Emotional, Behavioral, and Psychological Impact of the COVID-19 Pandemic

Aly N, Oluwátóyìn Foláyan M. COVID-19's psychological toll on oral health: A cross-sectional study in Iranian adults

BACKGROUND

The Coronavirus disease 2019 pandemic increased global psychological distress, emotional distress, and sleep disturbances, all known risk factors for compromised oral health. Despite this, there is limited understanding of the impacts of these psychological factors on oral health in certain populations, including Iranians. Thus, the present study investigates the associations between sociodemographic characteristics, emotional distress, sleep pattern changes, tooth brushing frequency, and oral ulcer reports in a sample of Iranian adults during the Coronavirus disease 2019 pandemic.

MATERIALS AND METHODS

This cross-sectional, web-based study collected data from Iranian adults between July and September 2022 using respondent-driven sampling. The Mental Health and Wellness questionnaire was used to gather information on sociodemographic characteristics, emotional distress, sleep pattern changes, toothbrushing frequency, and oral ulcer reports. Simple and multiple logistic regression served for statistical analysis.

RESULTS

Among the 240 participants, comprising 164 females and 76 males, with a mean age of 35.3 years (±13.3), 28 individuals (11.7%) reported reduced tooth brushing frequency, and 35 individuals (14.6%) reported oral ulcers. Male gender (OR = 2.75, p = 0.016) and sleep patterns changes (OR = 2.93, p = 0.01) increased the likelihood of reduced tooth brushing frequency. Additionally, being younger than 30 (OR = 2.87, p = 0.025) and fearing coronavirus transmission (OR = 3.42, p = 0.009) increased the odds of oral ulcers.

CONCLUSIONS

Male gender and sleep pattern changes were risk factors for reduced tooth brushing frequency among the present sample of Iranian adults during the Coronavirus disease 2019 pandemic. Additionally, being under 30 and fearing coronavirus transmission were identified as risk factors for oral ulcers in this population. To preserve and promote adults' oral health during public health crises, targeted educational initiatives, public health awareness campaigns, and integrated mental and oral healthcare approaches are encouraged.

Systematic review on attitudes towards death and dying in adults 50 years and older living in countries with community transmission of COVID-19

BACKGROUND

The COVID-19 pandemic has underscored older adults' vulnerability to severe illness or death. Increased public awareness of mortality, with daily reminders of preventive measures, spurred interest in understanding the impact on death-related thoughts. This systematic review analyses existing literature on death attitudes among individuals aged 50 and older during the COVID-19 pandemic and focuses on associated factors.

METHODS

A systematic literature search was conducted using the WHO COVID database without any language limit, up until April 2023. The review protocol was registered in PROSPERO and PRISMA guidelines were followed. Included studies were systematically analysed and summarized using a predefined data extraction sheet.

RESULTS

Of the 2297 studies identified, 9 met inclusion criteria. The review showed moderate to high levels of death anxiety during the pandemic, linked to direct health risks from COVID-19 rather than mitigation measures. The impact of health and personal factors on older people's death anxiety was complex, with a range of health and personal factors such as chronic conditions, loss of capacity, loneliness, occupation, and resilience associated with it, suggesting potential intervention avenues.

CONCLUSION

The systematic review shows a significant link between COVID-19 and heightened death anxiety among individuals aged 50 and above. Negative attitudes to death can harm physical and mental health, diminish life satisfaction, increase avoidance behaviour, impair coping mechanism and undermine end-of-life decision making. Findings underscore the need for further research into risk and protective factors (personal, health, and environmental) and the importance of standardized data collection to guide interventions and public health strategies aimed at mitigating death anxiety.

Long-term effects of the COVID-19 pandemic for patients with cancer

INTRODUCTION

Long COVID is defined as the continuation of symptoms, unexplainable by alternative diagnosis, longer than four weeks after SARS-CoV-2 infection. These symptoms might hinder daily activities and overall well-being, ultimately impacting quality of life (QoL). Several studies have reported fatigue as the most common symptom, followed by dyspnoea, headache and myalgia. Although it is assumed that long COVID affects 10-20% of SARS-CoV-2 infected individuals, recently numbers up to 60% were described for patients with cancer. This study uncovers the impact of the COVID-19 pandemic on QoL of patients with cancer and how long COVID manifests in this cohort.

METHODS

A group of 96 patients with cancer was followed from March 2022 till March 2023. Online questionnaires assessing symptoms associated with long COVID, anxiety and depression (HADS), quality of life (EORTC-QLQ-C30) and cognitive functioning (CFQ) were sent every three months during this period. Furthermore, a semi-structured focus group was organised for qualitative data collection.

RESULTS

Overall, these patients reported a negative impact of the enforced COVID-19 restrictions on the emotional and psychological wellbeing. Forty nine patients with cancer (51.0%) were infected with SARS-CoV-2 over the course of the study, of which 39 (79.6%) reported long COVID symptoms. The most commonly reported symptoms were myalgia (46.2%), fatigue (38.5%) and disturbed sleep (35.9%) and it was observed that male sex is associated with poor long COVID outcomes.

CONCLUSION

While patients with cancer experience similar long COVID symptoms as healthy controls, the prevalence is remarkably higher possibly due to their compromised immune system and weakened physiological reserve.

Burnout Among Nurses Working in Critical Care Units During the COVID-19 Pandemic

Burnout is a state of emotional and physical depletion. Its occurrence among critical care nurses (CCNs) is a concept that has gained traction yet remains an issue with global consequences. Nurses are especially vulnerable to burnout due to the persistent stressors they are exposed to, which include the general work environment, biological factors, and emerging changes caused by COVID-19. This study aims to assess the severity of burnout among CCNs during the COVID-19 pandemic and its associated factors. A descriptive cross-sectional questionnaire was used in this study to measure the estimated burnout rate among CCNs in Palestine and establish associations with potential factors. Maslach Burnout Inventory questionnaire was used for the task. The results showed out of the 173 participants, more than 35% reported severe overall burnout. Per burnout domains, it was found that around 70% of participants suffered from low personal accomplishment, while 59.5% had severe levels of depersonalization, and finally, more than 65% of critical nurses had severe emotional exhaustion. Out of the various variables tested, gender, age, type of hospital, PPE, and fear of transmission were found to be associated with overall burnout. CCNs in Palestine were found to be severely burned out and should be dealt with before getting out of hand. The research found variables related to burnout contributed to burnout. Recommendations for further studies and prioritization should be made.

COVID-19-Related Increases in Depressive and Anxious Symptoms Are Associated with Maladaptive Eating Among Patients up to 4 years Post-bariatric Surgery

INTRODUCTION

Depressive and anxious symptoms and maladaptive eating behaviors fluctuate with stressful events for patients seeking bariatric surgery. These associations are less clear for patients postoperatively. Using the COVID-19 pandemic as a frame, we examined associations between changes in depressive and anxious symptoms and maladaptive eating behaviors between up to four years postoperatively.

METHODS

Participants (N = 703) who underwent surgery between 2018 and 2021 completed web-based questionnaires between 2021 and 2022. Demographic and surgical data were obtained from electronic health records. Participants reported whether depressive and anxious symptoms increased or were stable/decreased during the COVID-19 pandemic, and completed eating behavior measures.

RESULTS

Many participants reported increased depressive (27.5%) and anxious (33.7%) symptoms during the COVID-19 pandemic. Compared to those who reported stable or decreased symptoms, these participants were as follows: (1) more likely to endorse presence of binge, loss-of-control, graze, and night eating; (2) reported higher emotional eating in response to anger and frustration, depression, and anxiety; and (3) reported higher driven and compulsive eating behaviors. Frequency of binge, loss-of-control, graze, and night eating episodes did not differ between groups (e.g., increased vs. stable/decreased anxious symptoms) among participants who endorsed any episodes.

CONCLUSION

A large portion of the sample reported increased depressive and anxious symptoms during the COVID-19 pandemic, and these increases were associated with maladaptive eating behaviors. Depressive and anxious symptoms and eating behaviors should be assessed postoperatively as significant stressors may be associated with increased distress and maladaptive eating behaviors that can affect postoperative outcomes. Postoperative interventions may be useful at simultaneously targeting these concerns.

Network analysis for inter-relationships of the suboptimal health status with depression and anxiety during the COVID-19 pandemic: A perspective of predictive, preventive, and personalized health

BACKGROUND

The Coronavirus Disease-2019 (COVID-19) pandemic has had a profound impact on suboptimal health status, depression, and anxiety, necessitating a comprehensive understanding of their inter-relationships at the national level. This study aims to investigate the inter-relationships among suboptimal health status, depression, and anxiety using a network analysis approach.

METHODS

We conducted a national survey between June 20 and August 31, 2022. Three network models were constructed and analyzed to independently examine the inter-relationships among suboptimal health status, depression, and anxiety.

RESULTS

A total of 26,152 participants were included in this study. The study network analysis indicated that item 9 (i.e., Slow response) exhibited the highest node strength within the suboptimal health status questionnaire-short form (SHSQ-SF) network, followed by item 5 (i.e., Breathlessness at rest). Additionally, positive correlations were observed between depression and anxiety severity and most of the SHSO-SF items.

