The Effect of Telerehabilitation on Physical Fitness and Depression/Anxiety in Post-COVID-19 Patients: A Randomized Controlled Trial

Aim: The aim of this research was to evaluate the impact of a telerehabilitation program on physical fitness, muscle strength, and levels of depression and anxiety in post-COVID-19 patients. Methods: Thirty-two individuals recovered from COVID-19 (48.20±12.82 years) were allocated into either a telerehabilitation (TG n=16) or control (CG n=16) group. Physical fitness, handgrip strength, depression and anxiety levels were assessed before and after an 8-week intervention. Results: There was a significant improvement in muscle strength in both groups. Physical fitness significantly increased compared to the CG at the end of the intervention. Levels of anxiety and depression significantly decreased after the intervention when compared to the CG. Conclusion: Eight weeks of functional telerehabilitation training is a viable and efficient way to rehabilitate patients affected by COVID-19, as it improved physical conditioning and mental health. © 2023, University Library System, University of Pittsburgh. All rights reserved.

University students? connectivity during the pandemic generated by the COVID-19

The topic refers to the processes of connectivity, access to digital tools, and the disposition of university students who were affected by their university semesters in person, and due to the health emergency caused by COVID-19, they had to go to virtual classes in an improvised way. The general aim was to inquire about the possession of digital tools, connectivity, and student disposition for virtual classes. This article is the product of an exploratory, non-experimental and descriptive study where the information was collected through an online survey published in a massive WhatsApp group, where there are more than 240 students of the Bachelor of Mathematics at the Universidad Del Atlantico whose total population ranges at 790 students. The main results obtained are the changes in a general way like this: 1) Some students do not feel prepared to receive classes remotely or complete enrollment procedures virtually;2) It is necessary to privilege the use of platforms that are low data consumption;and 3) In the region, the electricity service is not guaranteed on a regular basis, turning off access to connectivity.

AFMC: An alignment framework for multiple computing services and providers

The Hirschberg algorithm is commonly used for protein sequence alignment, which is a very important task in bioinformatics. This article presents the AFMC framework for using the Hirschberg method to perform sequence alignment in multiple cloud computing services of different models, such as Infrastructure-as-a-Service and Function-as-a-Service (FaaS). Experiments were carried out in which several instances of AWS EC2, Azure VMs and Google Compute Engine as well as varied configurations of AWS Lambda, Azure Function, and Google Cloud Function were used to pairwise align COVID-19 spike proteins. The services were submitted to different levels of simultaneity to align the genetic sequences. The findings reveal that there is a tradeoff between predicted execution time and cost for this application, for example, FaaS-oriented cloud service models generally took less time to process the workloads. On the other hand, it was observed that, as the level of concurrence increased, there was a marked augmentation in cost. In this context, a framework that provides multi cloud solutions for bioinformatics such as AFMC is essential. © 2023 John Wiley & Sons, Ltd.

Mutation and SARS-CoV-2 strain competition under vaccination in a modified SIR model.

The crisis caused by the COVID-19 outbreak around the globe raised an increasing concern about the ongoing emergence of variants of the virus that may evade the immune response provided by vaccines. New variants appear due to mutation, and as the cases accumulate, the probability of the emergence of a variant of concern increases. In this article, we propose a modified susceptible, infected, and recovered (SIR) model with waning immunity that captures the competition of two strain classes of an infectious disease under the effect of vaccination with a highly contagious and deadly strain class emerging from a prior strain due to mutation. When these strains compete for a limited supply of susceptible individuals, changes in the efficiency of vaccines may affect the behaviour of the disease in a non-trivial way, resulting in complex outcomes. We characterise the parameter space including intrinsic parameters of the disease, and using the vaccine efficiencies as control variables. We find different types of transcritical bifurcations between endemic fixed points and a disease-free equilibrium and identify a region of strain competition where the two strain classes coexist during a transient period. We show that a strain can be extinguished either due to strain competition or vaccination, and we obtain the critical values of the efficiency of vaccines to eradicate the disease. Numerical studies using parameters estimated from publicly reported data agree with our theoretical results. Our mathematical model could be a tool to assess quantitatively the vaccination policies of competing and emerging strains using the dynamics in epidemics of infectious diseases.

Oculomotor, vestibular, reaction time, and cognitive tests as objective measures of neural deficits in patients post COVID-19 infection.

