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This article outlines the shifts in NICU music therapy due to the COVID-19 pandemic in Italy, Japan, and Colombia, from the beginning of the outbreak in each of the countries until September 2020. Detailed information will be provided on how the pandemic has changed hospital policies and has had an impact on the families and the music therapy services. Furthermore, the authors discuss current biosecurity protocols, parental visiting guidelines, telehealth strategies, and the financial impact of the pandemic. While the way healthcare workers and healthcare institutions cope with the current situation may be unique according to cultural and societal particularities in each country, many overlaps between the three countries were found.

Background: Music and music therapy, live or recorded, has been gradually introduced in the Neonatal Intensive Care Unit (NICU) of our Hospital in addition to standard medical and nursing care, to improve premature neonates’ neurophysiological development. The present study focused on music genres, starting from the parents’ sound experience and musical tastes that neonates experienced during the pregnancy period. The study explored the effects of different music genres also on Extremely Low Birth Weight (ELBW) neonates since most studies refer to Very Low Birth Weight (VLBW) neonates with birth weight > 1000 gr. The study aims to investigate the influence of different music genres on Heart Rate Variability (HRV) of preterm neonates.Methods: a prospective randomized study was conducted. Preterm neonates (gestational age <32 weeks, birth weight <1500g), were recruited. On the basis of birth order, they underwent a daily randomized music listening program (25 minutes, every day, for 3 days) based on different music genres listening (soft pop-rap, pop-rock and classical music), followed by 1 day of no music monitoring (25 minutes). An electrocardiogram was performed to evaluate HRV parameters in each neonate with and without music exposure.Results: twenty-seven (13 ELBW, birthweight <1000 g and 14 VLBW, birthweight 1000-1500 g) infants were included and HRV parameters were analysed. In the VLBW group no significant results were found between the music genres. In the ELBW group, during Soft Pop-Rap music listening, starting after 5 minutes High Frequency (HF) increase significantly (HF P =0.0096) and Low Frequency (LF) and LF/HF indices decrease significantly (LF P= 0.0096; LF/HF P=0.0068). The same trend was from 15 minutes of music listening high frequency (HF) increased and low frequency (LF) decreased (LF P=0.007; HF P= 0.007), Consequently LF/HF also decreased significantly (LF/HF P = 0.0093).Conclusion: A significant decrease in the activity of the sympathetic and a simultaneous increase of the parasympathetic nervous system were found in the ELBW group during Soft Pop-Rap music listening. Further studies with a larger sample size are needed to confirm these findings and to elucidate the underlying mechanisms.Trial registration: ClinicalTrials.gov Identifier: NCT04049526 The Effects of different music genres on heart rate variability in extremely and very low birth weight new-borns.

Previous studies suggested that women undergoing hysterectomy and other major surgical procedure may experience preoperative anxiety. Contributing factors include an unfamiliar environment, loss of control, perceived or actual physical risk, and fear of postoperative pain. Women of reproductive age undergoing hysterectomy have a type of anxiety not common in other surgical populations. They are concerned over definite loss of reproductive potential and a major source of female identity, as well a potential impact on sexual function and perception of body image.There is growing interest in the use of music as a therapeutic intervention in obstetrics and gynecologic settings. The anxiolytic potential of music listening has been demonstrated among women undergoing surgery for a number of benign indications. A music intervention has been suggested as an effective strategy for reducing preprocedural waiting anxiety. No prior studies have specifically evaluated the impact of music therapy on women about to undergo a hysterectomy.The aim of this randomized clinical trial (RCT) was to determine the effect of music therapy in reducing the preoperative anxiety of patients undergoing total laparoscopic hysterectomy (TLH) for benign indications. The possible superiority of a music therapy pathway was compared with usual care (control). The study was conducted between March and September 2020 at a teaching hospital in Italy.The level of anxiety was evaluated by the State-Trait Anxiety Inventory Y Form (STAI-Y) at different time points: at baseline, and during preoperative, early postoperative, and late postoperative periods. The pathologic anxiety status cutoff was placed at STAI-Y state >45. Postoperative pain was evaluated using the visual analog scale 1, 3, and 6 hours after surgery. During the preoperative period, patients in the music arm experienced significantly lower anxiety levels (median STAI-Y score 38.0 vs 41.0; P = 0.002). The STAI-Y scores did not vary significantly by intervention at each subsequent time point. A significant difference between the music and control arms was found in the proportion of women with pathologic anxiety during the preoperative (16.7% vs 37.2, P = 0.04) and early postoperative period (0% vs 12.9%, P = 0.04), whereas no significant group difference was found during the late postoperative period (6.6% vs 7.1%, P = 0.93). Postoperative pain intensity did not differ between the groups at 1, 3, and 6 hours after surgery.These data suggest that music therapy significantly decreases preoperative anxiety in women undergoing total laparoscopic hysterectomy for benign conditions and may be a viable complementary modality to usual surgical care in a gynecologic setting. The data are consistent with that of previous randomized trials providing evidence for benefit of music therapy in other surgical populations.