Understanding the school community's response to school closures during the H1N1 2009 influenza pandemic

Perinatal meaning-making and meaning-focused coping in the COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic caused unprecedented levels of stress amongst pregnant women and new mothers. The current qualitative study explored the ways in which perinatal women made meaning of their experiences during the COVID-19 pandemic.

METHODS

Data came from a parent study in which 54 perinatal (pregnant and postpartum) women in the United States completed semi-structured interviews from October 2021 to January 2022 describing their experiences during the COVID-19 pandemic. The data was interpreted using a hermeneutic, phenomenological approach to delve deeply into the concept of meaning-making.

RESULTS

Despite high levels of stress and challenging circumstances, participants reported engaging in meaning-making through finding connection, focusing on gratitude, and identifying openings for change. Unique forms of meaning-making amongst this population include a sense of connection to women throughout history, connection to their baby, and recognition of the need for systemic change for perinatal women.

CONCLUSIONS

Perinatal women coped with the stress of the COVID-19 pandemic by making meaning from their experiences. Future research should further explore the importance of these aspects of meaning-making to perinatal women and implement these findings to adapt prevention and treatment approaches to address perinatal stress, especially during times of crisis.

Social Distancing in the COVID-19 Pandemic: Associated Factors, Health Outcomes, and Implications

Social distancing has reemerged as a public health measure for containing the spread of COVID-19. This integrative review aims to analyze the historical use of social distancing, the current application during COVID-19, individual factors that affect social distancing practices, and consequential health outcomes. We analyzed relevant literature from searches conducted on Scopus, PubMed, and PsycINFO. We found that resources, culture, age, gender, and personality are associated with the degree to which people practice social distancing. Furthermore, social distancing changes our lifestyles and behavior and results in multifaceted health outcomes, including decreased physical activity and sunlight exposure, increased weight gain, and impaired sleep quality. On the positive side, social distancing has been linked to reduced crime rates and environmental damage, as well as better social and family ties. Future interventions may be utilized to increase adherence to social distancing practices and to mitigate the negative health effects of social distancing.

The 'welcomed lockdown' hypothesis? Mental wellbeing and mobility restrictions

The COVID-19 pandemic and its mobility restrictions have been an external shock, influencing mental wellbeing. However, does risk exposure to COVID-19 affect the mental wellbeing effect of lockdowns? This paper examines the 'welcomed lockdown' hypothesis, namely the extent to which there is a level of risk where mobility restrictions are not a hindrance to mental wellbeing. We exploit the differential timing of exposure the pandemic, and the different stringency of lockdown policies across European countries and we focus on the effects on two mental health conditions, namely anxiety and depression. We study whether differences in the individual symptoms of anxiety and depression are explained by the combination of pandemic mortality and stringency of lockdown. We draw on an event study approach, complemented with a Difference-in-Difference (DiD), and Regression Discontinuity Design (RDD). Our estimates suggest an average increase in depression (3.95%) and anxiety (10%) symptoms relative to the mean level on the day that lockdown took effect. However, such effects are wiped out when a country's exhibits high mortality ('pandemic category 5'). Hence, we conclude that in an environment of high mortality, lockdowns no longer give rise to a reduction in mental wellbeing consistent with the 'welcome lockdown' hypothesis.

Psychiatric and non-psychiatric population vulnerabilities in time of a crisis: the unsuspected aggression factor

OBJECTIVES

In March 2020, France faced a health crisis due to the COVID-19 outbreak that, like previous infectious disease crises, involved high psychological and emotional stress, a series of factors that influenced the ongoing mental health crisis.

METHODS

We recruited 384 respondents to complete an online questionnaire during the second month of isolation: 176 psychotherapy recipients (68 were currently attending psychiatric care) and 208 healthy controls. We measured demographic characteristics, impulsivity, aggression, hopelessness, suicidal risk, and the global level of anxiety and depression in order to estimate potential discrepancies in clinical measures across these populations.

RESULTS

Our results indicate that the group currently undergoing psychiatric care was prone to loneliness and social isolation. Regarding clinical and nonclinical population, there were differences in suicidal risk, depression, anxiety, and hopelessness but mainly in aggression. Regression analysis also demonstrated that aggression surprisingly influenced anxiety levels. Patients undergoing therapy compared with patients who were not displayed differences only in suicidal risk, anxiety, and hopelessness, with those undergoing therapy having higher scores. The outpatient group undergoing therapy had a significantly lower level of impulsivity. Moreover, the regression to predict anxiety and depression levels from correlated factors highlighted the potentially heightened role of aggression in predicting anxiety in the clinical group.

CONCLUSION

New research into stress reactions should assess other clinical signals, such as aggression, and examine preventive mental health interventions in times of crisis.

Mental health status and psychosocial issues during Nationwide COVID-19 quarantine in Iran in 2020: A cross-sectional study in Mazandaran Province

The coronavirus disease 2019 (COVID-19) pandemic is spreading rapidly, and its psychosocial impact remains a big challenge. In this respect, quarantine has been recommended, as a significant practice, to prevent the given condition. Therefore, the present study was to determine the prevalence rates of depression, anxiety, and stress and to reflect on the impact of COVID-19, as a traumatic stressor event, on individuals. This web-based survey was fulfilled via an online questionnaire, completed by respondents selected through the cluster sampling technique, from March 24 to April 10, 2020, living in Mazandaran Province, Northern Iran. Accordingly, the data regarding demographic characteristics, physical health status, quarantine compliance, contact with COVID-19, and additional information were collected. The psychosocial impact of the pandemic was then assessed by the Impact of Event Scale-Revised (IES-R), and the respondents' mental health status was evaluated using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Data analysis was further performed by linear regression. The study findings, from 1075 respondents, revealed that 22.5% of the cases had moderate-to-severe depression, 38.5% of the individuals were suffering from moderate-to-severe anxiety, and 47.2% of the participants were experiencing moderate-to-severe stress. In 14.5% of the respondents, the psychosocial impact of COVID-19 also varied from the possibility of post-traumatic stress disorder (PTSD) to immunosuppression (p < 0.01). With the high prevalence rates of depression, anxiety, and stress, mental health professionals are suggested to develop psychosocial interventions and support plans for the general population to reduce the impact of the COVID-19 pandemic on public mental health status.

More Positive Emotion, Less Stress Perception?

Purpose

Shanghai, a mega-city with a population of 25 million, was becoming the first city in mainland China to erupt in the Omicron pandemic. The pandemic and the quarantine measures of whole city static management brought out big challenges for the population. This study sought to examine the psychological impact of such quarantine measures.

Methods

A cross-sectional study was conducted in China between April 8 to April 14, 2022. The survey contained inventories of stress perception, emotion states, duration of quarantine, and demographic characteristics. A total of 1,051 participants in Shanghai who were quarantined at home were included by random sampling.

Results

We found moderate-to-mild perceived stress (3.248±1.936) and emotion states (3.453±2.094). Individuals with high negative emotions had high levels of perceived stress. Specifically, the population aged 30-49, female, with higher household income, staying with the elderly or children, were more likely to report high stress and negative emotion. Hierarchical regression and the further path analysis indicated that emotion states partially mediated the relationship between quarantined days at home and perceived stress.

Conclusion

There was a moderate-to-mild level of perceived stress and emotion when quarantined at home for an average of 20 days in Shanghai. The present findings implicated more positive emotion then less stress perception at the same duration of quarantine. It was suggested to consider the measures taken to construct positive emotions for the public to overcome negativity and bring out a virtuous circle to thrive, if the quarantine has to be continued for preventing the pandemic.