Objective: An alarming proportion (>30%) of patients affected by SARS-CoV-2 (COVID-19) continue to experience neurological symptoms, including headache, dizziness, smell and/or taste abnormalities, and impaired consciousness (brain fog), after recovery from the acute infection. These symptoms are self-reported and vary from patient to patient, making it difficult to accurately diagnose and initiate a proper treatment course. Objective measures to identify and quantify neural deficits underlying the symptom profiles are lacking. This study tested the hypothesis that oculomotor, vestibular, reaction time, and cognitive (OVRT-C) testing using eye-tracking can objectively identify and measure functional neural deficits post COVID-19 infection. Methods: Subjects diagnosed with COVID-19 (n = 77) were tested post-infection with a battery of 20 OVRT-C tests delivered on a portable eye-tracking device (Neurolign Dx100). Data from 14 tests were compared to previously collected normative data from subjects with similar demographics. Post-COVID subjects were also administered the Neurobehavioral Symptom Inventory (NSI) for symptom evaluation. Results: A significant percentage of post COVID-19 patients (up to 86%) scored outside the norms in 12 out of 14 tests, with smooth pursuit and optokinetic responses being most severely affected. A multivariate model constructed using stepwise logistic regression identified 6 metrics as significant indicators of post-COVID patients. The area under the receiver operating characteristic curve (AUC) was 0.89, the estimated specificity was 98% (with cutoff value of 0.5) and the sensitivity was 88%. There were moderate but significant correlations between NSI domain key variables and OVRT-C tests. Conclusions: This study demonstrates the feasibility of OVRT-C testing to provide objective measures of neural deficits in people recovering from COVID-19 infection. Such testing may serve as an efficient tool for identifying hidden neurological deficits post COVID-19, screening patients at risk of developing long COVID, and may help guide rehabilitation and treatment strategies.

An overweight/obesity survey among dogs and cats attended at a veterinary teaching hospital during the second year of the COVID-19 pandemic

Anecdotal reports suggest that the new coronavirus SARS-CoV-2 pandemic (COVID-19) has increased overweight and obesity prevalence in dogs and cats. The present report aimed to perform a retrospective overweight/obesity survey on 1,001 consecutive cases attended in the Veterinary Clinics Hospital from the Federal University of Rio Grande do Sul during its reopening to the public after months closed due to the pandemic. The overall overweight or obesity observed prevalence was 36.63%;being the frequency in cats slightly greater (38.37%) than compared to dogs (35.76%). No local increase in these frequencies was detected. Neutering (dogs and cats), age greater than 10 years (dogs), and male gender (cats) were factors associated with overweight/obesity. Bodyweight was not registered in about 30% of the medical records, while the body condition score was not registered in about 50% of the cases. These flaws were more often observed in feline medical records and efforts to improve these data records are warranted. Copyright © 2022,Arquivo Brasileiro de Medicina Veterinaria e Zootecnia. All Rights Reserved.

