COVID’s mental-health toll: how scientists are tracking a surge in depression

A comparison of psychosocial health among individuals with different levels of hearing ability during the COVID-19 pandemic

OBJECTIVE

This study assessed the impact of the COVID-19 pandemic on psychosocial health among individuals with different levels of hearing ability.

DESIGN

For this cross-sectional study, adults completed an online digits-in-noise test and survey. Participants were categorised into "good", "insufficient", or "poor" hearing groups. Survey questions included topics on depression, anxiety, distress, somatisation, and loneliness levels. Multiple logistic, linear, and negative binomial regressions examined differences in psychosocial health between hearing groups. Moderation analyses identified vulnerable subgroups. Mediation analyses examined mediating effects of pandemic measures on hearing ability and psychosocial health.

STUDY SAMPLE

Eight-hundred and sixty-five adults with or without hearing impairment.

RESULTS

Individuals with poor hearing had a higher odds of having elevated anxiety levels and had higher somatisation levels compared to participants with good hearing. Chronic diseases significantly moderated the relationship between poor hearing ability and loneliness. Difficulties with communicating through facemasks, 1.5 m distance, plastic screens, and during video calls significantly mediated the relationships between hearing ability, anxiety and somatisation.

CONCLUSIONS

Results highlight the elevated anxiety and somatisation levels experienced among individuals with hearing impairment during the COVID-19 pandemic. More awareness is needed of the negative impact pandemic measures can have on psychosocial health during future health crises.

Patient Satisfaction with Psychological Treatment on a Voluntary Inpatient Psychiatric Unit

Despite the empirical literature suggesting the benefits of providing patient support and psychotherapy, research examining patient satisfaction with psychological services integrated within inpatient psychiatric treatment settings remains scarce. A sample of 122 adults within a voluntary inpatient psychiatric unit, who were receiving psychological services completed a satisfaction questionnaire. Overall, participants reported high levels of satisfaction with psychological services and perceived them as helpful to their overall care. These results remained consistent when exploratorily examining satisfaction and helpfulness prior to and during the COVID-19 pandemic. These findings suggest the importance of integrating psychologists within inpatient psychiatric treatment settings. Future research may investigate the influence of psychological services on patient outcomes and how psychologists are perceived by other treatment team members.

Proteome profiling of home-sampled dried blood spots reveals proteins of SARS-CoV-2 infections

BACKGROUND

Self-sampling of dried blood spots (DBS) offers new routes to gather valuable health-related information from the general population. Yet, the utility of using deep proteome profiling from home-sampled DBS to obtain clinically relevant insights about SARS-CoV-2 infections remains largely unexplored.

METHODS

Our study involved 228 individuals from the general Swedish population who used a volumetric DBS sampling device and completed questionnaires at home during spring 2020 and summer 2021. Using multi-analyte COVID-19 serology, we stratified the donors by their response phenotypes, divided them into three study sets, and analyzed 276 proteins by proximity extension assays (PEA). After normalizing the data to account for variances in layman-collected samples, we investigated the association of DBS proteomes with serology and self-reported information.

RESULTS

Our three studies display highly consistent variance of protein levels and share associations of proteins with sex (e.g., MMP3) and age (e.g., GDF-15). Studying seropositive (IgG+) and seronegative (IgG-) donors from the first pandemic wave reveals a network of proteins reflecting immunity, inflammation, coagulation, and stress response. A comparison of the early-infection phase (IgM+IgG-) with the post-infection phase (IgM-IgG+) indicates several proteins from the respiratory system. In DBS from the later pandemic wave, we find that levels of a virus receptor on B-cells differ between seropositive (IgG+) and seronegative (IgG-) donors.

CONCLUSIONS

Proteome analysis of volumetric self-sampled DBS facilitates precise analysis of clinically relevant proteins, including those secreted into the circulation or found on blood cells, augmenting previous COVID-19 reports with clinical blood collections. Our population surveys support the usefulness of DBS, underscoring the role of timing the sample collection to complement clinical and precision health monitoring initiatives.

The impact of COVID-19 lockdowns on mental health patient populations in the United States

During the start of the COVID-19 pandemic in 2020, lockdowns and movement restrictions were thought to negatively impact population mental health, since depression and anxiety symptoms were frequently reported. This study investigates the effect of COVID-19 mitigation measures on mental health across the United States, at county and state levels using difference-in-differences analysis. It examines the effect on mental health facility usage and the prevalence of mental illnesses, drawing on large-scale medical claims data for mental health patients joined with publicly available state- and county-specific COVID-19 cases and lockdown information. For consistency, the main focus is on two types of social distancing policies, stay-at-home and school closure orders. Results show that lockdown has significantly and causally increased the usage of mental health facilities in regions with lockdowns in comparison to regions without such lockdowns. Particularly, resource usage increased by 18% in regions with a lockdown compared to 1% decline in regions without a lockdown. Also, female populations have been exposed to a larger lockdown effect on their mental health. Diagnosis of panic disorders and reaction to severe stress significantly increased by the lockdown. Mental health was more sensitive to lockdowns than to the presence of the pandemic itself. The effects of the lockdown increased over an extended time to the end of December 2020.

Time processing in neurological and psychiatric conditions

A central question in understanding cognition and pathology-related cognitive changes is how we process time. However, time processing difficulties across several neurological and psychiatric conditions remain seldom investigated. The aim of this review is to develop a unifying taxonomy of time processing, and a neuropsychological perspective on temporal difficulties. Four main temporal judgments are discussed: duration processing, simultaneity and synchrony, passage of time, and mental time travel. We present an integrated theoretical framework of timing difficulties across psychiatric and neurological conditions based on selected patient populations. This framework provides new mechanistic insights on both (a) the processes involved in each temporal judgement, and (b) temporal difficulties across pathologies. By identifying underlying transdiagnostic time-processing mechanisms, this framework opens fruitful avenues for future research.

Helpful activities during the COVID-19 pandemic: Perceived benefits and actual association with psychiatric symptoms and psychological wellbeing

BACKGROUND

Few studies have rigorously examined the effectiveness of commonly reported coping activities during the COVID-19 pandemic. This study was designed to assess perceived helpful activities during the pandemic and to investigate the extent to which these activities were associated with psychological outcomes.

METHOD

Adults living in the US (N = 204), who were part of a longitudinal family study of depression responded to an online survey. They reported on their perceived helpful activities during the pandemic. General linear regression models (GLM) were used to evaluate the association between perceived helpful activities and current psychiatric symptoms, controlling for demographic factors, and pre-pandemic psychiatric history and symptoms.

RESULTS

The top perceived helpful activity during COVID-19 was communicating with friends/family via telephone text or video (75.5 %). However, of the top five activities endorsed, cooking/baking was associated with the most clinical outcomes, including lower anxiety/depression and greater psychological wellbeing (all ps < 0.05). These relationships were most prominent among younger individuals < age 40 years, females, and those with recent psychiatric history, although they extended to younger males, and individuals at high or low depression risk.

LIMITATIONS

Close ended items limited variability in coping activities reported. The study lacked data on substance use. The sample was racially and ethnically homogenous.

CONCLUSIONS

These findings move beyond anecdotal evidence that cooking/baking as a coping activity yields protection against psychopathology. Its ready accessibility and ability to confer benefits across a range of individual characteristics, make it a useful adjunct in therapeutic interventions for people confined to their homes.

