked by flexibility or an enhanced ability to move and shift between different cognitive sets. This hypothesis mentions that music can act as a tool, or primer, to facilitate the patient's receptibility to moving across cognitive states. These different cognitive sets can be reached by the patient by altering expectations, remoralization, and instilling hope in the present and the future, with help from different primers.
Healing practices use specific symbolic interventions called "flexibility primers;" these can help induce different degrees and states of cognitive and emotional flexibility. Flexibility primers can take different forms, including metaphors, images, and music and other media, which is how the flexibility hypothesis falls within the realm of medical ethnomusicology. Music is often used to prime the patients to represent, elicity, and enact cognitive and emotional flexibility in rituals of healing. Within this practice, to truly reach the patient, it is imperative to identify psychological processes and cultural forms that facilitate and evoke cognitive and emotional flexibility to understand the cultural specificity and potential efficacy of a particular set of primers. For example, when choosing music for this ritual, it might be in one's best interest to use cultural context to match the patient with a primer that they will be particularly receptive to, through language, style, etc. Because cultural specificity is highly correlated with the potential efficacy of different healing practices, we can use cultural context to guide intervention/healing design to best promote well-being. [16]
Rhythmic Drumming
There has been debate since the early 1950s among anthropologists and ethnomusicologists about the extent to which different psychological and socio-environmental factors play into the induction of trance states in different ritual contexts. The debate has been focused around the question: Can music (alone or in context) induce trance? Gilbert Rouget, an anthropologist, is a primary player in this debate; his 1980 book "Music and Trance: A Theory of Relations between Music and Possession" explores ritual trances involving music and reviews the anthropological literature on the neurophysiological effects of drumming and other repetitive auditory stimulation. Another researcher in this debate is Andrew Neher, who conducted laboratory studies about auditory driving, which is the ability of repetitive rhythmic auditory stimuli to alter brainwave activity in a one-to-one relationship. He found that if a subject hears drum rhythms at 8 beats/second, one's brainwaves will be influenced by this stimulus, producing more activity at 8 Hz and also influencing other brainwave frequency bands to alter brain activity as a whole. [17]
Many researchers have also found that drumming can have mood-altering effects on the brain and nervous system. This research has been applied to developing treatments for a range of physical conditions, mental illnesses, and personality disorders. Bittman et al. discovered that rhythmic auditory stimulation can improve immune function and increase relaxation, improve mood, and help manage stress, Maurer et al. found that drumming or hearing music where the predominant focus is on drum beats can help enhance hypnotic susceptibility, and Mandel et al. suggested that rhythmic stimulation can induce altered states of consciousness for psychotherapy. Additionally, many modern physiological reports on the effects of sustained rhythmic drumming reinforce that the act of drumming can help alter affective states and induce states of consciousness, hypnosis, and meditation through the diversion of attention to consistent patterns, as well as brainwave synchronization and entrainment. [17]
The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs in an attempt to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same sex and opposite sex partners so long as the HIV-positive partner maintains an undetectable viral load.
Music therapy, an allied health profession, "is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program."
HIV/AIDS denialism is the belief that human immunodeficiency virus (HIV) does not cause acquired immune deficiency syndrome (AIDS), despite conclusive evidence to the contrary. Some of its proponents reject the existence of HIV, while others accept that HIV exists but argue that it is a harmless passenger virus and not the cause of AIDS. Insofar as they acknowledge AIDS as a real disease, they attribute it to some combination of sexual behavior, recreational drugs, malnutrition, poor sanitation, haemophilia, or the effects of the medications used to treat HIV infection (antiretrovirals).
Orthomolecular medicine is a form of alternative medicine that aims to maintain human health through nutritional supplementation. The concept builds on the idea of an optimal nutritional environment in the body and suggests that diseases reflect deficiencies in this environment. Treatment for disease, according to this view, involves attempts to correct "imbalances or deficiencies based on individual biochemistry" by use of substances such as vitamins, minerals, amino acids, trace elements and fatty acids. The notions behind orthomolecular medicine are not supported by sound medical evidence, and the therapy is not effective for chronic disease prevention; even the validity of calling the orthomolecular approach a form of medicine has been questioned since the 1970s.
The spread of HIV/AIDS has affected millions of people worldwide; AIDS is considered a pandemic. The World Health Organization (WHO) estimated that in 2016 there were 36.7 million people worldwide living with HIV/AIDS, with 1.8 million new HIV infections per year and 1 million deaths due to AIDS. Misconceptions about HIV and AIDS arise from several different sources, from simple ignorance and misunderstandings about scientific knowledge regarding HIV infections and the cause of AIDS to misinformation propagated by individuals and groups with ideological stances that deny a causative relationship between HIV infection and the development of AIDS. Below is a list and explanations of some common misconceptions and their rebuttals.
Art therapy is a distinct discipline that incorporates creative methods of expression through visual art media. Art therapy, as a creative arts therapy profession, originated in the fields of art and psychotherapy and may vary in definition.
This is a timeline of AIDS, including AIDS cases before 1980.
Behavioral medicine is concerned with the integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness. These sciences include epidemiology, anthropology, sociology, psychology, physiology, pharmacology, nutrition, neuroanatomy, endocrinology, and immunology. The term is often used interchangeably, but incorrectly, with health psychology. The practice of behavioral medicine encompasses health psychology, but also includes applied psychophysiological therapies such as biofeedback, hypnosis, and bio-behavioral therapy of physical disorders, aspects of occupational therapy, rehabilitation medicine, and physiatry, as well as preventive medicine. In contrast, health psychology represents a stronger emphasis specifically on psychology's role in both behavioral medicine and behavioral health.