CONCLUSIONS

This study provided valuable insights into inter-relationships between suboptimal health status, depression, and anxiety, informing the development of comprehensive intervention strategies for the general population. These findings have important implications for promoting the well-being and mental health of individuals during and beyond the COVID-19 pandemic.

The protective effect of physical activity on mental health of middle school students at different stages during the COVID-19 outbreak

This study aims to further understand the changes in physical activity level(PAL) and mental health among adolescents before and after the outbreak of COVID-19 and explore the protective role of physical activity (PA) on the mental health of adolescents during major disasters. A convenient sampling method was used to conduct a cross-sectional survey. The cross-sectional data from 2838 Chinese middle school students (mean age = 14.91 ± 1.71 years, 49.54% female) were used, of which 1,471 and 1,367 were in 2021 and 2022, respectively. The PAL was collected using the Physical Activity Questionnaire for Children (PAQ-CN), mental health status was collected using the Mental Health Inventory of Middle School Students (MMHI-60), sociodemographic information was collected using a self-reported questionnaire. Before and after the outbreak of COVID-19, the PAL of adolescents was 2.36 ± 0.74 and 2.50 ± 0.66, respectively, with a significant difference (p < 0.01, 95% CI: 0.09, 0.19). The mental health scores were 1.71 ± 0.60 and 1.86 ± 0.73, respectively, with a significant difference (p < 0.01, 95% CI: - 0.20, - 0.10). The detection rates of mental health problems were 27.50% and 35.50%, respectively. The rates of achieving PAL standards were 30.20% and 18.00% among adolescents, while the rates of not achieving PAL standards were 39.60% and 18.00%. PA is a protective factor for the mental health of adolescents during major disasters.

Exploring the relationship between older adults' online health information seeking, negative emotions and prevention behaviors in the pandemic context: a two-wave longitudinal study

Introduction

During the COVID-19 pandemic, older adults were facing more mental health issues that may cause complex impacts on pandemic prevention, and turning to the internet for health information is a double-edged sword for them. This study aimed to investigate the reciprocal relationship between negative emotions and prevention behaviors in older adults, as well as the direct and moderating effects of online health information seeking (OHIS) on negative emotions and prevention behaviors.

Methods

Based on the common-sense model of self-regulation (CSM) and a sample of more than 20,000 participants from the Survey of Health, Aging and Retirement in Europe (SHARE), this study first used an autoregressive cross-lagged panel model (CLPM) to analyze the longitudinal effect of negative emotions on prevention behaviors. Second, the study used ordinary least squares (OLS) regression to explore the influence of OHIS usage frequency changes on negative emotions and prevention behaviors. Third, the study used multigroup analysis to examine the moderating effect of OHIS usage frequency changes on the CLPM.

Results

The findings indicate a significant longitudinal association where initial negative emotions predicted later prevention behaviors (β = 0.038, p < 0.001), and increased OHIS frequency was linked to positive changes in prevention behavior (β = 0.109, p < 0.001). Multigroup analysis revealed that the connection between negative emotions or increased negative emotions and prevention behaviors remained significant for those with no change or an increase in OHIS frequency but not for those with a decrease.

Conclusion

This study suggested that negative emotions may drive older adults to engage more in prevention behaviors and that OHIS can augment this effect. These results underscore the importance of addressing mental health and providing reliable online health information to support older adults in managing infectious disease risks.

Trends of fear and anger on YouTube during the initial stage of the COVID-19 outbreak in South Korea

BACKGROUND

The COVID-19 pandemic has been the most widespread and threatening health crisis experienced by the Korean society. Faced with an unprecedented threat to survival, society has been gripped by social fear and anger, questioning the culpability of this pandemic. This study explored the correlation between social cognitions and negative emotions and their changes in response to the severe events stemming from the COVID-19 pandemic in South Korea.

METHODS

The analysis was based on a cognitive-emotional model that links fear and anger to the social causes that trigger them and used discursive content from comments posted on YouTube's COVID-19-related videos. A total of 182,915 comments from 1,200 videos were collected between January and December 2020. We performed data analyses and visualizations using R, Netminer 4.0, and Gephi software and calculated Pearson's correlation coefficients between emotions.

RESULTS

YouTube videos were analyzed for keywords indicating cognitive assessments of major events related to COVID-19 and keywords indicating negative emotions. Eight topics were identified through topic modeling: causes and risks, perceptions of China, media and information, infection prevention rules, economic activity, school and infection, political leaders, and religion, politics, and infection. The correlation coefficient between fear and anger was 0.462 (p < .001), indicating a moderate linear relationship between the two emotions. Fear was the highest from January to March in the first year of the COVID-19 outbreak, while anger occurred before and after the outbreak, with fluctuations in both emotions during this period.

CONCLUSIONS

This study confirmed that social cognitions and negative emotions are intertwined in response to major events related to the COVID-19 pandemic, with each emotion varying individually rather than being ambiguously mixed. These findings could aid in developing social cognition-emotion-based public health strategies through education and communication during future pandemic outbreaks.

Excess Fatal Overdoses in the United States During the COVID-19 Pandemic by Geography and Substance Type: March 2020-August 2021

Objectives. To assess heterogeneity in pandemic-period excess fatal overdoses in the United States, by location (state, county) and substance type. Methods. We used seasonal autoregressive integrated moving average (SARIMA) models to estimate counterfactual death counts in the scenario that no pandemic had occurred. Such estimates were subtracted from actual death counts to assess the magnitude of pandemic-period excess mortality between March 2020 and August 2021. Results. Nationwide, we estimated 25 668 (95% prediction interval [PI] = 2811, 48 524) excess overdose deaths. Specifically, 17 of 47 states and 197 of 592 counties analyzed had statistically significant excess overdose-related mortality. West Virginia, Louisiana, Tennessee, Kentucky, and New Mexico had the highest rates (20-37 per 100 000). Nationally, there were 5.7 (95% PI = 1.0, 10.4), 3.1 (95% PI = 2.1, 4.2), and 1.4 (95% PI = 0.5, 2.4) excess deaths per 100 000 involving synthetic opioids, psychostimulants, and alcohol, respectively. Conclusions. The steep increase in overdose-related mortality affected primarily the southern and western United States. We identified synthetic opioids and psychostimulants as the main contributors. Public Health Implications. Characterizing overdose-related excess mortality across locations and substance types is critical for optimal allocation of public health resources. (Am J Public Health. 2024;114(6):599-609. https://doi.org/10.2105/AJPH.2024.307618).

Integrated Antigenic and Nucleic Acid Detection in Single Virions and Extracellular Vesicles with Viral Content

Virion-mediated outbreaks are imminent and despite rapid responses, continue to cause adverse symptoms and death. Therefore, tunable, sensitive, high-throughput assays are needed to help diagnose future virion-mediated outbreaks. Herein, it is developed a tunable in situ assay to selectively enrich virions and extracellular vesicles (EVs) and simultaneously detect antigens and nucleic acids at a single-particle resolution. The Biochip Antigen and RNA Assay (BARA) enhanced sensitivities compared to quantitative reverse-transcription polymerase chain reaction (qRT-PCR), enabling the detection of virions in asymptomatic patients, genetic mutations in single virions, and enabling the continued long-term expression of viral RNA in the EV-enriched subpopulation in the plasma of patients with post-acute sequelae of the coronavirus disease of 2019 (COVID-19). BARA revealed highly accurate diagnoses of COVID-19 by simultaneously detecting the spike glycoprotein and nucleocapsid-encoding RNA in saliva and nasopharyngeal swab samples. Altogether, the single-particle detection of antigens and viral RNA provides a tunable framework for the diagnosis, monitoring, and mutation screening of current and future outbreaks.

Building an implementation strategy for community-based rehabilitation for mental health in Colombia

INTRODUCTION

Scientific evidence indicates that the community-based rehabilitation (CBR) model is recommended for recovery from mental disorders. However, this approach encounters barriers and often lacks implementation strategies.

AIM

The aim of this study is to create a strategy for the implementation of CBR for mental health in Colombia through the identification of barriers and facilitators, together with the expected outcomes, from the perspective of mental health decision-makers in Colombia.

METHODS

This study adopts a qualitative descriptive approach, using focus group data collection methods and thematic analysis to code and analyze the data.

RESULTS

A total of 208 individuals participated in the study, including mental health decision-makers and health care professionals. Intersectoral collaboration, contextualization, financial resources, and community commitment and autonomy were identified as barriers and facilitators. The element that was considered a priority for successful implementation was the contextualization of strategies.

CONCLUSIONS

CBR needs to be strengthened through implementation science if these strategies are to be successfully developed and implemented in various contexts.

SPANISH ABSTRACT

http://links.lww.com/IJEBH/A210.