Work as a social determinant of health in high-income countries: past, present, and future

This paper, the first in a three-part Series on work and health, provides a narrative review of research into work as a social determinant of health over the past 25 years, the key emerging challenges in this field, and the implications of these challenges for future research. By use of a conceptual framework for work as a social determinant of health, we identified six emerging challenges: (1) the influence of technology on the nature of work in high-income countries, culminating in the sudden shift to telework during the COVID-19 pandemic; (2) the intersectionality of work with gender, sexual orientation, age, race, ethnicity, migrant status, and socioeconomic status as codeterminants of health disparities; (3) the arrival in many Organisation for Economic Co-operation and Development countries of large migrant labour workforces, who are often subject to adverse working conditions and social exclusion; (4) the development of precarious employment as a feature of many national labour markets; (5) the phenomenon of working long and irregular hours with potential health consequences; and (6) the looming threat of climate change's effects on work. We conclude that profound changes in the nature and availability of work over the past few decades have led to widespread new psychosocial and physical exposures that are associated with adverse health outcomes and contribute to increasing disparities in health. These new exposures at work will require novel and creative methods of data collection for monitoring of their potential health impacts to protect the workforce, and for new research into better means of occupational health promotion and protection. There is also an urgent need for a better integration of occupational health within public health, medicine, the life sciences, and the social sciences, with the work environment explicitly conceptualised as a major social determinant of health.

Overemphasis on publications may disadvantage historically excluded groups in STEM before and during COVID-19: A North American survey-based study

Publishing is a strong determinant of academic success and there is compelling evidence that identity may influence the academic writing experience and writing output. However, studies rarely quantitatively assess the effects of major life upheavals on trainee writing. The COVID-19 pandemic introduced unprecedented life disruptions that may have disproportionately impacted different demographics of trainees. We analyzed anonymous survey responses from 342 North American environmental biology graduate students and postdoctoral scholars (hereafter trainees) about scientific writing experiences to assess: (1) how identity interacts with scholarly publication totals and (2) how the COVID-19 pandemic influenced trainee perceptions of scholarly writing productivity and whether there were differences among identities. Interestingly, identity had a strong influence on publication totals, but it differed by career stage with graduate students and postdoctoral scholars often having opposite results. We found that trainees identifying as female and those with chronic health conditions or disabilities lag in publication output at some point during training. Additionally, although trainees felt they had more time during the pandemic to write, they reported less productivity and motivation. Trainees who identified as female; Black, Indigenous, or as a Person of Color [BIPOC]; and as first-generation college graduates were much more likely to indicate that the pandemic affected their writing. Disparities in the pandemic's impact on writing were most pronounced for BIPOC respondents; a striking 85% of BIPOC trainees reported that the pandemic affected their writing habits, and overwhelmingly felt unproductive and unmotivated to write. Our results suggest that the disproportionate impact of the pandemic on writing output may only heighten the negative effects commonly reported amongst historically excluded trainees. Based on our findings, we encourage the academy to consider how an overemphasis on publication output during hiring may affect historically excluded groups in STEM-especially in a post-COVID-19 era.

A study on the emotional and attitudinal behaviors of social media users under the sudden reopening policy of the Chinese government

Introduction

Since the outbreak of the COVID-19 pandemic, the Chinese government has implemented a series of strict prevention and control policies to prevent the spread of the virus. Recently, the Chinese government suddenly changed its approach and lifted all prevention and control measures. This sudden change in policy is expected to lead to a widespread outbreak of COVID-19 in China, and the public and local governments are not adequately prepared for the unknown impact on society. The change in the "emergency" prevention and control policy provides a unique research perspective for this study.

Methods

The purpose of this study is to analyze the public's attitudes and emotional responses to COVID-19 under the sudden opening policy, identify the key factors that contribute to these attitudes and emotions, and propose solutions. In response to this sudden situation, we conducted data mining on topics and discussions related to the opening of the epidemic on Sina Weibo, collecting 125,686 interactive comments. We used artificial intelligence technology to analyze the attitudes and emotions reflected in each data point, identify the key factors that contribute to these attitudes and emotions, explore the underlying reasons, and find corresponding solutions.

Results

The results of the study show that in the face of the sudden release of the epidemic, the public mostly exhibited negative emotions and behaviors, with many people experiencing anxiety and panic. However, the gradual resumption of daily life and work has also led some people to exhibit positive attitudes.

Conclusion

The significance of this study is to help the government and institutions understand the impact of policy implementation on users, and to enable them to adjust policies in a timely manner to respond to potential social risks. The government, emergency departments, and the public can all prepare for similar situations based on the conclusions of this study.

Proportional-Derivative Control of Cortisol for Treatment of PTSD

Mental illnesses, such as depression or post-traumatic stress disorder (PTSD), often impact an individual's physiological reaction to stress via their cortisol response. We examine the regulation of cortisol within the hypothalamic-pituitary-adrenal (HPA) axis as a dynamic biosystem. We investigate the difference between the cortisol regulation of people with PTSD and healthy controls. Additionally, we investigate models for potential therapies based on proportional-derivative (PD) control to normalize and improve the stress response of those with PTSD. Such a design may be relevant to improving the treatment of PTSD, as current medical interventions are frequently imprecise and may result in unwanted side effects. The use of a PD controller in administration of hormone therapy, in contrast, can be highly measurable and patient specific.Clinical Relevance- This paper offers an approach to treating post-traumatic stress disorder (PTSD) via stabilizing an individual's endocrinal regulation as a potential future alternative to current pharmaceutical practices.

Risk and protective factors associated with mental health status in an Italian sample of students during the fourth wave of COVID-19 pandemic

BACKGROUND

It is well known that the COVID-19 pandemic has caused a global health crisis, especially for young people. However, most studies were conducted during the first waves of the pandemic. Few Italian studies specifically attempted to broadly assess young people's mental health status during the fourth wave of the pandemic.

METHODS

This study aimed at evaluating the mental health status among a group of Italian adolescents and young adults during the fourth wave of the COVID-19 pandemic. 11,839 high school students and 15,000 university students (age range 14-25) were asked to complete a multidimensional online survey, of which 7,146 (26,6%) agreed to participate. The survey also included standardized measures for depression, anxiety, anger, somatic symptoms, resilience, loneliness and post-traumatic growth. Two separate clusters were identified through cluster analysis. Random forest, classification tree and logistic regressions analyses were applied to identify factors associated to a good or a poor level of mental health and, thus, to define students' mental health profiles.

RESULTS

Overall, the students in our sample showed high levels of psychopathology. The clustering methods performed identified two separate clusters reflecting groups of students with different psychological features, that we further defined as "poor mental health" and "good mental health". The random forest and the logistic regressions found that the most discriminating variables among those two groups were: UCLA Loneliness Scale score, self-harm behaviors, Connor-Davidson Resilience Scale-10 score, satisfaction with family relationships, Fear of COVID-19 Scale score, gender and binge eating behaviors. The classification tree analysis identified students' profiles, showing that, globally, poor mental health was defined by higher scores of loneliness and self-harm, followed by being of female gender, presenting binge eating behaviors and, finally, having unsatisfying family relationships.

CONCLUSIONS

The results of this study confirmed the major psychological distress caused by the COVID-19 pandemic in a large sample of Italian students, and provided further insights regarding those factors associated with a good or poor mental health status. Our findings suggest the importance of implementing programs targeting aspects that have been found to be associated to a good mental health.

Computational Study of Photodegradation Process and Conversion Products of the Antidepressant Citalopram in Water

Citalopram (CIT) is a commonly prescribed medication for depression. However, the photodegradation mechanism of CIT has not yet been fully analyzed. Therefore, the photodegradation process of CIT in water is studied by density functional theory and time-dependent density functional theory. The calculated results show that during the indirect photodegradation process, the indirect photodegradation of CIT with ·OH occurs via OH-addition and F-substitution. The minimum activation energy of C10 site was 0.4 kcal/mol. All OH-addition and F-substitution reactions are exothermic. The reaction of ¹O₂ with CIT includes the substitution of ¹O₂ for F and an addition reaction at the C14 site. The E_a value of this process is 1.7 kcal/mol, which is the lowest activation energy required for the reaction of ¹O₂ with CIT. C-C/C-N/C-F cleavage is involved in the direct photodegradation process. In the direct photodegradation of CIT, the activation energy of the C7-C16 cleavage reaction was the lowest, which was 12.5 kcal/mol. Analysis of the E_a values found that OH-addition and F-substitution, the substitution of ¹O₂ for F and addition at the C14 site, as well as the cleavage reactions of C6-F/C7-C16/C17-C18/C18-N/C19-N/C20-N are the main pathways of photodegradation of CIT.