Partner relationship quality, social support and maternal stress during pregnancy and the first COVID-19 lockdown

Introduction: Pregnancy has been associated with diminished maternal mental health and a deterioration in partner relationship quality. The recent COVID-19 quarantine measures have created additional stressors for pregnant women due to isolation and a surge in partner conflict.Objective: The purpose of this study was to assess how partner relationship conflict and social support may mediate mental health outcomes during the COVID-19 lockdown.Methods: A cross-sectional study with a sample of 152 pregnant women using psychological measures, (i.e. Prenatal Distress Questionnaire, Symptom Checklist-90-R, Duke-UNC-11 Functional Social Support Questionnaire, Perceived Stress Scale). Demographic characteristics, obstetrics history, and partner relationship conflict were assessed using questionnaires.Results: While there were few reports of physical violence in this sample, between 18% and 59% of women reported partner relationship conflict on the psychological subscale (e.g. afraid of one's partner or screamed at by one's partner). Further, the psychological subscale was significantly associated with symptoms of psychopathology. There was a significant negative association between social support and pregnancy-specific stress (p = .005), and perceived stress (p= .038).Conclusions: These findings suggest that partner relationship conflict and social support may act as important buffers for prenatal mental health in childbearing women during vulnerable situations, such as the COVID-19 pandemic.

Psychometric Analysis of the Quarantine Coping Strategies Scale (Q-COPE) in the Spanish Language

The possibility of facing an epidemic or pandemic resulting in mandatory isolation or quarantine has become a relevant construct for comparing and evaluating coping strategies under such conditions. The objective of this research was to develop and analyze the psychometric properties of a scale to assess quarantine coping strategies (Q-COPE). This was an instrumental study and 1110 Peruvian adults (M = 26.9 years; SD = 9.77) participated in the context of social isolation. For the construction of the scale, qualitative and quantitative procedures were followed. The internal structure was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The content analysis by expert judges supports the representativeness of the items related to the construct. EFA and CFA allowed the establishment of five factors: Emotional regulation, Information, Accommodation, Social support, and Altruism. The first-order model presents adequate goodness-of-fit indices: χ² = 489.048, df = 220, χ²/df = 2.223, SRMR = 0.025, CFI = 0.969, TLI = 0.965, RMSEA = 0.047. Likewise, the second order model presented similar values: χ² = 499.674, df = 225, χ²/df = 2.221, SRMR = 0.026, CFI = 0.969, TLI = 0.965, RMSEA = 0.047. The 23-item version was consistent with the proposed theory, obtained adequate fit indices and acceptable factor loadings (>0.70), and presented good internal consistency indexes evaluated by Cronbach's α, ordinal α, omega (ω), and H coefficient. It is concluded that the Q-COPE scale presents good psychometric properties that justify its use in an adult population and allows the assessment of the coping strategies that people use in the face of a quarantine situation.

Stress Levels, Attitude toward Vaccination and Personal Protective Equipment of Students at Wroclaw Medical University during the COVID-19 Pandemic

The study was conducted in March of 2021 on the students at Wroclaw Medical University from different years and faculties. Students who had mandatory physical education classes in the current year and met other eligibility criteria were enrolled. The aim of the study was to examine the impact of the pandemic on the lives of medical students. Ultimately, 660 responses to the study were included. To determine the level of stress, KPS questionnaires were used, which distinguish five types of stress. Moreover, the attitudes towards and status of vaccination were examined using PPE and declarative fettle. The findings pointed to a significantly higher level of stress in males compared to females (overall stress, 5.35 and 4.66, p = 0.0002), and increased external stress in some faculties (5.71 in dentistry, compared to overall 4.83, p = 0.009). Furthermore, medical students in their 2nd year were more stressed compared to those in their 1st year (overall stress 4.95 and 4.15, p < 0.0001). By knowing where the stress is highest, we can fight it more effectively and efficiently, by directing resources right where they are needed the most. A study about stress levels during the pandemic compared to physical activity should be developed.

The corona blues according to daily life changes by COVID-19: A partial least squares regression model

This study identifies determinants of the variation in depression resulting from COVID-19, specifies in detail the changes to daily life, and then compares the determinants' magnitude. The determinants were combined into three groups: first, the unpredictability of the disease and side effects by its response measures (specifically, restrictions on the freedom of movement and strain on social relationships); second, (mis)information through social media, public authorities, and mass media; and third, income reductions and other sociodemographic factors. Daily life changes were divided into four categories: travel/mobility, time at home (alone and with family), domestic activities (remote work, online shopping, food deliveries, reading, and online networking), and conflicts (with family and neighbors). We measured the total 29 predictors using data from the 2020 Seoul Survey, which is based on face-to-face interviews with a probability sample of adult residents. We made our estimations using partial least squares regression, which can analyze all original variables regardless of collinearity. The regression model found that major stressors include declines in out-of-home offline networking and the rise of domestic activities-and subsequent conflicts with family-restrictions on mobility (specifically, those of leisure travel), and income reductions. In contrast, changes to working and shopping (to remote work and online shopping) rather than leisure increased uses of private transportation modes. Moreover, we found influences of all forms of communications and media to be insignificant. We shall also provide a discussion on policy and academic implications of the findings.

Exploring the relationships between rule-governed behavior and adherence to guidelines aiming to reduce the spread of COVID-19

Research demonstrates that socially mediated consequences impact adherence to health mandates during pandemics. However, no published research has examined whether adherence varies based on the extent to which an individual relies on arbitrary social approval (i.e., displays generalized pliance). The present study explored the relationships between adherence to COVID-19 public health measures, two types of rule-following (pliance and tracking), and perceived peer behavior in a sample of adults (n = 288). Findings revealed that adherence was negatively correlated with generalized pliance and tracking was unrelated to adherence. Pliance did not moderate the relationship between peer adherence and individual adherence. Findings are discussed with reference to the need to develop easily adaptable and context sensitive measures of types of rule-following, in addition to a measure of social tracking.

Impact of COVID-19 public health restrictions on hospital admissions for young infants in Victoria, Australia

AIM

Strict public health measures during the COVID-19 pandemic led to less support for infants and their parents. We aimed to characterise the frequency and nature of infant admissions to the Royal Children's Hospital (RCH), Melbourne in 2020, compared to the previous year.

METHODS

A retrospective review of medical records identified infants ≤3 months admitted to the general medicine unit, RCH from March to September in 2019 and 2020. Diagnoses potentially related to the impact of public health measures and reduced family and community supports were identified and compared to all infant diagnoses across both years. Clinical characteristics and need for referral for additional supports or mental health services were also ascertained.

RESULTS

There were fewer admissions for infants ≤3 months in 2020 (n = 411) compared to 2019 (n = 678), with a threefold increase in admissions with a primary or secondary diagnosis of feeding difficulties, growth disturbance, infant irritability or maternal mental health concerns (191/411; 46% vs. 97/678; 14%). There were more infants of first-time parents (112/191; 59% vs. 44/97; 45%) and a reduction in the number of admissions due to infection (145/411; 35%; vs. 467/678; 69%).

CONCLUSION

During the COVID-19 pandemic, there was a threefold increase in admissions for infants ≤3 months due to poor growth, feeding difficulties, irritability and maternal mental health concerns in 2020 compared to 2019. These findings may inform future pandemic planning and policy development to ensure maintenance of community supports such as maternal child health nurse (MCHN) service delivery for young infants.

