Relationship of Musculoskeletal Symptoms and Musical Practice Intensity among Musicians During the COVID-19 Pandemic: A Descriptive Questionnaire Study.

INTRODUCTION: As soon as COVID-19 spread around the world, prevention and control measures were taken, such as masking and physical distancing, which changed people's routines, including musical practice among professional and amateur musicians. OBJECTIVE: This descriptive questionnaire study was designed to: 1) investigate how the pandemic affected musical practice among musicians; 2) determine how musicians remained motivated in their new routine; 3) identify the presence of pre-COVID musculoskeletal symptoms; and 4) analyze whether musculoskeletal symptoms decreased, maintained, or increased during the COVID-19 pandemic. METHODS: A total of 89 musicians from Brazil participated in an online survey, from August 2020 to January 2021. The survey form included questions about motivation, musical practice frequency, and the presence and characterization of musculoskeletal symptoms (adapted from the Nordic Musculoskeletal Questionnaire, NMQ). Musicians were asked to consider the periods before and during the pandemic to answer the questions. RESULTS: During the pandemic, the frequency of musical practice decreased (p<0.01), and it could be associated with the individual's perceptions of motivation. Musculoskeletal symptoms in the previous 12 months were reported by 58%. When comparing the period before the pandemic to the present, 35.3% of musicians reported their musculoskeletal symptoms had not changed, while 33.3% reported that they had increased. Wrists and hands, lower and upper back, shoulders, and neck were the body sites with most frequent complaints. CONCLUSION: The COVID-19 pandemic had a negative impact on the frequency of musical practice of the musicians assessed in this study, with a significant decrease in practice time. Musculoskeletal symptoms were present in this population prior to the pandemic, and these symptoms were mostly maintained or worsened.

Debunking highly prevalent health misinformation using audio dramas delivered by WhatsApp: evidence from a randomised controlled trial in Sierra Leone.

INTRODUCTION: Infectious disease misinformation is widespread and poses challenges to disease control. There is limited evidence on how to effectively counter health misinformation in a community setting, particularly in low-income regions, and unsettled scientific debate about whether misinformation should be directly discussed and debunked, or implicitly countered by providing scientifically correct information. METHODS: The Contagious Misinformation Trial developed and tested interventions designed to counter highly prevalent infectious disease misinformation in Sierra Leone, namely the beliefs that (1) mosquitoes cause typhoid and (2) typhoid co-occurs with malaria. The information intervention for group A (n=246) explicitly discussed misinformation and explained why it was incorrect and then provided the scientifically correct information. The intervention for group B (n=245) only focused on providing correct information, without directly discussing related misinformation. Both interventions were delivered via audio dramas on WhatsApp that incorporated local cultural understandings of typhoid. Participants were randomised 1:1:1 to the intervention groups or the control group (n=245), who received two episodes about breast feeding. RESULTS: At baseline 51% believed that typhoid is caused by mosquitoes and 59% believed that typhoid and malaria always co-occur. The endline survey was completed by 91% of participants. Results from the intention-to-treat, per-protocol and as-treated analyses show that both interventions substantially reduced belief in misinformation compared with the control group. Estimates from these analyses, as well as an exploratory dose-response analysis, suggest that direct debunking may be more effective at countering misinformation. Both interventions improved people's knowledge and self-reported behaviour around typhoid risk reduction, and yielded self-reported increases in an important preventive method, drinking treated water. CONCLUSION: These results from a field experiment in a community setting show that highly prevalent health misinformation can be countered, and that direct, detailed debunking may be most effective. TRIAL REGISTRATION NUMBER: NCT04112680.

Conscience and Vaccines: Lessons from Babylon 5 and COVID-19.

Babylon 5, like other great sci-fi franchises, touched on important ethical questions. Two ethical conundrums relating to the series' main characters included providing life-saving treatment to a child against their parents' wishes and potential involvement with a highly beneficial but morally dubious medication. I use these cases to discuss some aspects of the COVID-19 vaccines' development and roll-out, demonstrating that people (be it patients or clinicians) might object to some vaccines due to reasonable ethics and safety-based concerns rather than due to an anti-vaxxer mind-set. I highlight that it would be disingenuous to lump these two groups of objections together for not all objections to specific vaccines are objections to vaccination in general. Rather, governments and pharmaceutical companies should seriously engage with the concerns of reasonable objectors to provide citizens with the appropriate products and ensure large vaccination uptake - in the case of COVID-19 this should include giving patients the choice of the product they will be inoculated with.