Status of mental health among college and university students during first and second wave of COVID-19 outbreak in India: A cross-sectional study

Background

India has been badly affected by Covid-19 not only in terms of human lives but also has a long-term effect on mental health of the population. This paper is an attempt to understand the psychological effects of the pandemic on the college and university students in India after the second wave of COVID-19 outbreak and its associated factors.

Method

A web-based survey was conducted to collect information from the students both at individual and household level. The study applied binary and multivariate logistic regression to estimate the adjusted and unadjusted marginal effects of the predictor variables.

Result

Results show a significant increase in mental health concerns during the second wave of the pandemic, as compared to the first year. The key factors contributing to the higher prevalence of depression, anxiety, and stress are the difficulties faced in the adaptation to the new way of learning, fear of discontinuation of education due to financial constraints faced by household, limited physical interaction, and prolonged screen-time during the pandemic.

Limitation

The study has some limitations regarding selection of the sample as the survey was web-based. Also, the mental health situation of the students is self-reported and the study does not consider the prevailing mental health issues before the pandemic.

Conclusion

The study recommends initiatives like offering counselling classes and strategies to cope up with mental health disorders. Further, there is a need to conduct follow-up studies to assess the long-term impacts of prolonged home quarantine on the mental health of the students.

The effects of the pandemic on mental health in persons with and without a psychiatric history

BACKGROUND

Prospective studies are needed to assess the influence of pre-pandemic risk factors on mental health outcomes following the COVID-19 pandemic. From direct interviews prior to (T1), and then in the same individuals after the pandemic onset (T2), we assessed the influence of personal psychiatric history on changes in symptoms and wellbeing.

METHODS

Two hundred and four (19-69 years/117 female) individuals from a multigenerational family study were followed clinically up to T1. Psychiatric symptom changes (T1-to-T2), their association with lifetime psychiatric history (no, only-past, and recent psychiatric history), and pandemic-specific worries were investigated.

RESULTS

At T2 relative to T1, participants with recent psychopathology (in the last 2 years) had significantly fewer depressive (mean, M = 41.7 v. 47.6) and traumatic symptoms (M = 6.6 v. 8.1, p < 0.001), while those with no and only-past psychiatric history had decreased wellbeing (M = 22.6 v. 25.0, p < 0.01). Three pandemic-related worry factors were identified: Illness/death, Financial, and Social isolation. Individuals with recent psychiatric history had greater Illness/death and Financial worries than the no/only-past groups, but these worries were unrelated to depression at T2. Among individuals with no/only-past history, Illness/death worries predicted increased T2 depression [B = 0.6(0.3), p < 0.05].

CONCLUSIONS

As recent psychiatric history was not associated with increased depression or anxiety during the pandemic, new groups of previously unaffected persons might contribute to the increased pandemic-related depression and anxiety rates reported. These individuals likely represent incident cases that are first detected in primary care and other non-specialty clinical settings. Such settings may be useful for monitoring future illness among newly at-risk individuals.

Cases and context: Mask-related behaviors among U.S. trail visitors during the COVID-19 pandemic

The challenge of simultaneously providing outdoor recreation opportunities while protecting the public from SARS-CoV-2 virus and COVID-19 transmission, as well as future pandemics, remains foremost on managers' minds. Safe spaces and cultures are paramount for managers and visitors alike. Recommended protective measures against COVID-19 included physically distancing 1.8 m (six-feet) between parties and mask-wearing when distancing is not possible. Adoption of these protective measures is relatively unknown but essential to inform recreation management and planning through future health crises. Such adoption is likely influenced by both the pandemic context and site context, particularly related to visitor density. An observational study assessed mask-wearing behaviors among trail walkers on multiple trails in the United States from November 2020 through May 2021. Trained observers identified if walking groups were prepared to mask or had masks correctly worn as well as if encounters were compliant with the 1.8 m recommendations. Data collected across seven U.S. states enabled comparisons of mask-related behaviors across sites as well as considerations to: the influence of the pandemic context in terms of cases and vaccination rates, mask mandates, and trail density. Results from nearly 3000 encounters revealed significant variance in visible masks, low compliance of mask-wearing in encounters less than 1.8 m, significant influence of both COVID-19 cases and vaccination rates on mask wearing at half the sites, and no impact of state-level mask mandates when controlling for cases and vaccinations. Integrating public health data can inform predictions of compliant behaviors, or lack thereof, and needs exist to advance a safety culture.

Prevalence of depression, anxiety, and suicidal ideation during the Shanghai 2022 Lockdown: A cross-sectional study

BACKGROUND

Common mental disorders and suicidal ideation are associated with exposures to COVID-19 pandemic stressors, including lockdown. Limited data is available on the effect of city-wide lockdowns on population mental health. In April 2022, Shanghai entered a city-wide lockdown that sealed 24 million residents in their homes or residential compounds. The rapid initiation of the lockdown disrupted food systems, spurred economic losses, and widespread fear. The associated mental health effects of a lockdown of this magnitude are largely unknown. The purpose of this study is to estimate the prevalence of depression, anxiety, and suicidal ideation during this unprecedented lockdown.

METHODS

In this cross-sectional study, data were obtained via purposive sampling across 16 districts in Shanghai. Online surveys were distributed between April 29 and June 1, 2022. All participants were physically present and residents of Shanghai during the lockdown. Logistic regression was used to estimate the associations between lockdown-related stressors and study outcomes, adjusting for covariates.

FINDINGS

A total of 3230 Shanghai residents who personally experienced the lockdown participated the survey, with 1657 (55.5 %) men, 1563 (44.3 %) women, and 10 (0.02 %) other, and a median age of 32 (IQR 26-39), who were predominately 3242 (96.9 %) Han Chinese. The overall prevalence of depression based on PHQ-9 was 26.1 % (95 % CI, 24.8 %-27.4 %), 20.1 % (18.3 %-22.0 %) for anxiety based on GAD-7, and 3.8 % (2.9 %-4.8 %) for suicidal ideation based on ASQ. The prevalence of all outcomes was higher among younger adults, single people, lower income earners, migrants, those in poor health, and with a previous psychiatric diagnosis or suicide attempt. The odds of depression and anxiety were associated with job loss, income loss, and lockdown-related fear. Higher odds of anxiety and suicidal ideation were associated with being in close contact with a COVID-19 case. Moderate food insecurity was reported by 1731 (51.8 %), and 498 (14.6 %) reported severe food insecurity. Moderate food insecurity was associated with a >3-fold increase in the odds of screening for depression and anxiety and reporting suicidal ideation (aOR from 3.15 to 3.84); severe food insecurity was associated with >5-fold increased odds for depression, anxiety, and suicidal ideation (aOR from 5.21 to 10.87), compared to being food secure.

INTERPRETATION

Lockdown stressors, including food insecurity, job and income loss, and lockdown-related fears, were associated with increased odds of mental health outcomes. COVID-19 elimination strategies including lockdowns should be balanced against the effects on population wellbeing. Strategies to avoid unneeded lockdown, and policies that can strengthen food systems and protect against economic shocks are needed.

FUNDING

Funding was provided by the NYU Shanghai Center for Global Health Equity.

Association between the COVID-19 global pandemic and the prevalence of cats presenting with urethral obstruction at two university veterinary emergency rooms

OBJECTIVES

The aim of this study was to investigate a potential association between the COVID-19 pandemic stay-at-home orders and the prevalence of emergency room presentations for urethral obstruction (UO) in feline patients.

METHODS

Medical records and hospital census were retrospectively searched to identify the total number of cats and total number of male cats with UO presenting to two academic veterinary medical centers from 22 March to 10 August in the years 2018 (123), 2019 (137) and 2020 (175). Cats were grouped based on the year of presentation and the proportions of UO cases relative to all cats presenting to the emergency rooms during the same time frame. Absolute (year of interest - reference year) and relative ([year of interest - reference year]/[reference year]) change in prevalence was determined. These were compared for each year using a two-sample z-test.