Parenting and Children's Behavior During the COVID 19 Pandemic: Mother's Perspective

Since the onset of the COVID-19 pandemic, many parents have felt anxious, overwhelmed, and stressed out due to the changes in education and family and working routines. This work aimed to (a) describe three dimensions of perceived parenting (positive parenting, parenting stress, and parental school support) in the COVID-19 pandemic context, (b) describe possible changes perceived by mothers in their children's behavior during the social isolation phase, (c) analyze if behavioral changes vary according to the dimension of perceived parenting, and (d) analyze whether the characteristics of perceived parenting dimensions vary with mother's age, number of children and number of work hours. The purposive sample consisted of 646 mothers of school-aged children in Argentina. Questionnaires on sociodemographic and work-related data, and on children's behavior were administered, as well as an instrument (Vargas Rubilar et al., 2021) that assessed the three parenting dimensions (positive parenting, parenting stress, and parent-school support). The sociodemographic and work-related variables of the study were described using descriptive statistics: measures of central tendency, frequencies, and percentages. The changes perceived in children's behavior according to the reports given by the mothers regarding positive parenting, parenting stress, and school support were compared using the Mann Whitney's U test, respecting the qualitative nature of the evaluated indicators. A factorial MANOVA was conducted to analyze the effect of mother's age, ä number of children, and the number of work hours on parenting perceived by mothers. Parenting dimensions influenced the perceived children's behavior. Mothers with higher positive parenting perceived more changes in their children's behavior. In addition, those mothers who were more stressed out perceived more problems in almost all the measured behaviors than less stressed mothers. The mothers who reported to have provided more school support to their children perceived that they adapted better to online classes. Finally, mothers' age and the number of children I parenting, particularly on parenting stress and school support, whereas work hours did not. A number of children affected stress and school support, and age only affected parenting stress. The only significant interaction regarding parenting was observed between the number of children and the number of work hours, which specifically affected parenting stress. Although social isolation due to COVID-19 affected children's behavior, according to mothers, this might be partially linked to the number of children, mothers' age, and the mothers' parenting style. These initial findings may allow the identification of some protective factors and some risk factors of parenting in the Argentine context of a pandemic, and the design of preventive psychoeducational interventions to optimize the psychological wellbeing of families.

Depression before and during-COVID-19 by Gender in the Korean Population

This study explored the association between Coronavirus disease (COVID-19) and depression by comparing Patient Health Questionnaire-9 (PHQ-9) results pre-pandemic (2019) and after the start of the pandemic (2020). Data of 444,051 participants (200,206 male (45.1%); 243,845 female (54.9%)) were obtained from the Korean Community Health Survey conducted from 2019 to 2020. The independent variable of interest in this study was the year, divided into binary categories, 2019 and 2020. The dependent variable was depression, measured by the PHQ-9 scale. This dependent variable was also binary, dividing those who are considered depressed or not by a cut-off score of 10. A logistic regression model was employed to examine the association. Our results reveal that compared to participants in 2019, patients from the study sample of 2020 were marginally more likely to be depressed, especially female patients (male OR: 1.092, 95% CI [0.998 to 1.195], female OR: 1.066, 95% CI [1.002 to 1.134]). Moreover, using the participants from the year 2019 as a reference group, those who appeared anxious in response to the COVID-19-related questions in the survey showed more tendency to have a PHQ-9 score of 10 or more. Compared to participants from the 2019 group, those from 2020 more likely to be depressed were those with no-one to contact in case of emergency due to COVID-19 (male OR: 1.45, 95% CI [1.26 to 1.66], female OR: 1.46, 95% CI [1.33 to 1.60]), and individuals with concerns regarding economic loss (male OR: 1.18, 95% CI [1.07 to 1.30], female OR: 1.11, 95% CI [1.04 to 1.18]) and infection of a vulnerable family member at home due to COVID-19 (male OR: 1.16, 95% CI [1.05 to 1.28], female OR: 1.09, 95% CI [ 1.02 to 1.16]).

Adverse Effects from the Imposition of Social Restrictions in Greece: the Indirect Effect of COVID-19-Related Fear on Alcohol Consumption Through Loneliness

Quarantine and social distancing are crucial factors in blocking the consequences of COVID-19 but also can lead to higher levels of loneliness and social isolation. Therefore, any advantages of mandatory quarantine have to be weighed against any negative impact on physical and mental well-being. This study aimed to examine the relationship between COVID-19-related fear and alcohol use during the lockdown period and loneliness as a mediating factor increasing the impact of COVID-19-related fear on alcohol use. A sample of 279 young adults completed self-reported questionnaires on COVID-19-related fear, loneliness, and substance use. This exploratory cross-sectional research was administered from 11 until December 18, 2020. The results showed that loneliness during lockdown mode may exacerbate the emotional burden caused by COVID-19-related fear leading to increased alcohol consumption as a coping mechanism against unsatisfactory living conditions. This study’s results reflect the need for societal groups, as well as health care services to remain specifically considerate to the needs of individuals who report high levels of COVID-19-related fear and loneliness.

The Use of Big Data via 5G to Alleviate Symptoms of Acute Stress Disorder Caused by Quarantine Measures

This article investigates the role of Big Data in situations of psychological stress such as during the recent pandemic caused by the COVID-19 health crisis. Quarantine measures, which are necessary to mitigate pandemic risk, are causing severe stress symptoms to the human body including mental health. We highlight the most common impact factors and the uncertainty connected with COVID-19, quarantine measures, and the role of Big Data, namely, how Big Data can help alleviate or mitigate these effects by comparing the status quo of current technology capabilities with the potential effects of an increase of digitalization on mental health. We find that, while Big Data helps in the pre-assessment of potentially endangered persons, it also proves to be an efficient tool in alleviating the negative psychological effects of quarantine. We find evidence of the positive effects of Big Data on human health conditions by assessing the effect of internet use on mental health in 173 countries. We found positive effects in 110 countries with 90 significant results. However, increased use of digital media and exclusive exposure to digital connectivity causes negative long-term effects such as a decline in social empathy, which creates a form of psychological isolation, causing symptoms of acute stress disorder.

Curse of La Corona: unravelling the scientific and psychological conundrums of the 21st century pandemic

Microbes possess a tremendous potential to interact with their surroundings and have continued to shape the future of all life forms existing on earth. Of all the groups of microbes, viruses are the most nefarious creatures which cannot be solely classified as living or non-living but still pose the greatest threats to the biosphere. Viruses are minuscule, diverse and are probably the only entities that exhibit non-mutualistic association with other lifeforms while retaining their ability to infect and hijack any of the existing living being on the planet. The latest global devastation, caused by novel SARS-CoV-2, is unparalleled in the last century. This review encompasses the mysterious origin of this virus by tracking its lineage, which may help to decode the conundrum of SARS-CoV-2 and shed more light on its epidemiology. The implications and the challenge posed by this virus to the scientific community to the medical community and the economy at large are reflected. Also discussed is the paradigm shift brought upon by the COVID-19 pandemic on the human psyche and their behaviour.

COVID-19 pandemic: Impacts on mothers' and infants' mental health during pregnancy and shortly thereafter

The COVID-19 pandemic brought about a global crisis, with profound implications on public mental health. The current review focuses on the impact of the pandemic on the mental health of mothers and their infants during pregnancy and shortly after delivery. Literature shows that in similar disaster situations, mothers' stress reaction and mental health have a critical impact on infant development. Research data on perinatal mental health during the current COVID-19 pandemic is reviewed in conjunction with studies on the relationship between maternal stress, infant development, and psychopathology. Recommendations for perinatal mental health enhancement are discussed and topics for future research suggested.