Information processing style and institutional trust as factors of COVID vaccine hesitancy

This study investigates the factors contributing to COVID vaccine hesitancy. Vaccine hesitancy has commonly been attributed to susceptibility to misinformation and linked to particular socio-demographic factors and personality traits. We present a new perspective, emphasizing the interplay between individual cognitive styles and perceptions of public health institutions. In January 2020, before the COVID-19 pandemic, 318 participants underwent a comprehensive assessment, including self-report measures of personality and clinical characteristics, as well as a behavioral task that assessed information processing styles. During 2021, attitudes towards vaccines, scientists, and the CDC were measured at three time points (February-October). Panel data analysis and structural equation modeling revealed nuanced relationships between these measures and information processing styles over time. Trust in public health institutions, authoritarian submission, and lower information processing capabilities together contribute to vaccine acceptance. Information processing capacities influenced vaccination decisions independently from the trust level, but their impact was partially mediated by authoritarian tendencies. These findings underscore the multifactorial nature of vaccine hesitancy, which emerges as a product of interactions between individual cognitive styles and perceptions of public health institutions. This novel perspective provides valuable insights into the underlying mechanisms that drive this complex phenomenon.

Urban safety and psychological distress during the pandemic: the results of a longitudinal study

Introduction

In the last decades, a large body of literature has explored the topic of perceived safety and fear of crime in urban environments. The effects of psychological factors on such feelings have been studied, but rarely using prospective studies, and never when these factors intercept a worldwide dramatic event like the pandemic. This research aimed to analyze the variations of the feelings of urban safety during the pandemic, the role of resiliency and the effect of psychological stressors such as anxiety, stress, and depression.

Methods

During 2019 and 2022, before and after the pandemic, a face-to-face interview was administered to the same group of 195 participants. The PUSAS scale was used to measure unsafety, the ER89-R to assess for resiliency, the DASS-21 to collect data about the general distress (anxiety, stress and depression), and the CAS scale was used to evaluate the specific coronavirus anxiety. Structural equation models were applied to test a theoretical framework grounded on the relationships between these measures.

Results

The research findings showed decreased feelings of unsafety across the pandemic, consistent with the literature. The positive effect of ego-resiliency was significant but only for its interaction with data collected before the pandemic, whilst stress and anxiety impacted unsafety in 2022 through different pathways. None of the symptoms of general distress influenced the concern about crime and sense of vulnerability, as the feelings of unsafety were found independent from the variations of the specific coronavirus anxiety.

Discussion

Although the research findings did not confirm the impact of coronavirus, they presented some facets that disconfirm what the literature reported about the relationships between psychological distress and fear of crime. Implications about measurement issues are discussed.

Pediatric Traumatic Brain Injury Outcomes and Disparities During the COVID-19 Pandemic

BACKGROUND

To study the impact of the COVID-19 pandemic on traumatic brain injury (TBI) patient demographic, clinical and trauma related characteristics, and outcomes.

METHODS

Retrospective chart review was conducted on pediatric TBI patients admitted to a Level I Pediatric Trauma Center between January 2015 and June 2022. The pre-COVID era was defined as January 1, 2015, through March 12, 2020. The COVID-19 era was defined as March 13, 2020, through June 30, 2022. Bivariate analysis and logistic regression were performed.

RESULTS

Four hundred-thirty patients were treated for pediatric TBI in the pre-COVID-19 period, and 166 patients during COVID-19. In bivariate analyses, the racial/ethnic makeup, age, and sex varied significantly across the two time periods (p < 0.05). Unwitnessed TBI events increased during the COVID-19 era. Logistic regression analyses also demonstrated significantly increased odds of death, severe disability, or vegetative state during COVID-19 (AOR 7.23; 95 % CI 1.43, 36.41).

CONCLUSION

During the COVID-19 pandemic, patients admitted with pediatric TBI had significantly different demographics with regards to age, sex, and race/ethnicity when compared to patients prior to the pandemic. There was an increase in unwitnessed events. In the COVID period, patients had a higher odds ratio of severe morbidity and mortality despite adjustment for confounding factors.

LEVEL OF EVIDENCE AND STUDY TYPE

Level II, Prognosis.

Social media heterogeneity and preventive behaviours during the COVID-19 outbreak: a survey on online shopping

BACKGROUND

Residents' adoption of preventive behaviours proved beneficial in preventing the large-scale transmission of the virus during the early stages of the COVID-19 outbreak. It is critical to investigate how social media triggers residents' preventive behaviour decisions during the COVID-19 outbreak.

METHODS

This paper selected online shopping as a specific preventive behaviour for empirical investigation. An online cross-sectional survey was conducted through the Sojump website from 1 to 15 March 2020, and a total of 1,289 valid questionnaires were collected from China. This paper uses multiple regression analysis to investigate the heterogeneous impacts of different information sources on residents' online shopping willingness and online shopping behaviour and the heterogeneous impacts of different information content in social media on the transformation of residents' online shopping willingness and online shopping behaviour.

RESULTS

The findings indicate that both official-media and self-media positively promote residents' online shopping willingness and behaviour, with official-media having a stronger promotional effect than self-media. Furthermore, official-media and self-media can collaboratively promote residents' online shopping willingness and online shopping behaviour. The ease-of-use and usefulness of information significantly promoted the transformation of residents' online shopping willingness.

CONCLUSIONS

This study analyses the heterogeneous impacts of social media on residents' preventive behaviours from the perspectives of information source differentiation and information content differentiation, which enriches related studies and provides feasible paths for promoting residents' preventive behaviours.

Covid-19 hotlines, helplines and call centers: a systematic review of characteristics, challenges and lessons learned

BACKGROUND

During the Covid-19 pandemic, a number of hotlines/helplines/call centers was implemented to provide remote services and support public health. The objective of this study was to investigate the characteristics, challenges and lessons learned of implementing Covid-19 hotlines/helplines/call centers during the pandemic.

METHODS

PubMed, Web of Science, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest databases as well as Google Scholar were searched between 1st January 2020 and 31st December 2023 to retrieve relevant articles published in English. The quality and risk of bias of the studies were assessed using the Appraisal tool for Cross-Sectional Studies (AXIS), the Mixed Methods Appraisal Tool (MMAT), and Critical Appraisal Skills Programme (CASP) Checklist.

RESULTS

In total, 43 out of 1440 articles were included in this study. About half of the hotlines/helplines/call centers were launched in March 2020 (n = 19). Providing psychological support (n = 23), reliable information about Covid-19 (n = 10), healthcare advices about Covid-19 (n = 8), and triage (n = 7) were the most common purposes of implementing these services. The most common challenges included a lack of physical examination, unavailability of hotlines/helplines/call centers at the point of need, and delay in updating Covid-19 information. The most common lessons learned were employing qualified staff, providing proper training, and getting feedback from the callers and operators.

CONCLUSION

According to the results, most of the Covid-19 hotlines/helplines/call centers were launched in the early months of the pandemic, and about half of them were active seven days a week. Most of the operators were mental health providers and clinicians. The findings show the importance of continuous psychological support during crises, particularly when adequate information about the situation is not available. The challenges experienced by the callers and operators as well as the lessons learned by the service providers also need to be considered for future crises to increase the effectiveness of similar services.

Neuropsychological Symptoms and Quality of Life during the COVID-19 Pandemic in Children: A Survey in a Pediatric Population in the Abruzzo Region, Italy

BACKGROUND

The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general social impact of the pandemic.

METHODS

We conducted a cross-sectional survey that aims at investigating the neuropsychological effects and the QoL impairment of SARS-CoV-2 on a cohort of children and adolescents in the Abruzzo region (Italy). A questionnaire was submitted to caregivers with the help of the PEDIATOTEM platform. A control group of healthy subjects was also included to distinguish between the effects of infection from the general influence of the pandemic.

RESULTS

A total of 569 subjects responded: 396 COVID-19 patients (99 of whom had Long COVID-19) and 111 controls. After the pandemic, when compared with the COVID-19 group, the controls reported significantly increased appetite, sleeping habits, and time spent remotely with friends and a reduction in physical activity and time spent in person with friends. A significant higher rate of controls asked for psychological/medical support for emotional problems. On the other hand, the Long COVID-19 group showed more fatigue and emotional instability with respect to non-Long-COVID-19 subjects. No differences in QoL results (EuroQOL) were found between the COVID-19 patients and controls, while the Long-COVID-19 subgroup showed significantly higher rates of pain/discomfort and mood instability, as confirmed by the analysis of variation of responses from the pre-COVID-19 to the post-COVID-19 period.

CONCLUSIONS

Among COVID-19 patients, neuropsychological and QoL impairment was more evident in the Long COVID-19 subgroup, although emotional and relational issues were also reported by uninfected patients, with a growing request for specialist support as a possible consequence of social restriction.

Factors Associated with Israeli Arab Women Anxiety and Depression During the COVID-19 Pandemic

BACKGROUND

Reports have shown that women suffered from anxiety, stress, depression, and fatigue during the COVID-19 pandemic more than men. No study so far has examined the effect of the pandemic among the Arab minority in Israel.

OBJECTIVES

To examine the associations between levels of pandemic fatigue and stress of Israeli Arab women, and their anxiety and depression, along with their socio-demographic and socio-economic characteristics.

METHODS

A Cohen and Williamson questionnaire, which was based on a Likert scale, was distributed by the snowball method through social networks. Bivariate associations between the psycho-social and demographic characteristics and anxiety and depression were assessed using t-tests, chi-square tests, Z tests, and Pearson correlations. Multiple linear regressions were used to evaluate the associations with anxiety and depression, and the mediation model was examined with path analysis with bootstrapping.