RESULTS

The absolute and relative prevalence of UO presentations across the combined population increased significantly during the COVID-19 pandemic in comparison with 2018 (2.2% and 59%, respectively; P = 0.0003) and 2019 (1.9% and 48%, respectively; P = 0.0021). For the individual institutions, a significant increase in UO presentations was found for institution A when comparing 2020 with both 2018 (P = 0.0072) and 2019 (P = 0.0073), but not for institution B (P = 0.057 and P = 0.18, respectively). No significant differences were found when 2018 and 2019 were compared across the combined population or within institutions.

CONCLUSIONS AND RELEVANCE

The results of this study demonstrate an increased prevalence of UO during the initial months of the COVID-19 pandemic, which may be related to environmental change and stress imposed by stay-at-home orders.

Effects of workplace measures against COVID-19 and employees' worry about them on the onset of major depressive episodes: A 13-month prospective study of full-time employees

BACKGROUND

Workplace measures against COVID-19 may prevent the onset of major depressive episode (MDE) in the working population. This 13-month prospective study aimed to investigate the association of the number of workplace measures against COVID-19 and employees' worry about the measures on the onset of MDE during COVID-19 outbreaks in Japan.

METHODS

Data were collected from employees by using online questionnaires at baseline (May 2020) and the 7th survey (June 2021). The onset of MDE during the follow-up was retrospectively measured at the 7th survey, with a self-report scale based on the Mini-International Neuropsychiatric Interview according to the DSM-IV/DSM-5 criteria. Participants were asked to report the number of workplace measures against COVID-19 in their companies/organizations and their worry about these measures (scored 0-3). Multiple logistic regression was conducted of MDE on the number of workplace measures and worry about these, adjusting for demographic and work-related covariates and psychological distress at baseline.

RESULTS

Among 968 respondents employed in May 2020, 827 completed the 7th survey in June 2021 (80%). We excluded 75 respondents who reported they had an MDE in May 2020 or earlier. Worry about workplace measures was significantly associated with the onset of MDE after adjusting for the covariates (OR for 1 score increase, 1.53; 95% CI, 1.02-2.32; p = 0.042). No significant association was found between the number of workplace measures and the onset of MDE.

CONCLUSIONS

Worrying about workplace measures taken by company/organization may be a risk factor for the onset of an MDE among employees during the COVID-19 pandemic.

Postpartum depression crisis since the second lockdown and 'screening paradox': many women identified, very few treated

OBJECTIVE

Exposure to stressful situations, such as emergencies, infectious diseases, and natural disasters, may lead to a heightened risk of perinatal mental health problems. Declared on March 11th, 2020, the global COVID-19 pandemic triggered an additional burden on women in the perinatal period. Safety recommendations, such as social distancing and isolation, were opposite to the usual advice given to new mothers. Besides fear, changes in financial stability and daily life reorganization contributed to increased depressive symptoms. As the periods of epidemic waves and lockdowns were associated with a more significant burden for young families, we aimed to assess the intensification of depressive and anxiety symptoms during the pandemic concerning the time intervals of the three lockdowns introduced in Poland.

METHODS

1588 postpartum women took part in the online self-assessment with the Edinburgh Postnatal Depression Scale (EPDS) and General Anxiety Disorder 2 (GAD-2) questionnaire between January 1, 2020, and March 31, 2021. This self-screening is a part of a prevention program The Next Stop: Mum, implemented in the North of Poland.

RESULTS

The highest severity of PPD symptoms and anxiety were observed during the second lockdown in Poland: the mean score in the EPDS and anxiety assessment was significantly higher than the mean scores from previous pandemic periods. Since the second lockdown, the average EPDS and GAD-2 scores remained similarly high. Moreover, with the duration of the COVID-19 pandemic, the percentage of women with elevated symptoms of postpartum depression and anxiety began to increase. However, the Polish National Health Fund data indicate that only 0,7% of women giving birth in the northern macro-region of Poland received diagnosis and help from public funds. In The Next Stop: Mum project, 250 women benefited from psychological consultations.

CONCLUSION

Increased severity of depression and anxiety symptoms during the pandemic indicates the need for additional psychological support for postpartum women. However, very few women are diagnosed in health facilities in the first year postpartum and thus are rarely referred for further treatment. The study shows that the availability of services and the focus on social and individual barriers may be critical factors in implementing perinatal mental health programs and practices. This may be especially needed in a country where the screening obligation is new. In case of a further pandemic, policymakers and health care professionals should be aware that the duration of the restrictions and the repetition of lockdowns are associated with the aggravation of symptoms. The online screening without the possibility to discuss the results is only partially effective in increasing referrals for possibly affected women.

A qualitative analysis of psychosocial stressors and health impacts of the COVID-19 pandemic on frontline healthcare personnel in the United States

There is a dearth of qualitative studies exploring the lived experiences of frontline healthcare personnel (HCP) during the coronavirus disease (COVID-19) pandemic. We examined workplace stressors, psychological manifestations of said stressors, and coping strategies reported through coded open-text responses from 1024 online surveys completed over two months by 923 HCP participating in three nationwide cohorts from Spring 2020. Our findings suggest that risk, job insecurity, frustration with hospital administration, inadequate access to personal protective equipment, and witnessing patient suffering and death contributed to deteriorating mental and physical health. Negative health impacts included the onset or exacerbation of anxiety, depression, and somatic symptoms, including weight fluctuation, fatigue, and migraines. Coping mechanisms included substance use and food consumption, meditation and wellness, fitness, socializing with loved ones, and religious activities. Insights garnered from participants' responses will enable more personalized and effective psychosocial crisis prevention and intervention for frontline HCP in future health crises.

The effects of medicaid expansion on job loss induced mental distress during the COVID-19 pandemic in the US

The COVID-19 pandemic led to an unprecedented level of job losses in the U.S., where job loss is also associated with the loss of health insurance. This paper uses data from the 2020 Household Pulse Survey (HPS) and difference-in-difference (DD) regressions to estimate the effect of Medicaid expansion on anxiety and depression associated with job loss. Estimates show that the respondents who live in expansion states are 96.6% more likely to have Medicaid coverage, and 14.2% less likely to have moderate to severe mental distress following their job loss compared to those living in non-expansion states. The corresponding numbers associated with a family member's job loss are 36.3% and 7.6%, respectively. Next, we explore the mechanisms which suggest that the economic security provided by Medicaid is as important (if not more) as the access to or utilization of healthcare. The difference-in-difference-in-difference (DDD) estimates using just above and below the Medicare eligibility age (65) confirm these results.

Exploring the over-time, multifaceted impacts of three COVID-19 lockdowns on aspects of capability, wellbeing and mental health across vulnerabilities in Austria

The Austrian government imposed multiple major lockdowns during the COVID-19 pandemic, but the relevant measures and their perceptions varied over time. The aim of this study was to compare the over-time impacts of the three COVID-19 lockdowns between March 2020 and December 2021 for (capability) wellbeing and mental health in Austria. Adult Austrian residents (n = 87) completed an online survey about their experiences during three COVID-19 lockdowns, including capabilities (OxCAP-MH), depression and anxiety (HADS), and general wellbeing (WHO-5). Differences across the baseline and follow-up scores of these instruments were summarised by demographic/socioeconomic characteristics. Longitudinal comparisons of the impacts of the lockdowns were conducted using random effect models on panel data for overall instrument scores and individual capability items. The levels of (capability) wellbeing and mental health decreased for most respondents across the three lockdowns: average 2.4% reduction in OxCAP-MH scores, 18.8% and 9% increases in HADS depression and anxiety subscale scores respectively, and 19.7% reduction in WHO-5 score between the first and third lockdowns. Mental health treatment prior to the pandemic, social support and satisfaction with government measures were the most influential characteristics that determine the association with impacts of the chain of lockdowns. Our study is the first to assess the differential capability limiting aspects of lockdowns over time alongside their impacts on mental health and general wellbeing and calls for special attention for mental health patients, isolation and satisfaction with government measures.