Psychological Impact of the COVID-19 Pandemic on Pregnant Women: A Scoping Review

During the gestation period, pregnant women experience physical and psychological changes, which represent vulnerability factors that can boost the development of mental health conditions. The COVID-19 pandemic is producing new changes in the routines of the whole society, especially on lifestyle habits. The psychological impact associated with the COVID-19 pandemic and pregnant women remains unclear. A scoping review regarding the psychological impact of the COVID-19 pandemic on pregnant women was conducted. Searchers were conducted using the PubMed, Web of Science and CINAHL databases. Articles in Spanish, English and French were included. The search was conducted between November 2020 and September 2021. We identified 31 studies that evaluated 30,049 expectant mothers during the COVID-19 pandemic. Pregnant women showed high levels of anxiety and depression symptomatology. Fear of contagion and concerns regarding the health of the fetus were identified as the main variables related to psychological distress. An increase of the levels of depression, anxiety and stress during the COVID-19 pandemic amongst pregnant women has been observed. Moreover, an increased vulnerability of the fetus due to placental metabolic alterations is discussed. This review suggests that the COVID-19 pandemic is associated with a negative psychological impact on pregnant women. Thus, high levels of anxiety and depression symptoms suggest the need for a systematic approach.

Avoiding Crowded Places During COVID-19: Common Sense or a Complex Strategic Decision?

Introduction: Following a period of strict lockdowns during the COVID-19 pandemic, most countries introduced policies in which citizens were expected to avoid crowded places using common sense, as advised by the WHO. We argue that the ambiguity in the recommendation to “avoid crowded places” implicitly forces individuals to make a complex strategic decision.

Methods: Using a Dutch representative sample of 1,048 participants [42% male, mean age=43.78years (SD=12.53), we examine the effect of context on the decision to visit a hypothetical recreational hotspot under the policy recommendation to “avoid crowded places.” We randomize four levels of context on the crowdedness “on the streets” (no context, low, medium, and high context). Subsequently, participants are asked to estimate the percentage of others going out in the same situation. Finally, we assess the impact of a selection of personal characteristics on the likelihood of visiting a crowded place.

Results: Respondents are proportionally more likely to go in a low context and high context, compared to no context (diff=0.121, p<0.000, and diff=0.034, p<0.05, respectively) and middle context (diff=0.125, p<0.000, and diff=0.037, p<0.05, respectively). Low context information also decreases the expectation of others going out (−2.63%, z=4.68, p<0.000). High context information increases the expected percentage of others going out (significant only for medium to high context; 2.94%, z=7.34, p<0.001). Furthermore, we show that education, age, and health and risk attitude are all predictive of the likelihood to visit a crowded place, notwithstanding the context.

Discussion: Although there is a strong inclination to avoid crowded places during the COVID-19 pandemic (81%), we find two context-driven exceptions: when people expect to avoid crowded spots (in the “low” context, i.e., strategical decision-making) and when people expect others to go (social influence). The freedom provided by ambiguous public policy is implicitly asking more from the population than it initially seems. “Use your common sense” is often the accompanied advice, but our results show that more and better information concerning the context is essential to enable us to make an optimal decision for ourselves, and for society.

Perceived Changes in Family Life During COVID-19: The Role of Family Size

OBJECTIVE

The current study was aimed at exploring Italian parents' perceived negative and positive changes in family life during the COVID-19 pandemic, taking into account the role of the stage of the family life and family size.

BACKGROUND

During the emergency of the COVID-19 pandemic, millions of families drastically changed their daily life and routines. Little evidence exists on how family characteristics, such as family size or presence of children, are related to families' experience of family change.

METHOD

A large sample of 1,407 Italian parents (70.1% mothers) filled in an anonymous online survey during the third week of the lockdown period (between March 30 and April 7, 2020).

RESULTS

Results showed that parents reported perceiving more positive changes than negative ones, especially in terms of feeling more emotionally close to their children and spending more fun time with them. Interestingly, parents with two or more children reported more positive changes in family life compared with parents who had one child, showing a greater relational regenerative capacity in the face of COVID-19 lockdown.

CONCLUSION AND IMPLICATIONS

Investing in family relationships, especially for larger families, is an effective coping strategy to deal with traumatic situations and promote positive family changes in stressful situations.

Social distancing measures: barriers to their implementation and how they can be overcome - a systematic review

BACKGROUND

Despite their central role in the global response to the COVID-19 pandemic and previous infectious disease outbreaks, factors influencing the acceptability and implementation of social distancing measures are poorly understood. This systematic review aims to identify such factors drawing on qualitative literature.

METHODS

A systematic search was carried out in eleven databases. Papers were included in the review if they reported on qualitative studies of factors influencing the implementation of social distancing measures in potentially epidemic infectious diseases. An adapted meta-ethnographical approach was used for synthesis. Review findings were assessed for strength and reliability using GRADE-CERQual.

RESULTS

Twenty-nine papers were included from the systematic search that yielded 5620 results, and supplementary methods. The review identifies two broad categories of barriers to social distancing measures: individual- or community-level psychosocial phenomena, and shortcomings in governmental action or communication. Based on this, 25 themes are identified that can be addressed to improve the implementation of social distancing.

CONCLUSION

Among other findings, the review identifies the need for good communication as well as the need for authorities to provide comprehensive support as two key opportunities to increase acceptability and adherence. Further important enablers of adherence are adequate preparedness and appropriate legislation, the presence of community involvement, solidarity within communities and trust in governments and authorities.

Quarantine: Psychological aspects

Quarantine is an age old methods of preventing the spread of infection by restricting the movement of persons or goods. It has again come to global attention due to its widespread implementation during the COVID-19 pandemic. While the public health utility of quarantine is well established, it is associated with few psychological effects which are neither well known nor recognized. In this communication, the psychological side-effects of quarantine and their prevention are briefly discussed.

Exploring the relationship between the COVID-19 pandemic and changes in travel behaviour: A qualitative study

During the COVID-19 crisis, a series of measures were taken to restrict travel and social activities outside the home in order to curb the pandemic and ameliorate its negative effects. These unprecedented measures have had a profound impact on the number and purposes of trips and modes of travel. In China, although the pandemic is now generally under control and transport availability has returned to nearly normal, the extent of the changes in travel behaviour wrought during and after the pandemic still remains unclear. Therefore, the aim of this paper is to investigate the differences in individual travel behaviours during and after the COVID-19 pandemic, using Huzhou as an example. Semi-structured interviews were used to examine the influence of COVID-19 on the travel behaviour and perceptions of different groups. The results indicate that, initially, travel demand was greatly reduced. Second, decreased travel reduced participation in activities, which can have adverse effects on people's health as well as their subjective well-being. Third, the degree and duration of such impacts varied from person to person. Students, lower income cohorts, groups living in small communities with insufficient green spaces, and those working in tourism, catering, informal businesses and transport-related sectors were more vulnerable than others. Policymakers, urban and transport planners should therefore pay attention to the social inequities that arise from unequal access to transport and heterogeneity between individuals. Additionally, public transport systems require further development to promote social cohesion.

Roles of social media and counselling support in reducing anxiety among Malaysian during Covid-19 pandemic

Covid-19 pandemic has created crises among some Malaysians. The crises have both opportunity and threat impacts. Without proper intervention, some people will develop stress, anxiety, and depression. This study aims to explore the emotional anxiety that exists in the society due to Covid-19 pandemic and the roles of social media and counselling support in reducing anxiety among Malaysians. This quantitative research involved online survey throughout the country. The online survey is administered during the First Phase and the Second Phase of Movement Control Order (MCO). The survey contains 13 items which cover three domain: i) anxiety, ii) roles of social media, and iii) roles of counselling support in reducing anxiety among members of the society. There were 8375 respondents from various age groups, locations, as well as economic and educational statuses involved in the study. Data were analysed using descriptive and inferential analysis. Majority of 7233 (86.6%) respondents felt anxious due to Covid-19 pandemic. A total of 7871 respondents (94%) followed the latest updates on Covid-19 to reduce their anxiety. They used social media such as Facebook, Instagram and Twitter to gather information and follow the updates through television and press conference. A total of 5251 respondents (62.7%) were aware of the counselling support provided during the MCO, and 4603 respondents (55%) felt comfortable to have counselling support by phone. The findings will contribute to knowledge on the society's emotional anxiety in facing Covid-19. It reflects the actual situation happened in Malaysia during Covid-19 and MCO.

