You Don't Look Sick: Voices of Music Educators Living With Chronic Illnesses

The purpose of this study was to describe the experiences of music educators at varying career stages and teaching positions who experience chronic illnesses. Participants (n = 8) represented a variety of chronic illnesses and self-identified career stages. Research questions centered on how participants described navigating their chronic illnesses and how their illnesses impacted or influenced their work. Data included individual and focus group interviews. We found two themes. The first theme connected to realities and misconceptions of illness, including living with ever-present and often invisible symptoms and unpredictable flare-ups, which led to silence and isolation. The second theme described how participants adjusted their work with an emphasis on flexibility, including personal and professional modifications and considerations due to COVID-19. Recommendations are described in terms of professional support, representation, understanding, communication, community, self-advocacy, and broadening the scope of teacher wellness.

Potential Benefit of Masking and Other COVID-19 Infection Prevention Measures on Late-onset Infectionsin theNICU

Background: The incidence of nosocomial blood stream infections (BSI) among NICU admissions remains high, with significant mortality and morbidity. Due to COVID-19, there are increased infection prevention (IP) measures in NICUs including universal masking for all healthcare workers and families, social distancing, visitation restrictions, and increased attention to hand hygiene. These measures may also affect late-onset infection rates and offer understanding of novel interventions for prevention. Methods: We examined infection rates from three neonatal centers during the 24 months prior to implementation of COVID-19 IP measures (PRE-period) compared to the months after implementation from April 2020 (POST-period). Late-onset infections were defined as cultureconfirmed infection of the blood, urine, and other sterile fluids or identification of respiratory viral pathogens. An interrupted time series analysis of infection per 1000 patient days was performed based on a change-point Poisson regression with a lagged dependent variable and the number of patient days used as offsets. Each month was treated as independent with additional analysis using an observation-driven model to account for serial dependence. Results: Multicenter analysis to date included all infants cared for at three centers (Level 3 and 4) from 2018-2020. Monthly BSI rates decreased in the POSTperiod at the three centers (Figure 1). At all centers actual BSI rate was lower than the expected rate in the POST-period (Figure 2). The combined BSI rate per 1000 patient days was 41% lower compared to the rate prior to implementation (95% CI, 0.42 to 0.84, P = 0.004). In subgroup analysis of BSI by birthweight, during the POST-period there was a 39% reduction in infants < 1000g (P = 0.023), a 44% decrease for 1000-1500g patients (P = 0.292) and a 53% decrease in those > 1500g (0.083). Examining single center data from the University of Virginia through March 2021, there was a 36% decrease in all late-onset infections (BSI, UTI, Viral, and peritonitis) (95% CI, 0.46 to 0.90, P=0.011). Conclusion: In this preliminary analysis, we found a reduction of BSI after the implementation of COVID-19 infection prevention measures. Additionally, there were fewer viral infections, though there were a limited number of episodes. Further analyses of multicenter data and a larger number of patients from all 12 centers of our study network will elucidate the significance of these findings and the role some of these IP measures, such as universal masking, may have in infection prevention in the NICU (Supported in part by Grant Funding from the Gerber Foundation).

PSYCHOSOMATIC INTERVENTIONS FOR FUNCTIONAL POST-COVID SYNDROMES: OPEN-LABEL PLACEBO AND PACED BREATHING AS PATIENT-TAILORED INTERVENTIONS