Preventable deaths from SARS-CoV-2 in England and Wales: a systematic case series of coroners' reports during the COVID-19 pandemic

OBJECTIVES

To examine coroners' Prevention of Future Deaths (PFDs) reports to identify deaths involving SARS-CoV-2 that coroners deemed preventable.

DESIGN

Consecutive case series.

SETTING

England and Wales.

PARTICIPANTS

Patients reported in 510 PFDs dated between 01 January 2020 and 28 June 2021, collected from the UK's Courts and Tribunals Judiciary website using web scraping to create an openly available database: https://preventabledeathstrackernet/.

MAIN OUTCOME MEASURES

Concerns reported by coroners.

RESULTS

SARS-CoV-2 was involved in 23 deaths reported by coroners in PFDs. Twelve deaths were indirectly related to the COVID-19 pandemic, defined as those that were not medically caused by SARS-CoV-2, but were associated with mitigation measures. In 11 cases, the coroner explicitly reported that COVID-19 had directly caused death. There was geographical variation in the reporting of PFDs; most (39%) were written by coroners in the North West of England. The coroners raised 56 concerns, problems in communication being the most common (30%), followed by failure to follow protocols (23%). Organisations in the National Health Service were sent the most PFDs (51%), followed by the government (26%), but responses to PFDs by these organisations were poor.

CONCLUSIONS

PFDs contain a rich source of information on preventable deaths that has previously been difficult to examine systematically. Our openly available tool (https://preventabledeathstracker.net/) streamlines this process and has identified many concerns raised by coroners that should be addressed during the government's inquiry into the handling of the COVID-19 pandemic, so that mistakes made are less likely to be repeated. STUDY PROTOCOL PREREGISTRATION: https://osf.io/bfypc/.

Neonatal and child mortality - are they different in developing and developed countries?

Aim is to present the neonatal and child mortality in high-(HIC) and low-income (LIC) countries and possible influence of COVID-19 pandemic. In recently published sustainable development goals (SDGs) report and other sources the data on infant and under-five mortality (U-5MR) in HIC and LIC are presented. SDG 3.2 has targeted elimination of preventable child mortality, reduction of neonatal mortality rate (NMR) to less than 12 per 1,000 live births, and reduction of U-5MR to less than 25 per 1,000 live births by 2030. Negative influence of COVID-19 pandemic on performance of SDG 3.2 has been discussed. The lowest NMR was in HIC, almost 10 times lower than in LIC and sub-Saharan Africa (SSA). Data on the U-5MR between HIC and LIC are even worse because the difference was between 13 and 15 times lower in HIC. More children are dying after the neonatal period in LIC. In HIC, NMR comprises 56.3% of U-5MR, while in LIC it is 40.3%, and in SSA, it is 36.8%. Births attended by skilled birth personnel in HIC was 99.0% and in LIC it was only 58.6%, which might affect early NMR. The COVID-19 pandemic is affecting the delivery of perinatal health, with possible negative effects on stillbirth rates, NMR, U-5MR, maternal mortality rates, and many other indicators. The gap of the NMR and U-5MR between HIC and LIC has increasing tendency regardless of COVID-19 pandemic, affecting adversely perinatal health indicators in HIC and LIC.

Intolerance of Uncertainty and Health-Related Anxiety in Youth amid the COVID-19 Pandemic: Understanding and Weathering the Continuing Storm

The COVID-19 pandemic is a public health crisis that continues to impact individuals worldwide. While children may be less susceptible to severe medical complications, they are nonetheless vulnerable to stress and anxiety associated with the pandemic. However, current understanding of psychological functioning and potential strategies to mitigate distress amid a pandemic is naturally limited. Consequently, this article is an attempt to fill that gap. Existing literature on pandemics, health-related anxieties, intolerance of uncertainty, and psychopathological sequelae is summarized within the context of the COVID-19 outbreak. Conclusions from the empirical data and emerging theoretical models are reviewed and synthesized. Finally, several potentially engaging and effective examples of developmentally appropriate interventions targeting intolerance of uncertainty and health-related anxieties in pediatric patients during the peri- and post-pandemic periods are described.

Effects of Two Distinct Psychoactive Microbes, Lacticaseibacillus rhamnosus JB-1 and Limosilactobacillus reuteri 6475, on Circulating and Hippocampal mRNA in Male Mice

Discovery of the microbiota-gut–brain axis has led to proposed microbe-based therapeutic strategies in mental health, including the use of mood-altering bacterial species, termed psychobiotics. However, we still have limited understanding of the key signaling pathways engaged by specific organisms in modulating brain function, and evidence suggests that bacteria with broadly similar neuroactive and immunomodulatory actions can drive different behavioral outcomes. We sought to identify pathways distinguishing two psychoactive bacterial strains that seemingly engage similar gut–brain signaling pathways but have distinct effects on behaviour. We used RNAseq to identify mRNAs differentially expressed in the blood and hippocampus of mice following Lacticaseibacillus rhamnosus JB-1, and Limosilactobacillus reuteri 6475 treatment and performed Gene Set Enrichment Analysis (GSEA) to identify enrichment in pathway activity. L. rhamnosus, but not L. reuteri treatment altered several pathways in the blood and hippocampus, and the rhamnosus could be clearly distinguished based on mRNA profile. In particular, L. rhamnosus treatment modulated the activity of interferon signaling, JAK/STAT, and TNF-alpha via NF-KB pathways. Our results highlight that psychobiotics can induce complex changes in host gene expression, andin understanding these changes, we may help fine-tune selection of psychobiotics for treating mood disorders.

The sustainable health Agenda in the Americas: Pre-pandemic gaps and 2030 estimates of the SDGs indicators

The preliminary assessments of the impact of the COVID-19 pandemic have recently rekindled worries about the feasibility of the Sustainable Development Goals (SDGs). Notwithstanding the concern voiced by key academic and political actors, the actual evidence on the current gaps and distance from the goals is still very much unknown. This study estimates the global evolution curves for each health-related SDGs indicator in the World Health Organization’s SDGs platform. These curves synthesize the transnational trends at play in the evolution of each health-related topic, offering an average global counterfactual to compare with the actual information for each country. The empirical investigation focuses on the American continent, highlighting the health gaps before the COVID-19 outbreak in 33 countries of the region. The study also extrapolates these trends to predict the evolution of the health-related SDGs in each of these countries over the next decade using as the baseline scenario the International Monetary Fund’s economic forecasts. The results show a widening gap in the region, associated with the differential economic capacity of these countries. Some bottlenecks are shared by most countries in the continent, especially in the themes of violence and infectious diseases. The latter is likely to improve faster than other health themes in the next decade, whereas improvements in the theme non-communicable diseases can be more challenging. The findings provide much needed comparative evidence to guide the countries in the region to set priorities and concentrate efforts to accelerate progress in the health-related SDGs.

Resilience and Prosocial Behavior Among Chinese University Students During COVID-19 Mitigation: Testing Mediation and Moderation Models of Social Support

Purpose

Suffering during events such as the COVID-19 pandemic threatens university students' physical and psychological health. Given the literature indicating the protective role of resilience and social support, the current study explored the mediating and moderating roles of social support in the association between resilience and prosocial behavior among university students in mainland China during COVID-19 mitigation.

Methods

We conducted an online survey using convenience sampling from 23rd February to 3rd March 2020 among Chinese university students who had encountered home-quarantine due to the COVID-19 pandemic. Self-report scales were used to measure levels of resilience (Connor-Davidson Resilience Scale), social support (the Social Support Scale), and prosocial behavior (Prosocial Tendencies Measure). A total of 313 university students participated in this online survey. Hayes PROCESS macro for SPSS was used to test the hypothesized mediating and moderating effects of social support in the relationship between resilience and prosocial behavior.

Results

Pearson's correlations analysis showed that all outcomes of interest were positively associated. Importantly, social support (subjective support, objective support, and support utilization) mediated the indirect link of resilience with prosocial behavior. Furthermore, moderation analyses indicated that support utilization played a moderating role in this link. Support utilization may reduce the negative influence of COVID-19 on university students' prosocial behavior and serve as a protective factor between resilience and prosocial behavior in highly stressful contexts.