Using social media for health information on COVID-19 risk perceptions and mental health: An online survey of 4,580 pregnant women in China

BACKGROUND

Background: Social media has become an important source of health information during the COVID-19 period. Very little is known about the potential mental impact of social media use on pregnant women.

OBJECTIVE

Objective: The present study examined the association between using social media for health information, risk perception for COVID-19, worry due to COVID-19 and depression among pregnant women in China.

METHODS

Methods: A total of 4,580 pregnant women were recruited from various provinces of China and completed an online survey in March 2020.

RESULTS

Results: More than one-third (39.2%) reported always using social media for health information. Results from structural equation modeling showed that frequency of social media use for health information was positively associated with perceived susceptibility (β = .05, p <.001) and perceived severity of COVID-19 (β = .12, p < .001), which in turn, were positively associated with worry due to COVID-19 (β = .19 and .72, p <.001). Perceived susceptibility (β = .09, p <.001), perceived severity (β = .08, p <.001), and worry due to COVID-19 (β = .15. p <.001) all had a positive association with depression. Results from bootstrapping analysis showed that the indirect effects of frequency of social media use for health information on worry due to COVID-19 and depression were both significant.

CONCLUSIONS

Conclusions: The present study provided empirical evidence on how social media use for health information might have a negative impact on pregnant women's mental health. Interventions are needed to equip them with the skills to use social media properly.

CLINICALTRIAL

Implementation of preventive measures to prevent COVID-19: a national study of English primary schools in summer 2020

We examined the feasibility of implementing preventive measures to prevent SARS-CoV-2 transmission across 105 English primary schools in summer 2020 via a survey and interviews with headteachers. High rates of implementation of most recommended measures were noted with the exception of requiring 2 m distance for students, fitting hand sanitizers in classrooms and introducing one-way systems in school corridors. Measures such as regular handwashing and stopping assemblies were considered easy to implement. Majorly challenging measures included distancing between individuals (for students: 51%, N = 99; for staff: 34%; N = 98; for parents: 26%, N = 100), spacing out desks (34%, N = 99), keeping same staff assigned to each student group (33%, N = 97) and staggering break times (25%, N = 99). Rapid implementation was facilitated by staff commitment and communication among stakeholders, but hampered by limitations with guidance received, physical environments, resources, parental adherence and balancing preventive measures with learning. Difficulties with distancing for younger children suggest that smaller bubbles with fewer distancing requirements within these may be a policy option. Schools require further financial, human resource and other support for effective implementation of preventive measures.

Background and concurrent factors predicting non-adherence to public health preventive measures during the chronic phase of the COVID-19 pandemic

BACKGROUND

To determine factors that predict non-adherence to preventive measures for COVID-19 during the chronic phase of the pandemic.

METHODS

A cross-sectional, general population survey was conducted in Israel. Sociodemographic, health-related, behavioral and COVID-19-related characteristics were collected.

RESULTS

Among 2055 participants, non-adherence was associated with male gender, young age, bachelorhood, being employed, lower decrease in income, low physical activity, psychological distress, ADHD symptoms, past risk-taking and anti-social behavior, low pro-sociality, perceived social norms favoring non-adherence, low perceived risk of COVID-19, low perceived efficacy of the preventive measures, and high perceived costs of adherence to the preventive measures.

CONCLUSION

There appears to be a need for setting out and communicating preventive measures to specifically targeted at-risk populations.

Exploring the Psychological Effects of COVID-19 Home Confinement in China: A Psycho-Linguistic Analysis on Weibo Data Pool

BACKGROUNDS

With the rapid spread of COVID-19, strict home confinement has been implemented in most parts of Chinese regions. Millions of people were not allowed to leave their homes except for special reasons. Home confinement plays an essential role in curbing pandemic and promoting preventive behaviors, but it may affect individuals' mental health as well.

OBJECTS

The objective of this study was to explore the psychological impacts of home confinement.

MATERIALS AND METHODS

We collected more than 150,360 Weibo messages from 5,370 Chinese active users, and then extracted psycho-linguistic features from these messages. Psycho-linguistic analysis was carried out using the 2 (confinement vs. non-confinement) × 2 (before vs. after confinement) repeated measure analysis of variance (RM ANOVA).

RESULTS

The results showed that the frequency of positive emotion words was remarkably decreased during home confinement [F (1,5368) = 7.926, p = 0.005, η2 = 0.001]. In high-endemic subgroup, home confinement also reduced the frequency of exclusion words [F (1,3445) = 4.518, p = 0.034, η2 = 0.001] and inhibition words [F (1,3445) = 10.154, p = 0.001, η2 = 0.003].

CONCLUSION

Home confinement caused a decline in the use of positive emotion words. This indicates that home confinement can increase the frequency of negative emotions. The changes of exclusion words and inhibition words in high-endemic areas may be related to the high epidemic threat and the urgent need for social distancing in these areas.

The experience of individuals placed in quarantine: A systematic review, meta-summary, and meta-synthesis

Objective

To summarize the experience of individuals placed in quarantine during an outbreak.

Design

A meta‐summary and a meta‐synthesis based upon a systematic review of qualitative studies.

Sample

The Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Scopus databases were all searched up to April 2020.

Measurements

The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines were followed; then, the methodological quality of the studies included was assessed with the Critical Appraisal Screening Programme tool for qualitative studies.

Results

Five studies have been included documenting the experience of 125 adult individuals. A total of 16 codes emerged: in the meta‐summary, the most and least frequent codes were “Thinking about quarantine” (80%) and “Emotional roller coaster,” “Being alert for any symptom,” “Trusting or not?,” “Knowing who brought the infection,” and “Living in a surreal world” (20%). The codes which emerged were categorized into three main themes which summarized the whole experience of being placed in quarantine: (a) “Being swamped with a thousand emotions”; (b) “Being restrained”; and (c) “Needing to be considered.”

Conclusions

The experience of quarantine for people is a long journey which can feel chaotic due to uncertainty about the consequences on health, work, and the future. The findings of this study can help nurses in caring for quarantined individuals by enabling them to understand people's need for educational and emotional support. Ensuring the supply of consistent information is also important to increase people's compliance.

Community engagement for outbreak preparedness and response in high-income settings: A systematic review

BACKGROUND

This review aims to (i) identify and critique existing methods of community engagement for outbreak preparedness and response in high-income settings, and (ii) understand community members' experiences of community engagement, and their views and concerns towards pandemic planning/response.

METHODS

Following the PRISMA guidelines, a systematic review was conducted by searching Medline, Embase, PubMed, Global Health, CINAHL Plus and Scopus for publications from 2004 to June 2019. Potential literature was screened using explicit inclusion and exclusion criteria. Included studies were appraised using the Critical Appraisal Skills Programme Qualitative Research checklist. Those using deliberative approaches were appraised using additional criteria for judging deliberation quality. Thematic synthesis was then conducted.

RESULTS

Primary studies employed participatory research approaches, deliberative forums, interviews/focus groups to engage community members on pandemic planning/response with varying degrees of involvement and methodological rigour. This review indicates such endeavours must take into account instrumental and relational considerations: socioeconomic pressures; agency and capacity; diversity and divergent views; educate, communicate and engage; trust and transparency.