Background: Up to 80% of patients suffering from persistent symptoms more than six months after a COVID-19 infection complain about a variety of psychosomatic symptoms with no organ cause. Most patients suffer from chronic fatigue, pain, depression or difficulty concentrating. Experimental studies showed that these symptoms could be significantly improved after an open administration of placebos (“open-label placebo”) or with heart rate variability (HRV) biofeedback such as paced breathing. However, we insufficiently understand which patients benefit from which treatment. Methods: Patients (m/f) without organic causes for the complaints are randomised to three groups: an open-label placebo intervention (OLP), a paced breathing training (PBT) or no additional treatment (TAU). To detect a mean effect using a 2x3 ANOVA, N=90 patients will be included, and predictor analyses are performed. The OLP group takes 2 placebos/day and receives the information that placebos can significantly improve symptoms, e.g. via the activation of “self-healing powers”. The PBT group receives a standardized training to breath at 6 breaths/min for 10 min/day. At inclusion (T0) and after four (T1) and eight weeks (T2), treatment expectations, fatigue (FSMC), somatoform complaints, depressiveness, anxiety (PHQ), general health (SF-36) and quality of life, as well as cognitive performance using Corsi Span and Colour Stroop tests, will be assessed by questionnaires and tests, and an ECG will be recorded. Results: Preliminary results point to effective reductions of fatigue and other symptoms for both interventions compared to TAU, dependent on patients' individual factors such as treatment expectations, symptom severity during Covid-19 infection and at inclusion. HRV data will be analysed at the end of the study. Preliminary results will be presented at the conference. Conclusion: Patients with functional post-COVID syndromes can benefit from psychosomatic interventions aiming to improve treatment expectations and heart rate variability, depending on individual patients' factors. Patient-tailored interventions should be further investigated.

Effects of Green Plants on the Indoor Environment and Wellbeing in Classrooms-A Case Study in a Swedish School

Many schools in Sweden lack a proper indoor environment due to, e.g., poor thermal-envelope properties, overcrowded classes, poor visual appearance and insufficient ventilation. This study aims to explore the integration of a large number of indoor green plants into classrooms' environments. This case study consists of three parts: measurements of the indoor environment including a final energy model, a questionnaire to the pupils with questions about their well-being and qualitative interviews with teachers. The case was two classrooms in a secondary education facility in central Sweden with an average annual temperature of 3 degrees C and a long and dark winter period with snow. The results showed 10% lower CO2 and slightly higher and more stable temperatures due to the green plants. Worries about climate change and war among the pupils decreased after several months with the plants and worry about infectious disease increased. The teachers experienced fresher air from the plants and used the plant stands for a flexible classroom design. The conclusion is that indoor plants have the potential to contribute to a better indoor environment, but due to the high number of uncontrolled variables (including the effect of COVID-19) in measurements of real-life conditions, more studies are needed.

Results of a factor analysis of items regarding COVID-19 pandemic-specific workload among medical staff in Germany

IntroductionEpidemics lead to an increase in occupational stress and psychological strain among medical staff (cf. Mulfinger et al. 2020). However, there are no validated questionnaires to measure stress caused by an epidemic such as Covid-19, instead self-constructed questions are used frequently.ObjectivesThe aim was to develop items for the assessment of specific workload in epidemics which can be used to obtain longitudinal data.MethodsA sample of N=8078 persons working in the health care sector in Germany participated in the VOICE, EviPan online survey addressing the burden of Covid-19 pandemic during the 2nd quarter of 2020. We used 15 self-constructed items to examine whether these items can represent Covid-19 specific topics. A total of N=7549 (24% males) had complete data to run a confirmatory factor analysis using SEM procedure in Stata 14.2.ResultsFive factors were identified a priory: Factor (F) 1: Workload due to Covid-19 pandemic (4 items;Cronbachs’ alpha (α))=0.740);F 2: Fear, uncertainty of SarsCoV-2infection (self and others) (3 items;α= 0.741);F 3: Patient safety (3 items;α=0.533;F 4: Perception of protection concepts (2 items;α=0.590);F 5: Dysfunctional coping strategies (3 items;α=0.447). Fit-Indices: χ²(73)= 1373.849, p<.001, CFI=.946, TLI=.923, RMSEA=.0049, SRMR=.037)ConclusionsWe identified 5 factors associated with problems occurring during the Covid-19 pandemic with acceptable to good internal consistency. Most of the constructed items could therefore be used in further surveys to monitor stress, as a basis for recommendations in the area of stress prevention and interventions for medical staff during epidemics.