HIV-associated neurocognitive disorders (HAND) are neurological disorders associated with HIV infection and AIDS. It is a syndrome of progressive deterioration of memory, cognition, behavior, and motor function in HIV-infected individuals during the late stages of the disease, when immunodeficiency is severe. HAND may include neurological disorders of various severity. HIV-associated neurocognitive disorders are associated with a metabolic encephalopathy induced by HIV infection and fueled by immune activation of macrophages and microglia. These cells are actively infected with HIV and secrete neurotoxins of both host and viral origin. The essential features of HIV-associated dementia (HAD) are disabling cognitive impairment accompanied by motor dysfunction, speech problems and behavioral change. Cognitive impairment is characterised by mental slowness, trouble with memory and poor concentration. Motor symptoms include a loss of fine motor control leading to clumsiness, poor balance and tremors. Behavioral changes may include apathy, lethargy and diminished emotional responses and spontaneity. Histopathologically, it is identified by the infiltration of monocytes and macrophages into the central nervous system (CNS), gliosis, pallor of myelin sheaths, abnormalities of dendritic processes and neuronal loss.
Gary Michael Null is an American talk radio host and author who advocates pseudoscientific alternative medicine and produces a line of questionable dietary supplements.
A chronic condition is a human health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include diabetes, arthritis, asthma, cancer, chronic obstructive pulmonary disease, Lyme disease, autoimmune diseases, genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome. An illness which is lifelong because it ends in death is a terminal illness. It is possible and not unexpected for an illness to change in definition from terminal to chronic. Diabetes and HIV for example were once terminal yet are now considered chronic due to the availability of insulin for diabetics and daily drug treatment for individuals with HIV which allow these individuals to live while managing symptoms.
Taiwan's epidemic of HIV/AIDS began with the first case reported in December 1984. On 17 December 1990 the government promulgated the AIDS Prevention and Control Act. On 11 July 2007, the AIDS Prevention and Control Act was renamed the HIV Infection Control and Patient Rights Protection Act.
Energy medicine is a branch of alternative medicine based on a pseudo-scientific belief that healers can channel "healing energy" into a patient and effect positive results. Practitioners use a number of names including various synonyms for medicine and sometimes use the word vibrational instead of or in concert with energy. In most cases there is no empirically measurable energy involved: the term refers instead to so-called subtle energy. Practitioners may classify practice as hands-on, hands-off, and distant where the patient and healer are in different locations. Many schools of energy healing exist using many names: for example, biofield energy healing, spiritual healing, contact healing, distant healing, therapeutic touch, Reiki or Qigong.
Nosophobia, also known as disease phobia or illness anxiety disorder, is the irrational fear of contracting a disease, a type of specific phobia. Primary fears of this kind are fear of contracting HIV infection, pulmonary tuberculosis (phthisiophobia), venereal diseases, cancer (carcinophobia), heart diseases (cardiophobia), and catching the common cold or flu.
In 2007, neurologist Oliver Sacks released his book Musicophilia: Tales of Music and the Brain in which he explores a range of psychological and physiological ailments and their intriguing connections to music. It is broken down into four parts, each with a distinctive theme; part one titled Haunted by Music examines mysterious onsets of musicality and musicophilia. Part two A Range of Musicality looks at musical oddities musical synesthesia. Parts three and four are titled Memory, Movement, and Music and Emotions, Identity, and Music respectively. Each part has between six and eight chapters, each of which is in turn dedicated to a particular case study that fit the overarching theme of the section. Presenting the book in this fashion makes the reading a little disjointed if one is doing so cover to cover, however, it also means one may pick up the book and flip to any chapter for a quick read without losing any context. Four case studies from the book are featured in the NOVA program Musical Minds aired on June 30, 2009.
Traditional African medicine is a range of traditional medicine disciplines involving indigenous herbalism and African spirituality, typically including diviners, midwives, and herbalists. Practitioners of traditional African medicine claim to be able to cure a variety of diverse conditions including cancer, psychiatric disorders, high blood pressure, cholera, most venereal diseases, epilepsy, asthma, eczema, fever, anxiety, depression, benign prostatic hyperplasia, urinary tract infections, gout, and healing of wounds and burns and even Ebola.
Discrimination against people with HIV/AIDS or serophobia is the prejudice, fear, rejection, and stigmatization of people with HIV/AIDS. Marginalized, at-risk groups such as members of the LGBTQ+ community, intravenous drug users, and sex workers are most vulnerable to facing HIV/AIDS discrimination. The consequences of societal stigma against PLHIV are quite severe, as HIV/AIDS discrimination actively hinders access to HIV/AIDS screening and care around the world. Moreover, these negative stigmas become used against members of the LGBTQ+ community in the form of stereotypes held by physicians.
Falak is a style of music native to the Pamir Mountains of Central Asia, particularly the Badakhshan region of northeastern Afghanistan, southeastern Tajikistan, and northern Pakistan. Falak lyrics can involve religious-mystical themes of divine love, separation and reunion, or secular and melancholy lyrics of human love and suffering.
The stages of HIV infection are acute infection, latency and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, swollen lymph nodes, inflammation of the throat, rash, muscle pain, malaise, and mouth and esophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection, is defined by low CD4+ T cell counts, various opportunistic infections, cancers and other conditions.
HIV/AIDS research includes all medical research that attempts to prevent, treat, or cure HIV/AIDS, as well as fundamental research about the nature of HIV as an infectious agent and AIDS as the disease caused by HIV.
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