CONCLUSION

Community engagement for pandemic planning/response requires clear methods, processes and who 'community' constitutes. Instrumental and relational considerations must be addressed concurrently in pandemic planning/response to enhance preparedness for public health emergencies.

Quality of Life and Its Predictive Factors Among Healthcare Workers After the End of a Movement Lockdown: The Salient Roles of COVID-19 Stressors, Psychological Experience, and Social Support

Although healthcare workers play a crucial role in helping curb the hazardous health impact of coronavirus disease 2019 (COVID-19), their lives and major functioning have been greatly affected by the pandemic. This study examined the effects of the COVID-19 pandemic on the quality of life (QoL) of Malaysian healthcare workers and its predictive factors. An online sample of 389 university-based healthcare workers completed questionnaires on demographics, clinical features, COVID-19-related stressors, psychological experiences, and perceived social support after the movement lockdown was lifted. All domains of QoL were within the norms of the general population except for social relationship QoL, which was lower than the norm. Multiple linear regression analysis indicated that COVID-19-related stressors (e.g., stress due to annual leave being frozen, loss of daily routine, and frequent exposure to COVID-19 patients) and psychological sequelae (e.g., greater severity of depression, anxiety, and stress) predicted lower QoL. Conversely, greater perceived social support from friends and significant others predicted higher QoL. Clinical and demographic characteristics predicted QoL to a lesser extent: A history of pre-existing medical illness was associated only with lower physical health QoL, whereas older age and being single, divorced, or widowed were only predictive of higher environmental QoL. Efforts to enhance QoL among healthcare workers in response to the pandemic should focus on mitigating COVID-19-related stressors and psychological sequelae and facilitating social support.

The Impact of the COVID-19 Pandemic on Vulnerable People Suffering from Depression: Two Studies on Adults in France

This study investigated the difficulties experienced by people suffering from depression in coping with the stressful context of the COVID-19 pandemic and the lockdown. Two large samples of the French population were classified on the basis of their depressive symptoms and completed an online questionnaire on their emotions and their behaviors during the lockdown. Results showed that, compared to participants with no or mild mental health-related symptoms, participants with moderate to severe depressive symptoms suffered from greater psychological effects of the pandemic and the lockdown (fear, anxiety, sadness, sleep quality, loss of daily routine). However, health risk behaviors (smoking, drinking, non-compliance with lockdown and barrier gestures) and perceived vulnerability did not differ between the participant groups, although more severely depressed participants tended to be less respectful of health guidelines. In addition, the most heightened effects on the depressed participants were boredom and the feeling of social isolation, which was not compensated by the search for social affiliation. Supporting people with depression should be a public health priority because they suffer psychologically more than others from the pandemic and the lockdown.

Parenting activities and the transition to home-based education during the COVID-19 pandemic

This study reports on parent-child dynamics during initial COVID-19 related school closures, based on cross-sectional analyses of a survey that utilized a convenience sampling approach. Data were collected in April 2020, approximately five weeks after the World Health Organization declared that the Coronavirus was a pandemic. Participants (N = 405) were adults recruited throughout the U.S. This study examines data from parents (69% mothers and 31% fathers) with at least one child 0-12 years of age. The majority were White (71%) and 41% had at least a bachelor's degree. The majority of parents (78%) were educating their child at home due to COVID-19. Most (77.1%) reported use of online tools for at-home education, including educational apps, social media, and school-provided electronic resources. More than one-third (34.7%) of parents said their child's behavior had changed since the pandemic, including being sad, depressed, and lonely. Most parents were spending more time involved in daily caregiving of their children since COVID-19. Two out of every five parents met the PHQ-8 criteria for major depression or severe major depression (40.0%) and the GAD-7 criteria for moderate or severe anxiety (39.9%). Multivariate analyses indicated that, compared to non-depressed parents, parents who met criteria for probable major or severe depression (B = -0.16, 95% CI = [-0.29, -0.02], p = .021) and parenting stress (B = -0.37, 95% CI = [-0.47, -0.27], p < .001) were negatively associated with parents' perceived preparation to educate at home. Compared to parents with minimal or mild anxiety, parents with moderate or severe anxiety reported higher child anxiety scores (B = 0.17, 95% CI = [0.06, 0.28], p = .002). Parenting stress was also positively associated with higher child anxiety scores (B = 0.40, 95% CI = [0.32, 0.48], p < .001). Content analyses of open-ended questions indicated that school closures were a significant disruption, followed by lack of physical activity, and social isolation. Overall, study results suggested that parents' mental health may be an important factor linked to at-home education and child wellbeing during the pandemic.

The Effects of the Fear of Missing Out on People's Social Networking Sites Use During the COVID-19 Pandemic: The Mediating Role of Online Relational Closeness and Individuals' Online Communication Attitude

Forced isolation induced by COVID-19 pandemic dramatically impacted individuals' well-being, reducing the opportunities for social encounters, consequently resulting in a greater use of social media in order to maintain social relationships. Although the range of friend-related activities appeared to be severely constrained during quarantine, the Fear of Missing Out (FoMO) needs to be carefully examined, especially in relation to problematic social networking site use (PSNSU). Indeed, FoMO might enhance individuals' need to stay connected and communicate with other people, leading to PSNSU, in order to face the fear of being invisible in the world of social media in circumstances of physical isolation. The present study sought to evaluate the predictive role of FoMO on PSNSU during the COVID-19 pandemic, testing the mediating effect of online relational closeness and online communication attitude. A total of 487 Italian adults (59.3% women), aged between 18 and 70 years (mean age = 29.85 years; SD = 9.76), responded to an online survey during the period of COVID-19 pandemic lockdown in Italy. The survey included self-report measures assessing perceived FoMO, online communication attitude, relational closeness with online friends, and PSNSU. Participants declared they spent significantly more time social networking during the pandemic, particularly women. The total model accounted for a significant amount of variance in participants' PSNSU [R 2 = 0.54; F (9, 447) = 58.285, p < 0.001). Despite the other people's social rewarding experiences had been drastically reduced by the lockdown, findings showed a direct effect of FoMO on PSNSU. Moreover, FoMO had an effect on online communication attitude and online relational closeness, although only online communication attitude predicted, in turn, PSNSU. Conversely, relational closeness on social networking sites did not predict PSNSU. The present study suggests that, during COVID-19 lockdown, FoMO levels may have strengthened attitudes toward online communication, which, in turn, may have put some individuals at risk of PSNSU.

Psychosocial impact of the COVID-19 outbreak and lockdown on Spanish oncological patients: a quantitative approach

BACKGROUND

This study analyses the levels of distress and related psychosocial factors among cancer patients during the Spanish lockdown due to COVID-19.

METHODS

A total of 2,779 cancer patients took part in an observational and lateral study carried out between April 16, 2020 and April 25, 2020. An online questionnaire was distributed including distress-related variables, demographic variables, clinical variables about their oncological condition, socioeconomic variables and variables related to information management and social communication. Distress was measured according to the Kessler (K-6) scale, and its relationship with the remaining variables was analyzed by logistic regression.

RESULTS

33.5% of the patients yielded levels of clinical distress during lockdown. Younger patients and women yielded significantly higher levels of distress. High distress levels were generally associated with the following factors: trust in medical institutions; deterioration of the household's financial conditions; and media management of the information about the pandemic.

CONCLUSIONS

The lockdown triggered by COVID-19 increased distress among cancer patients, and this can be significantly related to a number of variables. Identifying distress, and said factors, at an early stage can help to develop mitigation strategies. Similarly, early detection can help to improve the way information is shared with patients, offer them support and resources and direct them to psychosocial services, increasing the patient's ability to return to normal after COVID-19.