RESULTS

Among 2294 Israeli Arab mothers who participated in the study, 63.7% were in the clinical range for anxiety, 67.4% for depression, and 57.5% for both anxiety and depression. Low economic status, pandemic fatigue, living in closed communities, and stress were related to anxiety and depression. Pandemic fatigue was positively related to stress, which was positively related to both anxiety and depression (standardized indirect effect = 0.137, SE = 0.014, 95%CI = 0.111, 0.164, p < .001; vs. 0.133, SE = 0.013, 95%CI = 0.108, 0.160, p < .001 respectively). The contribution of stress to anxiety and depression was significantly greater than that of pandemic fatigue (Z = 19.43 and Z = 18.04, p < .001, for anxiety and depression, respectively).

CONCLUSIONS

Demographic characteristics may put Arab women at a higher risk of anxiety and depression. Elevated stress alongside high fatigue may trigger mental health difficulties. The welfare of minorities should be addressed by policymakers in relation to their demographic needs.

Analysis of social metrics on scientific production in the field of emotion-aware education through artificial intelligence

Research in the field of Artificial Intelligence applied to emotions in the educational context has experienced significant growth in recent years. However, despite the field's profound implications for the educational community, the social impact of this scientific production on digital social media remains unclear. To address this question, the present research has been proposed, aiming to analyze the social impact of scientific production on the use of Artificial Intelligence for emotions in the educational context. For this purpose, a sample of 243 scientific publications indexed in Scopus and Web of Science has been selected, from which a second sample of 6,094 social impact records has been extracted from Altmetric, Crossref, and PlumX databases. A dual analysis has been conducted using specially designed software: on one hand, the scientific sample has been analyzed from a bibliometric perspective, and on the other hand, the social impact records have been studied. Comparative analysis based on the two dimensions, scientific and social, has focused on the evolution of scientific production with its corresponding social impact, sources, impact, and content analysis. The results indicate that scientific publications have had a high social impact (with an average of 25.08 social impact records per publication), with a significant increase in research interest starting from 2019, likely driven by the emotional implications of measures taken to curb the COVID-19 pandemic. Furthermore, a lack of alignment has been identified between articles with the highest scientific impact and those with the highest social impact, as well as a lack of alignment in the most commonly used terms from both scientific and social perspectives, a significant variability in the lag in months for scientific research to make an impact on social media, and the fact that the social impact of the research did not emerge from the interest of Twitter users unaffiliated with the research, but rather from the authors, publishers, or scientific institutions. The proposed comparative methodology can be applied to any field of study, making it a useful tool given that current trends in accreditation agencies propose the analysis of the repercussion of scientific research in social media.

Prevalence of irritable bowel syndrome and other functional gastrointestinal disorders in Uruguay

INTRODUCTION AND AIMS

Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders. Prevalence worldwide is estimated at 11%. There is little information on the prevalence of the other functional bowel disorders (FBDs). Our aim was to establish the prevalence of IBS and other FBDs according to the Rome IV criteria, in Uruguay.

MATERIALS AND METHODS

An observational, population-based prevalence study was conducted. Data were collected through an online questionnaire, utilizing the Rome IV criteria.

RESULTS

Of the 1,052 participants (79% women, mean patient age 44 years), 47.2% met the Rome IV diagnostic criteria for at least one of the FBDs analyzed. Functional constipation (FC) was the most frequent, at 18.7% (16.4-21.1), followed by IBS at 17.1% (14.9-19.4) and functional diarrhea (FD) at 15.4% (13.3-17.6). IBS with constipation (IBS-C) was the most frequent IBS subtype (35%) and the IBS with diarrhea (IBS-D) subtype predominated in men. All FBDs were more prevalent in women and youths. Of the survey participants with a FBD, 59% stated that they perceived no worsening of their symptoms related to the COVID-19 pandemic.

CONCLUSIONS

Ours is the first prevalence study on FBDs conducted on the Uruguayan general population. Half of the participants surveyed presented with a FBD analyzed in the study. FC was the most frequent, followed by IBS and FD. The prevalence rate of IBS was the highest, based on the Rome IV diagnostic criteria, and constipation was the most frequent subtype.

The Impact of the SARS-COVID-19 Lockdowns on the Subjectively Perceived Performance Level of Amateur Athletes after Returning to the Gyms

Since December 2019, few issues have garnered as much global attention as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-19). The imposed lockdowns in 2020/21, which led to the closure of all gyms, barred people from participating in their favourite sports activities. This study explores athletes' self-evaluations of their performance levels upon return to training facilities post-reopening. Data were collected in May 2021, after the end of the second lockdown, using a national online questionnaire. The study recorded 20 demographic and training-specific parameters to discern the factors influencing self-perceived performance upon resuming gym activities after the 2020/2021 lockdown. A total of 1378 respondents participated in the study. Of the total number of participants, 27.5% (365) reported regaining 100% of their original performance level after reopening their studios, a proportion that comprised 212 males, 150 females, and 3 individuals of unspecified gender. Additionally, 35.7% (474) estimated their performance level to be up to 75%, followed by 30% (398) recording their performance level at 50%, and a minority of 6.8% (90) determining their performance level to be up to 25%. Exercise intensity prior to lockdown, training experience, sex, and concurrent practice of another sport significantly influenced the athletes' self-assessment of their current fitness levels (p > 0.001, p > 0.001, p > 0.001, and 0.006, respectively). We need to understand the factors that shape self-perception, especially in case of another lockdown, in order to provide preventive assistance concerning mental and physical well-being. Positive influences on self-perception include prior athletic experience, intensive training before the lockdown, and continued participation in sports throughout the lockdown. Younger age is also favourable, but this may not necessarily reflect the benefits of youth; rather, it could indicate the current lack of accessible online sports activities for older individuals. Women, however, might have a less favourable perception of their own athletic performance.

Utilizing AI for extracting insights on post WHO's COVID-19 vaccination declaration from X (Twitter) social network

This study explores the use of artificial intelligence (AI) to analyze information from X (previously Twitter) feeds related to COVID-19, specifically focusing on the time following the World Health Organization's (WHO) vaccination announcement. This aspect of the pandemic has not been studied by other researchers focusing on vaccination news. By utilizing advanced AI algorithms, the research aims to examine a wealth of data, sentiments, and trends to enhance crisis management strategies effectively. Our methods involved collecting a dataset of tweets from December 2020 to July 2021. By using specific keywords strategically, we gathered a substantial 15.5 million tweets, focusing on important hashtags like #vaccine and #coronavirus while filtering out irrelevant replies and retweets. The assessment of three different machine learning models-BiLSTM, FFNN, and CNN - highlights the exceptional performance of BiLSTM, achieving an impressive F1-score of 0.84 on the test set, with Precision and Recall metrics at 0.85 and 0.83, respectively. The study provides a detailed visualization of global sentiments on COVID-19 topics, with a main goal of extracting insights to manage public health crises effectively. Sentiment labels were predicted using various classification models and categorized as positive, negative, and neutral for each country after adjusting for population differences. An important finding from the analysis is the variation in sentiments across regions, for instance, with Eastern European countries showing positive views on post-vaccination economic recovery, while China and the United States express negative opinions on the same topic.

Positive and negative emotions during the COVID-19 pandemic: A longitudinal survey study of the UK population

The COVID-19 pandemic has had a profound impact on society; it changed the way we work, learn, socialise, and move throughout the world. In the United Kingdom, policies such as business closures, travel restrictions, and social distance mandates were implemented to slow the spread of COVID-19 and implemented and relaxed intermittently throughout the response period. While negative emotions and feelings such as distress and anxiety during this time of crisis were to be expected, we also see the signs of human resilience, including positive feelings like determination, pride, and strength. A longitudinal study using online survey tools was conducted to assess people's changing moods during the pandemic in the UK. The Positive and Negative Affect Schedule (PANAS) was used to measure self-reported feelings and emotions throughout six periods (phases) of the study from March 2020 to July 2021. A total of 4,222 respondents participated in the survey, while a sub-group participated in each of the six study phases (n = 167). The results were analysed using a cross-sectional study design for the full group across each study phase, while prospective cohort analysis was used to assess the subset of participants who voluntarily answered the survey in each of the six study phases (n = 167). Gender, age and employment status were found to be most significant to PANAS score, with older people, retirees, and women generally reporting more positive moods, while young people and unemployed people generally reported lower positive scores and higher negative scores, indicating more negative emotions. Additionally, it was found that people generally reported higher positive feelings in the summer of 2021, which may be related to the relaxation of COVID-19-related policies in the UK as well as the introduction of vaccines for the general population. This study is an important investigation into what allows for positivity during a crisis and gives insights into periods or groups that may be vulnerable to increased negative states of emotions and feelings.

Examining evidence for a relationship between human-animal interactions and common mental disorders during the COVID-19 pandemic: a systematic literature review

Introduction

COVID-19 lockdowns, shelter in place, closures of transportation and mental health services, and dearth of mental health providers created new barriers to obtaining support for mental health needs at a time of increased rates of anxiety and depression. During the pandemic, a record number of households owned and adopted pets, opening a potential avenue to investigate the relationship between pets and mental health. This systematic literature review examined the question: What is the evidence for a relationship between human-animal interaction and/or animal ownership and common mental disorders among adults who interacted with pets compared to adults who did not during the COVID-19 pandemic?

