Nomi C. Levy-Carrick

Arts-based creative interventions have demonstrated positive psychological effects, including creativity, self-efficacy, and social connectivity, an approach deeply rooted in a humanistic framework that emphasizes the intrinsic value of every individual and the transformative power of creative expression. This study explored the feasibility and acceptability of a web-based music composition intervention to support survivors of serious illness hospitalized during the COVID-19 pandemic. Inspired by the New York Philharmonic Very Young Composers (VYC) program, trauma-informed care-trained teaching artists guided participants through four web-based sessions to develop unique compositions, culminating in a live, online performance. Feasibility data were based on adherence to intervention components. Acceptability data on resilience-related traits were self-reported via pre–post surveys. Fourteen participants enrolled, 12 completed all intervention sessions, and 10 attended the optional final performance. Qualitative analysis revealed five themes that contributed to participants’ positive experience: (I) Novelty, (II) Skill/Perspective Gained, (III) Pleasure, (IV) Self-Efficacy, and (V) Connection to others. Results suggest that the VYC-inspired music composition intervention is a feasible and highly acceptable method for fostering resilience-associated traits in patients impacted by serious illness.

A trauma-informed care interdisciplinary team within an outpatient psychiatry practice provides a framework for intentional consideration of the impact of trauma on psychopathology and patient engagement. This column highlights practical ways in which trauma-informed principles have the potential to transform clinical processes, improve patient engagement, improve provider sense of empowerment, and decrease patient emergency department visits and inpatient care utilization. Challenges with program development, implementation, and evaluation are also identified.

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The World Trade Center (WTC) Environmental Health Center (EHC) is a treatment program for community members with exposure to the 9/11 terrorist attack and its physical and emotional aftermath. Compared to the general responders program, the WTC EHC is diverse with equal gender distribution, representation of many races and ethnicities, and a wide range of social economic status. Patients in the WTC EHC were initially enrolled for physical symptoms, most of which were respiratory, however a large portion of the enrollees scored positive for probable posttraumatic stress disorder (PTSD). In this paper we identify patient characteristics associated with probable PTSD. We also determine the characteristics associated with the longitudinal change of PTSD symptoms, including persistence and remittance, using the widely used Posttraumatic Check List-17 (PCL) cut-off value of 44, as well as changes in PCL total score and symptom cluster scores in patients of Low and High PTSD symptom severity. Few patients with elevated scores achieved a score below 44. However, longitudinal improvement in PCL score at follow-up was identified for patients with High PTSD scores (PCL > 57.5). Changes in PCL symptom clusters differed between those with High and Low PCL scores. These data suggest improvement over time in PCL score that differs depending on the severity of the score and variable responses in the PCL symptom clusters.

Longitudinal assessment of lower respiratory symptoms (LRS) in community members with World Trade Center (WTC) exposures. Adult members of a treatment program with complete standardized visits were evaluated (n = 798). Association of demographic characteristics, mental health symptoms and lung function with trajectory of LRS between initial and monitoring visit was evaluated. Severe LRS were present in 70% at initial and 63% at monitoring visit. Initial severe LRS were associated with WTC dust cloud exposure and mental health symptoms. Spirometry measures were not associated with LRS severity or trajectory; improvement in LRS was associated with improved lung function measured with forced oscillometry techniques. Many community patients in a WTC treatment program had severe LRS associated with exposures and mental health symptoms. Improvement in LRS was associated with improvement in measures of small airway function. Am. J. Ind. Med. 59:777–787, 2016.

The assault and subsequent collapse of the World Trade Center towers in New York City on September 11, 2001 (9/11), released more than a million tons of debris and dust into the surrounding area, engulfing rescue workers as they rushed to aid those who worked in the towers, and the thousands of nearby civilians and children who were forced to flee. In December 2015, almost 15 years after the attack, and 5 years after first enactment, Congress reauthorized the James Zadroga 9/11 Health and Compensation Act, a law designed to respond to the adverse health effects of the disaster. This reauthorization affords an opportunity to review human inhalation exposure science in relation to the World Trade Center collapse. In this Special Article, we compile observations regarding the collective medical response to the environmental health disaster with a focus on efforts to address the adverse health effects experienced by nearby community members including local residents and workers. We also analyze approaches to understanding the potential for health risk, characterization of hazardous materials, identification of populations at risk, and shortfalls in the medical response on behalf of the local community. Our overarching goal is to communicate lessons learned from the World Trade Center experience that may be applicable to communities affected by future environmental health disasters. The World Trade Center story demonstrates that communities lacking advocacy and preexisting health infrastructures are uniquely vulnerable to health disasters. Medical and public health personnel need to compensate for these vulnerabilities to mitigate long-term illness and suffering.