Life Satisfaction during Forced Social Distancing and Home Confinement Derived from the COVID-19 Pandemic in Spain

Life satisfaction is one of the main dimensions of well-being related to psychological factors, being essential for a person to adjust to difficult circumstances. The restrictive measures adopted to minimize the diffusion of the coronavirus disease (COVID-19) could alter the subjective dimension of well-being, so the objective of this study was to determine the factors related to life satisfaction of the Spanish population during forced home confinement derived from the COVID-19 pandemic. A cross-sectional study was designed, based on an online survey, and disseminated through the main social networks, which included the Satisfaction with Life Scale (SWLS) and sociodemographic and COVID-19-related variables. The possible relationships between the different variables were studied using univariate and multivariable regression analyses. A total of 3261 subjects participated in the study. Factors associated with greater personal life satisfaction were fewer days of home confinement (β = (-0.088); p ≤ 0.001), the perception of having received enough information (β = 0.076; p ≤ 0.001), having private access to the outside (β = 0.066; p ≤ 0.001), being employed (β = 0.063; p ≤ 0.001), being male (β = 0.057; p = 0.001) and not having been isolated (β = 0.043; p = 0.013). The results of this study provide novel information about the profiles of people related to greater well-being and life satisfaction during forced social distancing and home confinement, but more studies are needed to help to understand and complement these findings.

Distance learning during social seclusion by COVID-19: Improving the quality of life of undergraduate dentistry students

BACKGROUND

Social isolation is ongoing worldwide with the aim to stem the spread of the novel coronavirus SARS-CoV-2 responsible for the COVID-19 pandemic. However, social isolation leads to significant psycho-emotional changes. This study aimed to assess the effect of distance education (DE) activities implemented due to social isolation, on the quality of life of undergraduate dentistry students.

METHOD

An e-questionnaire (Google Forms® ) was administered to identify specific DE activities after social isolation and included the World Health Organization Quality of Life (WHOQOL)-Bref questionnaire. The e-questionnaire was sent 14 days after the initiation of social isolation, remaining available for 48 hours. Cronbach's alpha and the means of the quality-of-life domains were calculated and analysed using the Friedman/Dunn and Spearman's correlation tests. After ranking, chi-squared and Fisher's exact tests plus multinomial logistic regression were performed (SPSS, P < .05).

RESULT

There was an excellent internal consistency of WHOQOL-Bref (α = 0.916), and the mean quality of life (0-100) was 70.66 ± 12.61. The psychological domain was the most affected (P < .001). The social domain exhibited the weakest correlation with overall quality of life (P < .001, r = 0.688). The use of the Internet, cell phones and streaming media increased, although all students had DE activities. In the multivariate analysis, attending virtual meetings (P = .028) and performing DE activities in an office/study room (P = .034) were significantly associated with good quality of life.

CONCLUSION

Facing social isolation never previously experienced by this generation, undergraduate dentistry students are at risk of reduced quality of life. Therefore, performing DE activities through devices with teacher-student interaction is a key coping tool.

A longitudinal observation of general psychopathology before the COVID-19 outbreak and during lockdown in Italy

OBJECTIVE

Italy has been largely involved by the COVID-19 pandemic. The present study aimed at evaluating the impact of the lockdown during the pandemic on mental health adopting both a longitudinal and a cross-sectional design. Accordingly, the study investigated general psychopathology a few weeks before the COVID-19 outbreak (T0) and during lockdown (T1), and the associations between lockdown-related environmental conditions, self-perceived worsening in daily living and psychopathology.

METHODS

130 subjects (aged 18-60 years) were included in the longitudinal design, and an additional subsample of 541 subjects was recruited for the in-lockdown evaluation. Socio-demographic data and the Brief Symptom Inventory were collected both at T0 and T1. Moreover, at T1 an online survey was administered for the evaluation of lockdown-related environmental conditions and self-perceived variations in daily living induced by quarantine, along with the Impact of Event Scale-Revised.

RESULTS

Longitudinal analysis showed that phobic anxiety and depressive symptoms increased at T1 as compared with T0, whereas interpersonal sensitivity and paranoid ideation decreased. Pre-existing general psychopathology predicted COVID-19-related post-traumatic symptomatology. Cross-sectional analyses underlined that self-perceived deteriorations in various areas of daily living were associated with general and post-traumatic psychopathology, and with several lockdown-related conditions, especially economic damage.

CONCLUSION

The present study underlined a different trend of increased internalizing and decreased interpersonal symptoms during COVID-19 quarantine in Italy. Furthermore, the results showed that subjects with pre-existing psychopathology and those reporting economic damage during the pandemic were more likely to develop deterioration of their mental health.

Prevalence and Factors Associated with Mental and Emotional Health Outcomes among Africans during the COVID-19 Lockdown Period-A Web-based Cross-Sectional Study

Mental health and emotional responses to the effects of COVID-19 lockdown in sub-Saharan Africa (SSA) are of serious public health concern and may negatively affect the mental health status of people. Hence, this study assessed the prevalence of mental health symptoms as well as emotional reactions among sub-Saharan Africans (SSAs) and associated factors among SSAs during the COVID-19 lockdown period. This was a web-based cross-sectional study on mental health and emotional features from 2005 respondents in seven SSA countries. This study was conducted between 17 April and 17 May 2020 corresponding to the lockdown period in most SSA countries. Respondents aged 18 years and above and the self-reported symptoms were feeling anxious, being worried, angry, bored and frustrated. These were the main outcomes and were treated as dichotomous variables. Univariate and multivariate logistic regression analyses were used to identify the factors associated with these symptoms. We found that over half (52.2%) of the participants reported any of the mental health symptoms and the prevalence of feeling bored was 70.5% followed by feeling anxious (59.1%), being worried (57.5%), frustrated (51.5%) and angry (22.3%) during the COVID-19 pandemic. Multivariate analysis revealed that males, those aged >28 years, those who lived in Central and Southern Africa, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Similarly, people who perceived low risk of contracting the infection, and those who thought the pandemic would not continue after the lockdown had higher odds of mental health and emotional symptoms. Health care workers had lower odds for feeling angry than non-healthcare workers. During the COVID-19 lockdown periods in SSA, about one in two participants reported mental health and emotional symptoms. Public health measures can be effectively used to identify target groups for prevention and treatment of mental health and emotional symptoms. Such interventions should be an integral component of SSA governments' response and recovery strategies of any future pandemic.

Loneliness, Emotion Dysregulation, and Internalizing Symptoms During Coronavirus Disease 2019: A Structural Equation Modeling Approach

Background: Our study aimed to test the hypotheses that an increased level of loneliness experienced during coronavirus disease 2019 (COVID-19) confinement was predictive of internalizing symptoms and that this pathway was mediated by emotion dysregulation levels. Methods: To reach this aim, we performed an online longitudinal survey recruiting 1,330 participants at Time 1 (at the beginning of the lockdown) and 308 participants at Time 2 (few days before the end of the lockdown). All filled out a set of questionnaires: demographic data, University of California, Los Angeles Loneliness scale, Difficulties in Emotion Regulation Scale-18 items, and Depression Anxiety and Stress Scale-21 items. Hypotheses were tested using structural equation modeling in two steps and controlling for age. First, hypotheses were tested on cross-sectional data. Then, a cross-lagged panel analysis was performed on longitudinal data. Results: Models obtained a good fit and evidenced the predictive role of loneliness levels on the three outcomes (i.e., depression, anxiety, and stress). Moreover, we found that emotion dysregulation levels partially mediated the longitudinal relationship between loneliness and both depression and stress but not between loneliness and anxiety levels. Conclusions: This study points out that a central goal of clinical intervention could be the ability to regulate negative emotional states.