Methods

To address this question, four databases were searched: Medline, PsycINFO, Web of Science, and SCOPUS for peer-reviewed literature published between 2020 and July 2023. Of the 1,746 articles identified by the searches, 21 studies were included in this review.

Results

Results suggest that there exists a relationship between animal ownership and strong pet attachment and pet interaction, though the directionality of the relationship was not investigated by the included studies. There was an association between having a stronger relationship with a pet and lower feelings of depression and other mental health symptoms. There was also evidence of an association between anxiety and higher levels of animal attachment.

Conclusion

Understanding the association between human-animal interaction and common mental disorders may be helpful to clinicians assessing the mental health of clients. Clinicians may glean additional insight about stressors, risk factors, social supports, and lifestyle of clients based on the client's status as a pet owner. Future research could further explore the direction of the causal relationship of human-animal interaction and/or animal ownership on common mental disorders; this could further inform how the HAI relationship can be used to support clients with mental health struggles.

Identification and nutritional management of malnutrition and frailty in the community: the process used to develop an Australian and New Zealand guide

Malnutrition and frailty affect up to one-third of community-dwelling older adults in Australia and New Zealand (ANZ), burdening individuals, health systems and the economy. As these conditions are often under-recognised and untreated in the community, there is an urgent need for healthcare professionals (HCPs) from all disciplines to be able to identify and manage malnutrition and frailty in this setting. This paper describes the systematic and iterative process by which a practical guide for identifying and managing malnutrition and frailty in the community, tailored to the ANZ context, was developed. The development of the guide was underpinned by the Knowledge-to-Action Framework and included the following research activities: (1) a comprehensive literature review; (2) a survey of ANZ dietitians' current practices and perceptions around malnutrition and frailty; (3) interviews with ANZ dietitians; and (4) a multidisciplinary expert panel. This resulted in the development of a guide tailored to the ANZ context that provides recommendations around how to identify and manage malnutrition and frailty in the community. It is now freely available online and can be used by all HCPs across several settings. The approach used to develop this guide might be applicable to other conditions or settings, and our description of the process might be informative to others who are developing such tools to guide practice in their healthcare environment.

The Psychosocial Effects of Lockdown Due to the COVID-19 Pandemic on Children in 2021

Objectives The COVID-19 pandemic led to a nationwide lockdown that isolated numerous children and adolescents, significantly affecting their mental well-being. Therefore, this study aimed to assess the challenges faced by children during the pandemic and identify the potential contributing factors. Additionally, given the existing concerns surrounding the mental health of female children and adolescents, our study aimed to investigate the presence of sex-based disparities in children's observed emotional and behavioral difficulties during the COVID-19 lockdown. Methods Participants in this study were parents of children aged 6-17 years. An observational cross-sectional study was conducted through verbal administration of a validated semi-structured questionnaire, the Parent Report Measure, from June 2021 to August 2021 at a nearby community health center. The questionnaire collected socio-demographic details and utilized the Strengths and Difficulties Questionnaire (SDQ), a screening tool to assess children's emotional and behavioral aspects during the six-month lockdown period. The responses were then analyzed using appropriate statistical tools like SPSS statistics, and cumulative SDQ scores were used to categorize participants. Results Out of the total 280 responses analyzed, the prosocial subscale exhibited the highest number of abnormal responses, 73 (26.1%), followed by conduct (42; 15%), hyperactivity (41; 14.6%), and peer (41; 14.6%) subscales. These results indicated that children displayed decreased empathy towards others, restlessness, fidgetiness, reduced attention span, frequent tantrums, and a preference for solitary activities. Furthermore, there was a significant association between abnormal subscale scores and the sex of children. Females showed a considerably higher prevalence of emotional problems (172; 61.5%) than males. Among the behavioral responses, a more significant proportion of females displayed abnormal scores in the conduct subscale (170; 60.7%), while abnormal hyperactivity scores were more frequently observed among males (178; 63.4%). Regarding the peer problems subscale, the proportion of females was slightly higher than males (150; 53.7%) and nearly equal in the prosocial domain. A more significant proportion of females displayed abnormal scores for overall difficulties 144 (51.5%), indicating a notable sex-based disparity. Conclusion Our findings highlight the pandemic's significant impact on many children's psychological well-being. The results emphasize the need for targeted interventions to address the mental health concerns that arose in this population. The observed disparity in emotional and behavioral difficulties among female children is particularly concerning, highlighting the need for gender-sensitive support and care. Various strategies can be helpful, such as virtual support groups, indoor recreational activities, reduced screen time and excessive news consumption, and effective communication with parents. Furthermore, our study also indicates the need to dive deep into such areas of pediatric research to understand and plan timely interventions.

What our children lost and gained at the time of school closure during the Covid-19 pandemic: a study on psychological distress, behavioural concerns and protective factors of resilience among preschool children in Kerala, India

BACKGROUND

The pandemic has put at risk the social and emotional development of children on account of the paucity of arenas for social interaction. This study from Kerala, India was conducted to assess the resilience factors, behavioural concerns, psychological distress symptoms among the children aged 3 to 5 years. We also tried to look into the lost opportunities that could have aided the social and emotional development of children like peer interaction, child care hours.

METHODS

The cross-sectional study was conducted among the children aged 3 to 5 years. A total of 535 children attending the immunisation clinics were enrolled by consecutive sampling. Devereux Early Childhood Assessment P2 (DECA P2) questionnaire was used to assess the levels of resilient factors and behavioural concerns in the study population.

RESULTS

We observed a high proportion of children in the area of need category of protective factors under DECA P2. The proportion of children falling under area of concern was 64.5%, 49%, 68.4% for attachment/relationship, self-regulation, and initiative respectively. 24.9% study subjects have a behavioural concern score that puts them in the area of need category. The logistic regression model we created identified 'Male Gender,' 'Mothers could spend only less time for child care' and 'electronic devices used as pacifier' as significant predictors for belonging to Area of need Behavioural Concerns T score category.

CONCLUSION

A large proportion of children aged between 3 to 5 years with reported behavioural concerns and lack of protective factors for socioemotional development. This can be attributed partly to the ongoing pandemic and its associated restrictions. The increased child care hours invested by parents or grandparents could have sized down the full impact that the pandemic would have had on the socio emotional development of the child. Increased time spent using electronic devices coupled with dwindled opportunities for interaction with peers have been notable challenges.

Changes in value priorities due to the COVID-19 pandemic-A 4-year cross-sectional study with German students

In March 2020, the WHO declared the coronavirus a pandemic. Since then, the German government has tried to control the spread of the virus with various restrictions. These restrictions had a direct impact on the life of German students. In this study, we investigate to what extent the restrictions led to a change of value priorities of German students. From January 2019 to January 2022, we conducted a cross-sectional study with four measurement points and, in total, 1,328 participants. Two measurement points were before the first outbreak of COVID-19 in Germany, one in the second lockdown phase and the third after two years in the pandemic. In this study, the students were asked to indicate their value priorities while solving a real-world decision problem important to them. Results suggest increased value priorities of the values Intellectual Fulfillment and Environment and Nature and a decrease of Family and Partner value priority as a direct effect of the second lockdown phase. We also found small differences regarding value priorities between the male and female subjects. The data show bounce-back effects as the pandemic became more normal to the students. In the long run, value priorities seem to be stable, with the exception of a longer-lasting increase in Freedom and Independence.

Addressing mental health need after COVID-19: a systematic review of remote EMDR therapy studies as an emerging option

Introduction

The COVID-19 pandemic has been associated with a substantial rise in mental health challenges, prompting a need for accessible and effective therapeutic interventions. This review summarizes the evidence on remote Eye Movement Desensitization and Reprocessing (EMDR) therapy delivered in response to the increased need.

Methods

A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases including PsychINFO, EMBASE, MEDLINE, and Web of Science were searched to identify studies assessing the efficacy of EMDR therapy administered online.

Results

Sixteen articles meeting the inclusion criteria were selected, involving 1,231 participants across various age groups. Studies covered remote individual and group EMDR sessions and self-administered computerized protocols. Findings indicate promising outcomes in reducing PTSD symptoms, anxiety, and depression.

Discussion

The analysis of the selected studies demonstrates the feasibility and potential efficacy of online EMDR as an accessible therapeutic option for addressing mental health difficulties, particularly during times of limited in-person interaction. However, the studies revealed limitations such as small sample sizes, absence of control groups, and reliance on self-reported measures.Systematic review registration: The present review was registered on "The International Database to Register Your Systematic Reviews" (INPLASY) with the registration number 2023120018 and DOI number 10.37766/inplasy2023.2.0068.