Conclusion

Our findings enrich research on prosocial behavior by investigating the potential internal and external variables that influence such behavior during periods of suffering. Findings also provide evidence for the need to promote university students' prosocial behavior.

Efficacy of neurostimulation across mental disorders: systematic review and meta-analysis of 208 randomized controlled trials

Non-invasive brain stimulation (NIBS), including transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS), is a potentially effective treatment strategy for a number of mental conditions. However, no quantitative evidence synthesis of randomized controlled trials (RCTs) of TMS or tDCS using the same criteria including several mental conditions is available. Based on 208 RCTs identified in a systematic review, we conducted a series of random effects meta-analyses to assess the efficacy of NIBS, compared to sham, for core symptoms and cognitive functioning within a broad range of mental conditions. Outcomes included changes in core symptom severity and cognitive functioning from pre- to post-treatment. We found significant positive effects for several outcomes without significant heterogeneity including TMS for symptoms of generalized anxiety disorder (SMD = -1.8 (95% CI: -2.6 to -1), and tDCS for symptoms of substance use disorder (-0.73, -1.00 to -0.46). There was also significant effects for TMS in obsessive-compulsive disorder (-0.66, -0.91 to -0.41) and unipolar depression symptoms (-0.60, -0.78 to -0.42) but with significant heterogeneity. However, subgroup analyses based on stimulation site and number of treatment sessions revealed evidence of positive effects, without significant heterogeneity, for specific TMS stimulation protocols. For neurocognitive outcomes, there was only significant evidence, without significant heterogeneity, for tDCS for improving attention (-0.3, -0.55 to -0.05) and working memory (-0.38, -0.74 to -0.03) in individuals with schizophrenia. We concluded that TMS and tDCS can benefit individuals with a variety of mental conditions, significantly improving clinical dimensions, including cognitive deficits in schizophrenia which are poorly responsive to pharmacotherapy.

Shall We Dance? Recreational Dance, Well-Being and Productivity Performance During COVID-19: A Three-Country Study

Mental health issues are increasingly prevalent worldwide, emphasizing the need to research antecedents and consequences of well-being. Prior research shows that within organizations, higher levels of subjective well-being (SWB) promote productivity performance. Building on this research, the authors hypothesize that recreational dance positively influences productivity through higher SWB. Survey data from Brazil, Italy, and the United Kingdom reveal that recreational dancers are more productive than nondancers due to their higher intrinsic motivation and SWB. Dancing has an additional direct effect on productivity, beyond the mediating role of SWB. The results indicate well-being and productivity improvements in all three countries, although they show a moderating effect such that the relationship between recreational dance and SWB is stronger when social norms are perceived to be looser. This study indicates potentially far-reaching benefits that could be achieved by including recreational dance in corporate well-being programs. International dance organizations could market dance classes as a pathway to increase productivity at work and explore synergies with public health marketing to promote the benefits of recreational dance in joint international campaigns.

The Relationship Between Adjustment and Mental Health of Chinese Freshmen: The Mediating Effect of Security and the Moderating Effect of Gender

During the COVID-19 pandemic, many universities are confronted with campus lockdown or even school closures to reduce the risk of infection. However, these measures pose a threat to the mental health of adolescents. In particular, freshmen who have just entered the university campus may suffer from more serious mental health risks. In this study, 1,818 freshmen were analyzed by using the Chinese College Student Adjustment Scale (CCSAS), Sense of Security Questionnaire (SQ), and Symptom Check List 90 (SCL-90) of the qualitative method. The results showed that adjustment had an impact on mental health. Firstly, there was a significant negative association between adjustment and mental health. Secondly, adjustment had a significant predictive effect on mental health. Finally, a sense of security and gender affected the relationship between adjustment and mental health. Collectively, adjustment, sense of security, and gender exerted impacts on the mental health of freshmen, suggesting that we should create a warm and harmonious campus environment for students and conduct targeted education for male and female students.

Within Clinic Reliability and Usability of a Voice-Based Amazon Alexa Administration of the Patient Health Questionnaire 9 (PHQ 9)

Over the last two decades, metric-based instruments have garnered popularity in mental health. Self-administered surveys, such as the Patient Health Questionnaire 9 (PHQ 9), have been leveraged to inform treatment practice of Major Depressive Disorder (MDD). The aim of this study was to measure the reliability and usability of a novel voice-based delivery system of the PHQ 9 using Amazon Alexa within a patient population. Forty-one newly admitted patients to a behavioral medicine clinic completed the PHQ 9 at two separate time points (first appointment and one-month follow up). Patients were randomly assigned to a version (voice vs paper) completing the alternate format at the next appointment. Patients additionally completed a 26-item User Experience Questionnaire (UEQ) and open-ended questionnaire at each session. Assessments between PHQ 9 total scores for the Alexa and paper version showed a high degree of reliability (α = .86). Quantitative UEQ results showed significantly higher overall positive attitudes towards the Alexa format with higher subscale scores on attractiveness, stimulation, and novelty. Further qualitative responses supported these findings with 85.7% of participants indicating a willingness to use the device at home. With the benefit of user instruction in a clinical environment, the novel Alexa delivery system was shown to be consistent with the paper version giving evidence of reliability between the two formats. User experience assessments further showed a preference for the novel version over the traditional format. It is our hope that future studies may examine the efficacy of the Alexa format in improving the at-home clinical treatment of depression.

The pandemic brain: Neuroinflammation in non-infected individuals during the COVID-19 pandemic

While COVID-19 research has seen an explosion in the literature, the impact of pandemic-related societal and lifestyle disruptions on brain health among the uninfected remains underexplored. However, a global increase in the prevalence of fatigue, brain fog, depression and other "sickness behavior"-like symptoms implicates a possible dysregulation in neuroimmune mechanisms even among those never infected by the virus. We compared fifty-seven 'Pre-Pandemic' and fifteen 'Pandemic' datasets from individuals originally enrolled as control subjects for various completed, or ongoing, research studies available in our records, with a confirmed negative test for SARS-CoV-2 antibodies. We used a combination of multimodal molecular brain imaging (simultaneous positron emission tomography / magnetic resonance spectroscopy), behavioral measurements, imaging transcriptomics and serum testing to uncover links between pandemic-related stressors and neuroinflammation. Healthy individuals examined after the enforcement of 2020 lockdown/stay-at-home measures demonstrated elevated brain levels of two independent neuroinflammatory markers (the 18 kDa translocator protein, TSPO, and myoinositol) compared to pre-lockdown subjects. The serum levels of two inflammatory markers (interleukin-16 and monocyte chemoattractant protein-1) were also elevated, although these effects did not reach statistical significance after correcting for multiple comparisons. Subjects endorsing higher symptom burden showed higher TSPO signal in the hippocampus (mood alteration, mental fatigue), intraparietal sulcus and precuneus (physical fatigue), compared to those reporting little/no symptoms. Post-lockdown TSPO signal changes were spatially aligned with the constitutive expression of several genes involved in immune/neuroimmune functions. This work implicates neuroimmune activation as a possible mechanism underlying the non-virally-mediated symptoms experienced by many during the COVID-19 pandemic. Future studies will be needed to corroborate and further interpret these preliminary findings.

A Preliminary Study of COVID-19-related Stressors, Parenting Stress, and Parental Psychological Well-being Among Parents of School-age Children

The COVID-19 pandemic has had substantial health, social, and economic effects on families. Consequent lockdowns and school closures heightened the burden on parents of school-age children. Many parents, while working from home, had to care for their children with restricted access to caregiver resources and to support their children's education through homeschooling or remote learning provided by their schools. These duties created challenges and pressures on parents. Using online survey data collected from 197 parents of school-age (Prek-12) children during the first three months of the COVID-19 pandemic in the U.S., this preliminary study examined the relations among COVID-19-related stressors, including fear of COVID-19 and problems associated with school closures, parenting stress, and parental psychological well-being. Fear of COVID-19 and various issues associated with school closures were related to parenting stress and parental well-being. Parents with less instrumental and emotional support reported higher levels of parenting stress and lower levels of psychological well-being. The results of hierarchical multiple regressions revealed that parenting stress was the strongest predictor of parental psychological distress. Social support was associated with parental well-being but did not mediate the relation between parenting stress and parental well-being. The findings suggest that parenting stress during the COVID-19 lockdowns might take a toll on the mental health of parents of school-age children. Parents of school-age children need multiple layers of support, including targeted support addressing stressors related to school closures and parenting under quarantine.