Explaining the problems faced by Iranian housewives during the COVID-19 quarantine period, and their adaption strategies: A qualitative study

BACKGROUND

Housewives have several problems during the quarantine phase; so, the current study was designed to describe the challenges faced by Iranian housewives during the quarantine period in relation to COVID-19 and compatibility measures for it.

METHODS

The current research employed a qualitative methodology and a traditional content analysis method on 34 quarantined women in Tehran. Purposive sampling and snowballing were used to find participants, and semi-structured interviews were used to gather data. The Guba and Lincoln criteria were also employed to assess the quality of the study findings.

RESULTS

After analyzing the data, 4 main categories and 18 subcategories were extracted, including (1) individual problems (personal health problems, life with fear and anxiety, low mental health, lifestyle imbalance, Internet addiction); (2) family problems (violence and conflict in the family, tension in managing family members, disruption of the educational and economic situation of family members, intensification of domestic tasks and roles); (3) social problems (social isolation, disregard for social customs, restricted access to cyberspace); and (4) compatibility strategies (spirituality, strengthening family relationships, division of tasks between family members, optimal use of leisure, positive use of cyberspace, development of individual skills).

CONCLUSION

Their problems can be ameliorated by providing contraception to housewives, improving their mental health and reducing their worries and fears, modeling a healthy lifestyle during quarantine, offering solutions that reduce violent behavior and manage family conflict, and expanding their access to virtual communications.

Impacts of COVID-19 pandemic on urban park visitation: a global analysis

The COVID-19 pandemic has resulted in over 33 million confirmed cases and over 1 million deaths globally, as of 1 October 2020. During the lockdown and restrictions placed on public activities and gatherings, green spaces have become one of the only sources of resilience amidst the coronavirus pandemic, in part because of their positive effects on psychological, physical and social cohesion and spiritual wellness. This study analyzes the impacts of COVID-19 and government response policies to the pandemic on park visitation at global, regional and national levels and assesses the importance of parks during this global pandemic. The data we collected primarily from Google's Community Mobility Reports and the Oxford Coronavirus Government Response Tracker. The results for most countries included in the analysis show that park visitation has increased since February 16th, 2020 compared to visitor numbers prior to the COVID-19 pandemic. Restrictions on social gathering, movement, and the closure of workplace and indoor recreational places, are correlated with more visits to parks. Stay-at-home restrictions and government stringency index are negatively associated with park visits at a global scale. Demand from residents for parks and outdoor green spaces has increased since the outbreak began, and highlights the important role and benefits provided by parks, especially urban and community parks, under the COVID-19 pandemic. We provide recommendations for park managers and other decision-makers in terms of park management and planning during health crises, as well as for park design and development. In particular, parks could be utilized during pandemics to increase the physical and mental health and social well-being of individuals.

Noli Timere: The Role of Reassuring Adults in Dealing with COVID-19 Anxiety in Pediatric Age

Since the earliest stages of the Corona Virus Disease-19 (COVID-19) spread, the elderly has been identified as the most vulnerable and health authorities have rightly focused on that population. Minor attention was paid to pediatric populations and their emotional reactions. Actually, children and adolescents faced severe anxiety, fear and stress conditions. An efficient management of the pandemic, therefore, must take into account the pediatric population which cannot be neglected as a minor matter compared to the elderly, the economy and health care. Since the lockdown time is over, children and adolescents must recover sociality, return to living in the open air, rediscover playing, free time, aiming for the beauty of their everyday life. In order to mitigate the long-term impact of COVID-19, the key response is the reassuring presence of the adult as 'a secure base'. The current study aimed to collect an overview of the recent references that report evidence on the role of adults in containing pandemic anxiety COVID-19 in pediatric populations, suggesting the need to ensure a reassuring presence of the adult, an effective child-parent communication, a child-friendly day and a long-lasting shared time with parents.

The impact of quarantine on mental health status among general population in China during the COVID-19 pandemic

Quarantine and isolation measures urgently adopted to control the COVID-19 pandemic might potentially have negative psychological and social effects. We conducted this cross-sectional, nationwide study to ascertain the psychological effect of quarantine and identify factors associated with mental health outcomes among population quarantined to further inform interventions of mitigating mental health risk especially for vulnerable groups under pandemic conditions. Sociodemographic data, attitudes toward the COVID-19, and mental health measurements of 56,679 participants from 34 provinces in China were collected by an online survey from February 28 to March 11, 2020. Of the 56,679 participants included in the study (mean [SD] age, 36.0 [8.2] years), 27,149 (47.9%) were male and 16,454 (29.0%) ever experienced home confinement or centralized quarantine during COVID-19 outbreak. Compared those without quarantine and adjusted for potential confounders, quarantine measures were associated with increased risk of total psychological outcomes (prevalence, 34.1% vs 27.3%; odds ratio [OR], 1.34; 95% CI, 1.28-1.39; P < 0.001). Multivariable logistic regression analyses showed that vulnerable groups of the quarantined population included those with pre-existing mental disorders or chronic physical diseases, frontline workers, those in the most severely affected areas during outbreak, infected or suspected patients, and those who are less financially well-off. Complying with quarantine, being able to take part in usual work, and having adequate understanding of information related to the outbreak were associated with less mental health issues. These results suggest that quarantine measures during COVID-19 pandemic are associated with increased risk of experiencing mental health burden, especially for vulnerable groups. Further study is needed to establish interventions to reduce mental health consequences of quarantine and empower wellbeing especially in vulnerable groups under pandemic conditions.

Impacts of social distancing during COVID-19 pandemic on the daily life of forestry students

University life has changed profoundly due to social distancing measures to control the spread of COVID-19. Over the longer term, the coronavirus crisis may affect the mental health of undergraduate students who are required to cope with remote options and forgo the usual campus life. The aim of this study is thus to investigate the impacts of COVID-19 on undergraduate students' mental health and daily life in order to assist policymakers improve pandemic control plans and help educators and healthcare experts provide support to affected undergraduates. Results are based on quantitative data collected via online questionnaires which were completed by 181 Greek undergraduate forestry students. The analysis indicated that the students were highly affected by the closure of universities and the transition to distance learning. Moreover, they experienced negative emotions, mostly concern and anger, during the lockdown. T-test showed that female respondents experienced strong negative emotions like fear, panic and despair to a higher degree than male students who were more optimistic about the pandemic. Surprisingly, the students did not exercise outdoors every day even though it was allowed during the 42-day quarantine. In addition, they used mostly television and scientific articles to obtain information about COVID-19. The results presented in this study offer insights into university students' experience with the pandemic and reveal their reaction to remote education. It is recommended to monitor university students' mental health frequently and to provide them with psychological counselling and practical advice on how to manage anxiety and fear. Finally, education and training on remote learning could help reduce students' anxiety over online classes and exams.

Extrapulmonary complications of COVID-19: A multisystem disease?

The outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been recently declared a pandemic by the World Health Organization. In addition to its acute respiratory manifestations, SARS-CoV-2 may also adversely affect other organ systems. To date, however, there is a very limited understanding of the extent and management of COVID-19-related conditions outside of the pulmonary system. This narrative review provides an overview of the current literature about the extrapulmonary manifestations of COVID-19 that may affect the urinary, cardiovascular, gastrointestinal, hematological, hematopoietic, neurological, or reproductive systems. This review also describes the current understanding of the extrapulmonary complications caused by COVID-19 to improve the management and prognosis of patients with COVID-19.