Suicide Risk Screening and Assessment before and after the COVID-19 Pandemic in New Inmates

(1) Background: Suicide is the main cause of death in Italian prisons. The largest number of inmates who killed themselves was recorded during three years of the COVID-19 pandemic. This study aimed to explore psychosocial risk factors for suicide among inmates incarcerated before and after the onset of COVID-19. (2) Methods: At prison reception, inmates underwent clinical interviews and were assessed using the Blaauw Scale and Suicide Assessment Scale. Psychological distress, measured by the Symptom Checklist-90-R, was compared between inmates admitted before and after COVID-19. Regression analyses were run to examine psychosocial vulnerabilities associated with suicidal intent in newly incarcerated individuals at risk of suicide. (3) Results: Among the 2098 newly admitted inmates (93.7% male) aged 18 to 87 years (M = 39.93; SD = 12.04), 1347 met the criteria for suicide risk, and 98 exhibited high suicidal intent. Inmates who entered prison after the onset of COVID-19 were older and had fewer social relationships. They had a higher prevalence of recidivism and substance abuse, along with elevated levels of psychological distress. An increase in perceived loss of control, anergia, obsessive-compulsive symptoms, phobic anxiety, and paranoid ideation emerged as the factors most strongly associated with high suicidal intent. (4) Conclusions: These findings support the value of psychosocial screening in promptly identifying inmates at risk of suicide, enabling the implementation of targeted, multi-professional interventions. Future research should replicate these results, with a focus on longitudinal studies that monitor the same inmates throughout their incarceration period.

Social media insights into spatio-temporal emotional responses to COVID-19 crisis

The Coronavirus pandemic has presented multifaceted challenges in urban emotional well-being and mental health management. Our study presents a spatio-temporal sentiment mining (STSM) framework to address these challenges, focusing on the space-time geography and environmental psychology. This framework analyzes the distribution and trends of 6 categories of public sentiments in Shanghai during the COVID-19 crisis, considering the potential urban spatial influencing factors. The research specifically draws on social media data temporally coinciding with the spread of COVID-19 and the pre-trained language model RoBERTa-wwm-ext to classify public sentiment, in order to characterize the distribution and trends of dominant urban sentiment under the influence of epidemic at different phases. The interactions between urban geospatial features and sentiments are further modelled and explained using LightGBM algorithm and SHapley Additive exPlanations (SHAP) technique. The experimental findings reveal the subtle yet dynamic impact of the urban environment on the long-term spatial variation and trends of public sentiment under the epidemic, with green spaces and socio-economic status emerging as significant factors. Regions with higher permanent population consumption demonstrated more positive sentiments, underscoring the significance of socio-economic factors in urban planning and public health policy. This research offers the most extensive analysis to date on the influence of urban characteristics on public sentiment during Shanghai's epidemic life cycle also lays the groundwork for applying the STSM framework in future crises beyond COVID-19.

"We have to lie low … that sort of poisons me more and more": A qualitative study of violent political rhetoric and health implications for Spanish and Chinese speaking immigrants

BACKGROUND

In recent years, the historical legacy of anti-immigrant sentiment in the US has resurfaced, fueled by a new wave of anti-immigrant political rhetoric. Violent political rhetoric, defined as either explicit or metaphorically targeted language to dehumanize targeted groups, can incite discriminatory treatment of immigrants at both interpersonal and institutional levels, shaping their health and healthcare experiences. This qualitative study explores and compares how Spanish- and Chinese-speaking immigrant populations in Chicago make sense of violent political rhetoric against their racial and ethnic identities, utilize coping strategies to maintain their sense of belonging, and experience downstream health consequences.

METHODS

In 2019, 14 semi-structured focus groups were conducted among immigrants to the U.S. (n = 79). Participants were recruited from four community sites in either Hispanic/Latino or Chinese neighborhoods in Chicago. Focus groups were conducted by racially- and linguistically concordant interviewers in Spanish, Mandarin, or Cantonese. The research team developed a codebook iteratively and analyzed transcripts using grounded theory and the constant comparison method.

RESULTS

Participants included Chinese (61%) and Spanish-speaking immigrants (39%), with an average age of 61.4 years (sd = 13); the majority were female (62%), unemployed (68%), and attained less than a high school diploma (53%). Self-reported stress due to political rhetoric was more pronounced among Spanish-speaking participants (93%) than Chinese participants (39.6%). Immigrants responded to manifestations of violent political rhetoric in numerous ways including mobilizing the model minority myth with internalized racism, anticipatory stress, and "high effort" coping mechanisms (John Henryism), all with downstream health effects.

CONCLUSION

Violent political rhetoric is one of the mechanisms by which racism and xenophobia exacerbate a toll on the health of racialized immigrant groups. These processes have implications for both interpersonal and institutional experiences, as well as health and healthcare interactions. We propose a conceptual model that outlines these mechanisms and points to potential areas of intervention to ameliorate immigrant health inequities.

Resilience of University Students During the Coronavirus Disease 2019 Pandemic and Results of a Pilot Positive Psychotherapy Intervention Study

Objective

University students were significantly affected by the 2019 coronavirus disease pandemic, with significant impacts on their mental health, resilience skills, and life skills. The primary aim of this study was to evaluate these parameters by focusing on the experiences of 472 university students as well as examining correlations between mental states, resilience, and life skills. The secondary aim was to conduct a pilot study of a 10-week psychoeducation program that uses positive psychotherapy to improve resilience skills.

Methods

The first phase of this research project was designed as a quantitative and correlative study, while the second phase was designed as a quasi-experimental model. Data collection tools used in the first phase included the Sociodemographic Information Form, Life Skills Scale (LSS), Symptom Checklist (SCL90R), and Brief Resilience Scale (BRS). The Resilience Scale for Adults (RSA) was used in the second phase. The sample group for the first phase was 472 university students from several university institutes in Cyprus, while the quasi-experimental group consisted of 33 psychology students from the University of Cyprus.

Results

The average mental symptoms score for students based on SCL90R was 1.10 ± 0.70, showing they have psychological symptoms and grievances. Significant negative correlations were found between the BRS general score and the LSS general and SCL90R scores (all P = .001). The model was found to be significant and could explain 18.5% of the effect according to the predictive status of LSS and SCL90R scores in BRS scores.

Conclusion

In conclusion, this study provides vital insights into the mental well-being of university students during the pandemic. The findings reveal a concerning prevalence of psychological symptoms and distress among students, indicating a significant impact of the COVID-19 crisis on their mental health. This research also demonstrated the effectiveness of targeted interventions. The positive changes in resilience skills and reduced mental health symptoms observed after the 10-week study period highlight the importance of proactive approaches. This study underscores the urgent need for accessible mental health resources and tailored support mechanisms for university students, especially during times of crisis. Addressing these issues is crucial for fostering a resilient and mentally healthy student population.

Where I am from matters: factors influencing behavioral and emotional changes in autistic individuals during COVID-19 in Latin America

Background

The COVID-19 pandemic brought an increased incidence of disease and mortality in the world at large, making it a particularly salient and stressful life event. For those individuals residing in Latin America, the pandemic was met with fragmented healthcare systems, economic downturn, and sociopolitical crisis which puts autistic individuals at risk for more detrimental outcomes. Behavioral and emotional challenges experienced by autistic individuals at the beginning of the pandemic could later develop into more severe symptomatology as the pandemic progresses. The present study aimed to explore changes in dysregulated (overt and internalizing) behaviors and preoccupation with getting sick during the COVID-19 pandemic among autistic children in 7 Latin American countries.

Method

Sample consisted of 1,743 caregivers, residing in: Argentina (n = 677, 38.8%) Brazil (n = 156, 9%), Chile (n = 251, 14.4%), Dominican Republic (n = 171, 9.8%), Mexico (n = 126, 7.2%), Uruguay (n = 259, 14.9%) and Venezuela (n = 103, 5.9%). The majority of caregivers who completed the questionnaire were mothers (85.1%), and most had a male autistic child (81.6%). A series of independent sample t-tests were conducted to assess country differences in dysregulated behaviors and preoccupation with getting sick. Linear regressions were conducted to identify which demographic characteristics and micro-level contextual factors predicted dysregulated overt behaviors and psychological changes.

Results

Contextual factors, such as country of residence, were related to preoccupation with getting sick and dysregulated behavior. Particularly, residing in Mexico and Brazil were related to changes in preoccupation with getting sick and mental health concerns. Coexistence predicted dysregulated internalizing behaviors, while being older significantly predicted preoccupation with getting sick. Increased screen time only predicted anxiety.

Conclusion

Our findings highlight differences and predictions of behavioral challenges and psychological changes based on certain contextual factors and individual characteristics while experiencing severe life stressors such as a worldwide pandemic. This knowledge could help inform policies and decrees aimed at protecting those most vulnerable due to their increased difficulty adapting to change.

"The COVID-19 pandemic and operational challenges, impacts, and lessons learned: a multi-methods study of U.S. prison systems"

BACKGROUND

The purpose of this study was to examine how the COVID-19 pandemic changed U.S. prison operations and influenced the daily work of prison staff.

METHODS

In collaboration with the National Institute of Corrections, we administered a survey to 31 state correctional agencies in April 2021 and conducted five focus groups with 62 correctional staff.

RESULTS

Using a framework of bounded rationality, we find that daily operations were strained, particularly in the areas of staffing, implementing public health policy efforts, and sustaining correctional programming. While prison systems and staff were under-prepared to respond to the pandemic, they attempted to address complex problems with the limited resources they had.