The Impact of COVID-19 Lockdown Announcements on Mental Health: Quasi-Natural Experiment in Lombardy, Italy

Background

Evidence showed that mental health problems have risen markedly during COVID-19. It is unclear if part of the mental sufferings relates to the climate of uncertainty and confusion originated from rough communication by health officials and politicians. Here, we test the impact of unanticipated policy announcements of lockdown policies on mental health of the older population.

Methods

We used a representative telephone-based survey of 4400 people aged 65 years or older in Italy’s Lombardy region to compare information on self-reported symptoms of anxiety, depression and poor-quality sleep of subjects interviewed on the days of the policy announcement with that of subjects interviewed on other days. We used regression models adjusting for potential socio-demographic confounders as well study design with inverse probability weighting.

Results

On days when policymakers announced to extend the lockdown, mental health deteriorated on average by 5.5 percentage points [95% confidence interval (CI): 1.1–9.8] for self-reported anxiety symptoms and 5.1 percentage points (95% CI: 2.7–7.4) for self-reported depressive symptoms. The effect of the announcement to shorten the lockdown is more moderate but statistically significant. These associations were short term in duration; after just 1 day, self-reported mental health and sleep quality return to levels better than pre-announcement until a new policy change.

Conclusions

Our research shows that lockdown policy announcements are associated with short-term worsening in mental distress, highlighting the importance of appropriate communication strategies and political determinations in crisis times.

Tourists' Health Risk Threats Amid COVID-19 Era: Role of Technology Innovation, Transformation, and Recovery Implications for Sustainable Tourism

Technology innovation has changed the patterns with its advanced features for travel and tourism industry during the outbreak of COVID-19 pandemic, which massively hit tourism and travel worldwide. The profound adverse effects of the coronavirus disease resulted in a steep decline in the demand for travel and tourism activities worldwide. This study focused on the literature based on travel and tourism in the wake global crisis due to infectious virus. The study aims to review the emerging literature critically to help researchers better understand the situation. It valorizes transformational affordance, tourism, and travel industries impacts posed by the virus COVID-19. The study proposed a research model on reviving the international tourism activities post COVID-19 pandemic to gain sustainable development and recovery. The scholars have debated seeking the best possible ways to predict a sustainable recovery of travel, tourism, and leisure sectors from the devastating consequences of coronavirus COVID-19. In the first phase, the study describes how the current pandemic can become transformational opportunities. It debates the situation and questions related to the emergence of the COVID-19 outbreak. The present research focuses on identifying fundamental values, organizations, and pre-assumptions related to travel and tourism revival and help academia and researchers to a breakthrough in initiating the frontiers based on research and practice. This study aims at exploring the role of technological innovation in the crisis management of COVID-19 tourism impacts, tourists' behavior, and experiences. The travel and tourism industry's main stakeholders include tourism demand and organizations that manage tourists' destinations and policymakers. They have already experienced the stages of responses, recovery, and resetting tourism recovery strategies. The study provides valuable insight into the coronavirus consequences on travel and tourism and practical implications for global tourism and academic research revitalization.

Global COVID-19 Vaccine Inequity: Failures in the First Year of Distribution and Potential Solutions for the Future

Within the first year of distribution of vaccines against COVID-19, high-income countries (HICs) have achieved vaccination rates of 75-80%, whilst low-income countries (LICs) vaccinated <10%. This disparity in access has been one of the greatest failures of international cooperation during the SARS-CoV-2 pandemic. Global COVID-19 vaccine inequity affects us all, with ongoing risk of new variants emerging until global herd immunity is strengthened. The current model of global vaccine distribution is based on financial competition for limited vaccine supplies, resulting in HICs getting first access to vaccines, with LICs being forced to rely on voluntary donations through schemes like COVAX. Pharmaceutical companies own the intellectual property (IP) rights for COVID-19 vaccines, allowing them to control manufacturing, distribution, and pricing. However, the pharmaceutical industry did not develop these vaccines alone, with billions of dollars of public funding being instrumental in their discovery and development. Solutions to enable global equitable access already exist. The next step in scale up of manufacture and distribution worldwide is equitable knowledge sharing and technology transfer. The World Health Organization centralized technology transfer hub would facilitate international cooperation. Investments made into developing this infrastructure benefit the COVID-19 response whilst promoting future pandemic preparedness. Whilst globally there is majority support for waivers of IP to facilitate this next step, key opponents blocking this move include the UK and other European countries which host large domestic pharmaceutical industries. A nationalistic approach is not effective during a global pandemic. International cooperation is essential to achieve global goals against COVID-19.

Current directions in digital interventions for mood and anxiety disorders

PURPOSE OF REVIEW

The purpose of this review is to provide an overview of the current scope of digital interventions for anxiety and mood disorders, with a focus on smartphone apps, for clinicians and mental healthcare providers.

RECENT FINDINGS

Of the 11 randomized controlled trials analyzed, 7 showed evidence that guided digital interventions (those supported by humans) were effective in improving anxiety and mood symptoms, and 3 showed evidence that unguided (those not supported by humans) interventions were effective. Psychoeducation was the most popular feature of both guided and unguided interventions. Attrition was highest (50%) in the unguided app-based intervention and lowest in the guided interventions. Many studies lacked active control groups and comparison was often made to a nondigital or waitlist control condition.

SUMMARY

Guided digital interventions continue to show promising results and can be used to enhance clinical care with minimal resources although more direct comparisons to existing treatments are necessary to understand their actual efficacy. Unguided self-help apps and chatbots remain promising, but more work is necessary to understand the real-world engagement and efficacy of these interventions.

Changes in Surgical Pathology Case Volume and Amendment Rates During the COVID-19 Pandemic

OBJECTIVES

Surgical pathology volume decreased during the peak of the coronavirus disease 2019 (COVID-19) pandemic. We looked at the 4 months with the greatest reduction in surgical pathology volume during the COVID-19 pandemic and compared them with those same months in 2019 to determine changes in specimen volume. We compared the amendment rates during those periods and types of amendments issued (identification [ID], report defect [RD], diagnostic information [DI]).

METHODS

All pathology reports between March to June 2019 and March to June 2020 were extracted from the pathology information system. All amendments issued were extracted over the same period and then subclassified by two pathologists.

RESULTS

There was a 52.1% reduction in surgical pathology volume between the 4-month periods in 2019 and 2020 (P = .04). The amendment rate was 0.9% in 2019 compared with 1.4% in 2020, representing a 65.5% increase in amendments overall. There was a 53.3% reduction in amendments issued for ID, a 3.8% reduction in RD, and a 23.2% increase in amendments issued for DI. The change in amendments was not statistically significant.

CONCLUSIONS

These findings suggest that a reduction in workload would not improve error rates. The circumstances of the pandemic highlight the many factors contributing to error rates in surgical pathology.

Work and worker health in the post-pandemic world: a public health perspective

The COVID-19 pandemic has highlighted the importance of work in shaping population health and wellbeing. This Viewpoint applies a multilevel systems framework to assist in understanding the diverse and complex interactions of forces affecting worker health and wellbeing, and how trending changes in employment and working conditions have been accelerated by the pandemic. Government agencies concerned with population health and wellbeing, and economic activity must expand their capacity to monitor, evaluate, and respond to these trends. In addition, integrated enterprise and workplace-based approaches that consider the interactions among these multidimensional drivers will build organisation and worker resilience to navigate the continual changes in work and worker safety, health, and wellbeing in a post-pandemic world.