CONCLUSIONS

Results underscore a need in corrections for prioritizing further developments and reviews of collaborative policies and practices for managing crisis situations. Seeking avenues for leveraging technological innovations to improve operations and facilitate enhanced communication are especially warranted. Finally, meaningful reductions in the prison population, changes in physical infrastructure, and expansions of hiring and retention initiatives are critical for positioning prisons to manage future emergencies.

ED Visits for Schizophrenia Spectrum Disorders During the COVID-19 Pandemic at 5 Campus Health Systems

Importance

Although substantial research has reported grave population-level psychiatric sequelae of the COVID-19 pandemic, evidence pertaining to temporal changes in schizophrenia spectrum disorders in the US following the pandemic remains limited.

Objective

To examine the monthly patterns of emergency department (ED) visits for schizophrenia spectrum disorders after the onset of the COVID-19 pandemic.

Design, Setting, and Participants

This observational cohort study used time-series analyses to examine whether monthly counts of ED visits for schizophrenia spectrum disorders across 5 University of California (UC) campus health systems increased beyond expected levels during the COVID-19 pandemic. Data included ED visits reported by the 5 UC campuses from 2016 to 2021. Participants included persons who accessed UC Health System EDs had a diagnosis of a psychiatric condition. Data analysis was performed from March to June 2023.

Exposures

The exposures were binary indicators of initial (March to May 2020) and extended (March to December 2020) phases of the COVID-19 pandemic.

Main Outcomes and Measures

The primary outcome was monthly counts of ED visits for schizophrenia spectrum disorders. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes, categorized within Clinical Classification Software groups, were used to identify ED visits for schizophrenia spectrum disorders and all other psychiatric ED visits, from the University of California Health Data Warehouse database, from January 2016 to December 2021. Time-series analyses controlled for autocorrelation, seasonality, and concurrent trends in ED visits for all other psychiatric conditions.

Results

The study data comprised a total of 377 872 psychiatric ED visits, with 37 815 visits for schizophrenia spectrum disorders. The prepandemic monthly mean (SD) number of ED visits for schizophrenia spectrum disorders was 519.9 (38.1), which increased to 558.4 (47.6) following the onset of the COVID-19 pandemic. Results from time series analyses, controlling for monthly counts of ED visits for all other psychiatric conditions, indicated 70.5 additional ED visits (95% CI, 11.7-129.3 additional visits; P = .02) for schizophrenia spectrum disorders at 1 month and 74.9 additional visits (95% CI, 24.0-126.0 visits; P = .005) at 3 months following the initial phase of the COVID-19 pandemic in California.

Conclusions and Relevance

This study found a 15% increase in ED visits for schizophrenia spectrum disorders within 3 months after the initial phase of the pandemic in California across 5 UC campus health systems, underscoring the importance of social policies related to future emergency preparedness and the need to strengthen mental health care systems.

Vaccine Hesitancy in India: Facilitators and Inhibitors

COVID-19 is yet not completely over; however, many people are hesitant to take COVID-19 vaccines despite their availability. Vaccine hesitancy is a major roadblock to attaining normalcy and controlling the spread of the COVID-19 virus. The present research used a multitheoretical framework (Health Belief Model, 3Cs framework, fatalism, and religious fatalism) to comprehend the complexity of vaccine hesitancy. Thus, the present study aimed at exploring vaccine hesitancy in India by using key components of the Health Belief Model, 3Cs framework, fatalism, religious fatalism, and some demographics as predictors. Data were collected electronically with the help of Google Forms from 639 Indian adults following snowballing and convenience sampling techniques with standardized measures (albeit some modifications to suit the context of the study). Descriptive analysis and hierarchical regression analysis were run in SPSS (V-22) to analyze the data. Results revealed that participants of the present study scored relatively high on vaccine hesitancy. Muslims as compared with Hindus and vaccination status emerged as significant predictors of vaccine hesitancy out of the demographic factors. Fear of COVID-19, vaccine convenience, and religious fatalism also significantly predicted vaccine hesitancy. Thus, a comprehensive approach is needed to strategically use these predictors to control vaccine hesitancy.

Thinking about it: the impact of COVID-19-related stimuli on prospective memory

Background

Since 2020, information regarding COVID-19 has been a constant presence in the news, in our conversations and thoughts. Continuous exposure to this type of stimuli could have an impact on cognitive processes essential for our everyday activities, such as prospective memory (PM). PM is the ability to remember to perform an intention at a specific point in the future, like remembering to take prescribed medicines at a specific time or to turn off the stove after cooking. Do COVID-related stimuli affect our ability to perform a PM task?

Methods

To answer this question, we proposed a novel version of the classical paradigm used to investigate PM. Namely, this paradigm includes a baseline condition, in which an ongoing task is presented alone, and a PM condition in which the same task is proposed again together with a second (prospective) task. In this study, a short video clip was presented between the baseline and the PM condition. The video clip displayed either neutral, negative, or COVID-related content. Additionally, participants were asked to respond to two questionnaires and a series of questions regarding their well-being and experience with the pandemic. Namely, the DASS-21 scale (evaluating depression, anxiety, and stress), and the COVID-19-PTSD questionnaire (a questionnaire evaluating post-traumatic stress disorder symptoms related to the pandemic experience) were administered. Participants' performance and responses were analyzed using a linear mixed effect (LME) model approach, and correlation analyses were run to highlight possible correlations between participants' scores in the DASS-21, the COVID-19-PTSD, and the additional questions on their personal experience with the pandemic.

Results

The LME models revealed significant effects of the displayed video on performance: in line with previous studies, the clip displaying standard negative contents led to impaired accuracy in the ongoing task in the PM condition, compared to the Baseline. In contrast, participants who saw the COVID-related clip showed improved accuracy in the ongoing task compared to the other participants, selectively in the block performed after the video clip was displayed (PM condition). Furthermore, the explanatory power of the LME model calculated on accuracy to the ongoing trials was enhanced by the inclusion of the scores in the anxiety subscale of the DASS-21, suggesting a detrimental role of anxiety. Altogether, these results indicate a different effect of the exposure to classical negative contents (associated with a cost in terms of accuracy in the ongoing task between the baseline and the PM condition) and the pandemic-related one, which was instead characterized by a higher accuracy to ongoing trials compared to the other video clips. This counterintuitive finding seems to suggest that COVID-related stimuli are processed as "acute stressors" rather than negative stimuli, thus inducing a state of increased alertness and responsivity.

Reduction of adverse events in a psychiatric inpatient eating disorder unit during the COVID-19 pandemic

TOPIC

Globally, the COVID-19 pandemic had impacted the health care delivery including inpatient psychiatric facilities. Within psychiatric settings, life of inpatients was profoundly altered.

PURPOSE

This paper aimed to understand if pandemic-related changes within an inpatient Eating Disorder Unit in a specialized psychiatric hospital in Ontario, Canada impacted incidence of aggression and use of coercive methods among adolescents.

SOURCE USED

An exploratory study design was used to examine incidence of aggression, self-harm, code whites, staff assist, restraints and seclusion, and nasogastric feeding (NGF) among adolescents with eating disorders before and after the modified service delivery within the inpatient unit. Descriptive analyses were conducted.

RESULTS

Analyses revealed a complete reduction in episodes of self-harm, aggression, staff assists, use of restraint and seclusion as well as an 80.14% reduction on average use of NGF.

CONCLUSION

Authors speculate that the change in environment and program delivery method, peer influence, and shift in power relations between patient and staff may have resulted in improved experiences. This report provides insights to adopt a recovery-oriented service delivery for adolescents with eating disorders in inpatient settings.

Impact of social isolation caused by the COVID-19 pandemic on the mood profile of active and sedentary older adults: physical activity as a protective factor

Background

The COVID-19 pandemic has changed our habits and lifestyle due to social isolation and mobility restrictions. This new scenario, together with the fear of contracting the coronavirus, influenced mental health, especially among older adults, who presented reductions in social contact and physical activity (PA). Thus, the objective of the study was to analyze the impact caused by social isolation during the COVID-19 pandemic on the mood states of active and sedentary older adults.

Methods

This is an observational study conducted during the COVID-19 pandemic. Older adults aged over 60 years, who were registered in the database of the Secretariat for the Promotion of Citizenship from a city in southern Brazil, participated in the research. An online questionnaire was applied with questions about sociodemographic characteristics, level of PA, confinement, and mood states in two periods: May 2020 and June 2021. The Mann-Whitney U test was used to compare the mood states of active and inactive individuals during the pandemic.

Results

One hundred and fifty participants answered the questionnaire, of which 80 (53.3%) reported practicing PA. More active older adults suffered fewer changes in mood when compared to inactive older adults, with lower levels of confusion (p = 0.035), depression (p = 0.002), and fatigue (p = 0.000). Older adults confined for more than 50 days were more likely to develop depression. In addition, the mood state correlated with the variable fear of contracting the coronavirus; the greater the fear, the greater the mental confusion, depression, fatigue, and tension, and the lower the vigor in the older adults. The practice of PA is also correlated with the mood state; the greater the number of hours dedicated to PA, the lower the confusion, depression, fatigue, and tension of the older adults.

Conclusion

The practice of PA positively influenced the mental health of older adults during periods of isolation and social restrictions. PA has a protective factor for the development of mental health problems and improves mood states, with greater time performing PA leading to more benefits.

The Impact of the COVID-19 Pandemic on Patients With CKD: Systematic Review of Qualitative Studies

RATIONALE & OBJECTIVE

COVID-19 disproportionately affects people with comorbidities, including chronic kidney disease (CKD). We describe the impact of COVID-19 on people with CKD and their caregivers.

STUDY DESIGN

A systematic review of qualitative studies.

SETTING & STUDY POPULATIONS

Primary studies that reported the experiences and perspectives of adults with CKD and/or caregivers were eligible.

SEARCH STRATEGY & SOURCES

MEDLINE, Embase, PsycINFO, CINAHL searched from database inception to October 2022.

DATA EXTRACTION

Two authors independently screened the search results. Full texts of potentially relevant studies were assessed for eligibility. Any discrepancies were resolved by discussion with another author.

ANALYTICAL APPROACH

A thematic synthesis was used to analyze the data.

RESULTS

Thirty-four studies involving 1,962 participants were included. Four themes were identified: exacerbating vulnerability and distress (looming threat of COVID-19 infection, intensifying isolation, aggravating pressure on families); uncertainty in accessing health care (overwhelmed by disruption of care, confused by lack of reliable information, challenged by adapting to telehealth, skeptical about vaccine efficacy and safety); coping with self-management (waning fitness due to decreasing physical activity, diminishing ability to manage diet, difficulty managing fluid restrictions, minimized burden with telehealth, motivating confidence and autonomy); and strengthening sense of safety and support (protection from lockdown restrictions, increasing trust in care, strengthened family connection).

LIMITATIONS

Non-English studies were excluded, and inability to delineate themes based on stage of kidney and treatment modality.

CONCLUSIONS

Uncertainty in accessing health care during the COVID-19 pandemic exacerbated vulnerability, emotional distress, and burden, and led to reduced capacity to self-manage among patients with CKD and their caregivers. Optimizing telehealth and access to educational and psychosocial support may improve self-management and the quality and effectiveness of care during a pandemic, mitigating potentially catastrophic consequences for people with CKD.

PLAIN-LANGUAGE SUMMARY

During the COVID-19 pandemic, patients with chronic kidney disease (CKD) faced barriers and challenges to accessing care and were at an increased risk of worsened health outcomes. To understand the perspectives about the impact of COVID-19 among patients with CKD and their caregivers, we conducted a systematic review of 34 studies involving 1,962 participants. Our findings demonstrated that uncertainty in accessing care during the COVID-19 pandemic exacerbated the vulnerability, distress, and burden of patients and impaired their abilities for self-management. Optimizing the use of telehealth and providing education and psychosocial services may mitigate the potential consequences for people with CKD during a pandemic.

Substance Use among Emerging Adults during the COVID-19 Pandemic: A Review through the Lens of Sustainable Development Goals

Public health initiatives, including lockdowns to reduce the spread of COVID-19, have resulted in societal stressors like loneliness, job loss, and economic collapse linked to worsening mental health outcomes, such as depression, anxiety, and coping-related substance use. The various psychosocial stressors caused by the pandemic have potentially led to the increased use of substances across the globe, particularly among emerging adults. The current study summarises the literature on substance use among emerging adults during the COVID-19 pandemic. The terms "coronavirus", "COVID-19", "substance use", "substance abuse", "drug use", drug abuse", "emerging adults", and "young adults" were all used in different combinations throughout the search, using the Scopus, PubMed, and JSTOR databases. Using this method, a total of 28 English-language citations published between 2020 and 2023 were obtained. Following a study of the articles mentioned above, 16 papers were removed. The remaining 12 papers were included in this review. Even though substance use dropped when COVID-19 lockdowns began, it rose when restrictions were removed, particularly among those with prior substance use. Studies related to mental health need to assess substance use, as many emerging adults use substances to cope with distress, including isolation and loneliness, which are part of the current mental health crisis among emerging adults.

Emotions, COVID-19 related thoughts and satisfaction with life during the critical period from control to relaxation

Introduction

In the context of declining mortality rates and increasing infectivity, it has become unavoidable for the majority of individuals to experience a COVID-19 infection at some point. This study aimed to investigate the psychological well-being of the general population during China's transition period from strict control measures to relaxed policies in COVID-19 prevention and control, as well as the impact of COVID-19 related thoughts on emotion and life satisfaction during widespread infections.

Methods

A cross-sectional study was conducted involving a sample size of 1578 participants. Participants completed self-report questionnaires assessing positive and negative emotions, thoughts about COVID-19, and satisfaction with life. Demographic characteristics such as sex, age, and education level were controlled for in the analysis.

Results

The findings revealed that individuals who had been infected with COVID-19 (specifically the Omicron variant BA.5.2 or BF.7) reported lower levels of positive emotions compared to those who were uninfected or had recovered from the infection. There was a significant relationship between COVID-19-related thoughts, emotions, and life satisfaction. Positive COVID-19 related thoughts were found to mediate the relationship between negative emotions and satisfaction with life.

Discussion

This study represents a comprehensive examination conducted in China, focusing on assessing the impact of the COVID-19 pandemic on the general population during the critical transition period from control to relaxation. Throughout this period, the number of infections experienced fluctuations, initially rising but eventually declining over a one-month span. In such a momentous historical period, maintaining a positive perspective on COVID-19 and its management becomes paramount in enhancing the emotional well-being, life satisfaction and overall well-being of individuals.

Perceptions of everyday life during lenient COVID-19 restrictions in Sweden- an interview study

BACKGROUND

Both COVID-19 and its associated societal restrictions have affected individuals' health and everyday life. In Sweden, more lenient public health restrictions were implemented, with individuals asked to act responsibly in terms of reducing spread of disease. The majority of studies reporting on experiences of Covid-19 restrictions have been in the context of more substantial mandatory rules aimed at reducing social contact, therefore it is important to describe how more lenient restrictions have impacted individuals' well-being. This study aims to describe perceptions of everyday life during the first wave of the COVID-19 pandemic, perceived by individuals with no underlying medical condition, and living with more lenient public health restrictions in Sweden.

METHOD

The participants were recruited from individuals who originally had participated in an online survey about life satisfaction, health, and physical activity. Fifteen individuals (median age 49, range 26-76 years, seven women) in various social situations, such as living alone/cohabiting, having children at home, geographical area and size of city were interviewed. Qualitative content analysis was applied to the data.

RESULTS

An overall theme "Both hindrances and opportunities in important life domains were experienced within the same person during lenient Covid-19 restrictions" was derived and covered three categories: "New possibilities of flexibility in work and better health", "Life went on as usual with minor adjustments" and "Everyday life changed and became more difficult" together with eight subcategories. For most participants, both facilitating and hindering important domains in life were described. Unexpected findings were positive experiences regarding working from home, physical activities, leisure time activities and the balance between work and leisure time. In areas where only minor adjustments were made, life was perceived as going on as before. On the other hand, restrictions increased worries and were perceived to have negative effects on social participation.

CONCLUSION

The impact of the pandemic and lenient restrictions in Sweden on the participants´ everyday life was multifaceted. Both hindrances and opportunities in important life domains were experienced within the same person. An increased flexibility in work- and leisure activities were perceived having positive effects for health and wellbeing and led to a better balance in life.

The association between COVID-19 preventive behaviors and mental health conditions

BACKGROUND

An unintended consequence of COVID-19 quarantine preventive measures, is the increased prevalence of anxiety and depression. The purpose of this study was to examine the association between COVID-19 preventive behaviors and mental health conditions.

METHODS

A cross-sectional study was conducted using secondary data collected weekly from US adults aged 18 and older nationwide as part of the COVID-19 Household Impact Survey (CIS) from the University of Chicago. Logistic regression examined associations between COVID-19 preventive behaviors (wearing a face mask, washing or sanitizing hands, and keeping six-feet distance from those outside their household), mental health conditions (self-reporting feeling nervous, anxious, or on edge, feeling lonely, and feeling hopeless about the future and a history of a mental health condition) and demographic factors.

RESULTS

Majority of study participants were under 60 years (62.2%), female (55.8%), and non-Hispanic White (72.2%). Overall, participants more likely to have followed all three COVID-19 measures were those who reported high psychological distress compared to those with low distress for feeling anxious (adj. OR 1.16, 95% CI: 1.06-1.28, p = 0.002), lonely (adj. OR 1.12, 95% CI: 1.02-1.23, p = 0.019) or hopeless (adj. OR 1.10, 95% CI: 1.00-1.21, p = 0.043) for more than a day during the past 7 days.

CONCLUSION

Our findings highlight that individuals with mental health conditions reported more psychological distress. Specifically, feeling depressed, anxious, lonely, and hopeless were triggered and exacerbated as a result of the pandemic and may have long-term effects on general well-being and productivity. Therefore, our findings have important implications on the need to include mental health promotion as part of pandemic response efforts. This includes developing policies and allocating funding so as to ensure sustainable mental health interventions and support, public and provider education on the importance of screening for mental health issues.

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.