Year of Zoom in a Year of Doom: Lessons Learned Delivering ERP Remotely During the COVID-19 Pandemic

In response to the COVID-19 pandemic and consequential shutdown measures, many mental health professionals started providing therapy to patients exclusively via telehealth. Our research center, which specializes in studying and treating obsessive-compulsive disorder (OCD), historically has provided in-person exposure and response prevention (ERP) to adults with OCD, but shifted to telehealth during the pandemic. Unlike in other modes of talk therapy, ERP's emphasis on therapist-supervised exposures presented unique opportunities and challenges to delivering treatment entirely via a virtual platform. This paper provides case examples to illustrate lessons we learned delivering ERP exclusively via telehealth in New York from March 2020 through June 2021 and offers recommendations for future study and practice. Though we observed a number of drawbacks to fully remote ERP, we also discovered advantages to delivering ERP this way, meriting additional research attention.

Mental health outcome and resilience among aiding Wuhan nurses: One year after the COVID-19 outbreak in China

OBJECTIVE

This study aimed to explore whether aiding Wuhan experience of nurses was associated with adverse mental health outcome one year after the COVID-19 outbreak in China.

METHODS

In this study, 100 nurses with and 100 nurses without aiding Wuhan experience a year ago were enrolled from February 1, 2021 to March 31, 2021 in Zhejiang Province, China. Depression, anxiety, insomnia, distress and psychological resilience of participants was assessed and analyzed.

RESULTS

A total of 100 participants from 112 aiding Wuhan nurses completed the survey, with a response rate of 89.3%. Another 100 nurses from the same hospitals without aiding Wuhan experience were enrolled as controls. In both groups, a considerable proportion of participants reported symptoms of depression (46.0% for the aiding Wuhan group vs. 49.0% for the controls, similarly hereinafter), anxiety (40.0% vs. 38.0%), and PTSD (61.0% vs. 56.0%). Aiding Wuhan nurses were more likely to suffer from insomnia (41.0% vs. 29.0%, P = 0.041). Multivariable logistic regression analysis showed that aiding Wuhan experience was not associated with depression (adjusted OR (AOR) 0.22; 95%CI, 0.05-1.01), anxiety (AOR 0.53; 95%CI, 0.12-2.43), insomnia (AOR 1.52; 95%CI, 0.76-3.02), PTSD (AOR 0.50; 95%CI, 0.19-1.34), or resilience (AOR 1.59; 95%CI, 0.78-3.26). Resilience was negatively correlated with depression, anxiety, insomnia, and PTSD.

CONCLUSIONS

This survey indicated that aiding Wuhan experience a year ago did not cause additional adverse mental health outcomes in nurses, expect for insomnia. The psychological status of nurses in general calls for more attention.

The relationship between sentiment score and COVID-19 cases in the United States

The coronavirus disease (COVID-19) continues to have devastating effects across the globe. No nation has been free from the uncertainty brought by this pandemic. The health, social and economic tolls associated with it are causing strong emotions and spreading fear in people of all ages, genders and races. Since the beginning of the COVID-19 pandemic, many have expressed their feelings and opinions related to a wide range of aspects of their lives via Twitter. In this study, we consider a framework for extracting sentiment scores and opinions from COVID-19–related tweets. We connect users’ sentiment with COVID-19 cases across the United States and investigate the effect of specific COVID-19 milestones on public sentiment. The results of this work may help with the development of pandemic-related legislation, serve as a guide for scientific work, as well as inform and educate the public on core issues related to the pandemic.

COVID-19 Pandemic and Stress: Coping with the New Normal

COVID-19 is the new face of pandemic. Since the discovery of COVID-19 in December 2019 in Wuhan, China, it has spread all over the world and the numbers are increasing day by day. Anyone can be susceptible to this infection but children, older adults, pregnant women, and people with comorbidity are more vulnerable. The spread of coronavirus resulted in closures of schools, businesses, and public spaces worldwide and forced many communities to enact stay at home orders, causing stress to all irrespective of their age, gender, or socioeconomic status. The sudden and unexpected changes caused by the outbreak of coronavirus are overwhelming for both adults and children, causing stress and evoking negative emotions like fear, anxiety, and depression, among different populations. The aim of the paper is to ascertain how stress during this pandemic inculcates various psychological health issues like depression anxiety, OCD, panic behavior, and so on. Further, the paper is an attempt to identify different general as well as population specific coping strategies to reduce the stress level among individuals and prevent various stress-induced psychological disorders with reference to different theories and research articles.

Photodegradation of three antidepressants in natural waters: Important roles of dissolved organic matter and nitrate

Antidepressants have become ubiquitous emerging organic pollutants. Therefore, it is essential to investigate photodegradation of the antidepressants in environment waters for their ecological risk assessment. However, photodegradation behavior of antidepressants varied from different structures and photodegradation mechanism was rarely known for most antidepressants. Herein, citalopram (CIT), paroxetine (PAR) and fluvoxamine (FLUVO) were employed to study the photodegradation behavior of antidepressants in lake water. Results show that direct photolysis of CIT decreased when pH increased from 6 to 9 while the pH effect was not obvious on direct photolysis of FLUVO and PAR. Photodegradation of CIT occurred from its triplet-state and can undergo self-photosensitization through reaction with the generated hydroxyl radical (·OH). In lake water, PAR and FLUVO are degraded mainly via direct photolysis, while CIT is transformed mainly via indirect photolysis. Dissolved organic matter (DOM) and NO₃^- was proved to be the main factors affecting antidepressants photodegradation in lake water. DOM and NO₃^- showed inhibition effect on photodegradation of FLUVO and PAR, while promoted CIT degradation. The promotion effect of CIT was mainly through reaction with ·OH and excited triplet-state of DOM while singlet oxygen played a minor role. Based on the photodegradation products identified by MS/MS, the photodegradation pathways were proposed for CIT and PAR, respectively. For FLUVO, one (Z)-isomer degradation product was also found. Understanding the photodegradation behavior of antidepressants is vital for providing data to do ecological risk assessment.

Online guided meditation training (Isha Kriya) improves self-reported symptoms of anxiety and depression within 2 weeks of practice-An observational study

INTRODUCTION

Anxiety and depression have increased dramatically 2-3-fold with the COVID-19 pandemic. There is an urgent need for safe, cost-effective, and scalable approaches to alleviate this parallel mental health pandemic. Meditation has previously been shown to reduce stress, anxiety, and depression symptoms. Furthermore, online delivery of mind-body interventions will be impactful in addressing disparities in access to mental healthcare. In this observational pilot study, we investigate the impact of a digitally delivered guided meditation followed by daily practice on symptoms of anxiety and depression.

METHODS

Initially, 57 male and 202 female subjects enrolled in this study. Participants attended a webinar where they learned the Isha Kriya meditation practice. They were subsequently requested to perform the intervention daily for 6 weeks. Subjects were given scales to assess anxiety and depression at baseline, 2, 4, and 6 weeks following the training. The changes in the self-reported anxiety and depression scores were examined by the linear mixed effect models.

RESULTS

Participants completed survey responses for the following time points: baseline (n = 82), week 2 (n = 58), week 4 (n = 37), and week 6 (n = 28). During the 6 weeks of the study over 68% of subjects were compliant with their daily practice. When comparing baseline with week 2, the mean anxiety scores decreased from 25.4 to 16.8 (p < 0.01, d = 1.31). Similarly, mean depression scores decreased from 15 to 8.81 (p < 0.01, d = 0.9). The reduced scores for both anxiety and depression were maintained at weeks 4 and 6.

CONCLUSION

This preliminary study assesses the effectiveness of online meditation training on self-reported symptoms of anxiety and depression. After 2 weeks of practice, those with baseline anxiety and depression showed significant improvement with a large effect size. The results from weeks 4 and 6 show sustained reduced anxiety and depression symptoms. These findings suggest that daily Isha Kriya practice could alleviate symptoms of these conditions. Future studies utilizing randomized control trials should be conducted to rigorously evaluate the benefits of this meditation practice on anxiety and depression.

TRIALS REGISTRATION

ClinicalTrials.gov, identifier: NCT05065476.