Analise Da Resposta Imunologica Celular Em Idosos Apos Vacinacao Com Coronavac

Objetivos: A COVID-19 e uma doenca infecciosa, onde a maioria dos infectados desenvolve quadros leves, no entanto, idosos e individuos com comorbidades estao relacionados aos casos mais graves. A fim de conter a propagacao da doenca, foram desenvolvidas vacinas com a finalidade de inducao de memoria imunologica. Entretanto, estudos sobre a efetividade da imunizacao em idosos ainda sao escassos e nao se sabe exatamente como sera o comportamento nessa populacao. Dessa forma, o objetivo desta pesquisa foi avaliar esta resposta imune celular em idosos de Instituicoes de Longa Permanencia (ILPS) no estado de Sergipe, Brasil, induzida pela vacina CoronaVac. Material e Metodos: Este estudo prospectivo foi realizado com idosos (grupo idosos-GI) e profissionais (grupo controle-GC) de ILPS. Todos receberam a vacina CoronaVac e as analises foram feitas 30 dias apos a administracao da segunda dose da vacina. Respeitando-se os aspectos eticos e legais, os participantes foram submetidos a um questionario estruturado, e foram coletadas amostras de sangue periferico para analise das populacoes de linfocitos T CD4+ e CD8+ e os subtipos de memoria que foram avaliados por citometria de fluxo multiparametrica. Resultados: Foram avaliados 28 individuos, sendo 23 idosos (GI) e cinco profissionais (GC). No GI, nove eram do sexo feminino e 14 do masculino, com medias de idade 81,6 (67-89) e 74,1 (64-89), respectivamente. O grupo GC foi composto por duas mulheres e tres homens, e as medias de idades foram de 36,5 (24 e 49) para as mulheres e 45,0 (30-64) para os homens. Foi observado aumento da expressao dos linfocitos TCD3+ e TCD4+ nos idosos vacinados (p=0,0010 e p=0,0383) em comparacao ao GC. Os idosos tambem apresentaram aumento de LTCD4+ e LTCD8+, ambos de memoria efetora (CD45RA-CCR7-) demonstrando p=0,0471 e 0,0138, respectivamente. Avaliando as diferencas entre os sexos dos idosos, observou-se que os homens apresentaram aumento no numero total de LTCD8+ (p=0,0464) e LTCD8+ de memoria efetora (p=0,0199);e diminuicao nos LTCD4+ de memoria central (CD45RA-CCR7+) quando comparados com as mulheres (p= 0,0440). Discussao: Apesar de todos os avancos no controle da doenca e melhoria nos desfechos dos pacientes mais graves, inumeras questoes ainda permanecem sem resposta: As vacinas conferem a mesma protecao da infeccao ou sao fatores sinergicos? Idosos apresentam a mesma resposta aos imunizantes que os jovens? Nas infeccoes por SARS-CoV-2, as respostas dos LT sao detectadas em quase todos os casos, sendo as respostas das LT CD4+ mais proeminentes do que as respostas dos LT CD8+. Diferentemente das situacoes relatadas apos a infecao pelo SARS-CoV-2, avaliando a resposta ao imunizante CoronaVac, o presente trabalho demonstrou que idosos apresentaram maior producao de LTCD4+ quando comparados aos jovens. Entretanto, apesar de os LTCD8+ nao terem respostas diferentes entre os grupos (idosos e jovens), apresentaram maior resposta nos idosos do sexo masculino. Conclusao: Neste trabalho, foi observado que os homens parecem apresentar memoria efetora rapida maior que das mulheres, entretanto, as mulheres apresentaram memoria central maior, sugerindo imunidade prologada maior nas mulheres idosas do que nos homens. Copyright © 2022

Avaliacao Da Resposta Imunologica Em Idosos Institucionalizados Apos Imunizacao Contra a Covid-19

Objetivos: A COVID-19 e uma doenca provocada pelo virus SARS-CoV-2, descoberta em dezembro de 2019 na China. A maioria dos individuos infectados desenvolvem quadros leves sem necessidade de hospitalizacao, idosos e portadores de comorbidades sao suscetiveis a forma mais grave da doenca, compondo os "grupos de risco". A fim de conter a propagacao da doenca, vacinas foram desenvolvidas para induzir memoria imunologica contra o virus na populacao. Entretanto, estudos sobre a efetividade dessa imunizacao em idosos, em cenarios nao controlados, ainda sao escassos. O objetivo deste trabalho foi avaliar a resposta imunologica conferida pela vacina contra a COVID-19 em uma Instituicao de Longa Permanencia para Idosos de Sergipe (ILPI). Material e Metodos: Foram incluidos no estudo os idosos institucionalizados que receberam o esquema vacinal completo da CoronaVac, bem como os profissionais que atuam no local. Um questionario estruturado foi elaborado, e os cuidadores e responsaveis dos idosos forneceram as informacoes necessarias para seu preenchimento. Amostras de sangue periferico foram coletadas 30 dias apos o esquema vacinal completo para a realizacao da sorologia para COVID-19 por imunoensaio de fluorescencia (FIA). Resultados: Os participantes foram divididos em dois grupos: idosos institucionalizados com 60 anos ou mais (n = 50), e trabalhadores da mesma instituicao com menos de 60 anos (n = 34). A media de idade do grupo dos idosos e de 86,94+/-8,90 anos, no grupo dos profissionais a media foi de 44,24 +/- 8,02 anos. Os resultados do presente estudo demonstram que nao houve deteccao de anticorpos IgM em 20% dos idosos e 23,53% dos trabalhadores da ILPI 30 dias apos imunizacao completa, nao apresentando diferenca significativa entre os grupos. Em contrapartida, foi possivel detectar anticorpos IgG em 48% dos idosos, em contraste com o resultado obtido para os profissionais (97,06%), denotando uma diferenca significativa entre os grupos. Discussao: Estes achados parecem demonstrar uma resposta menor da producao dos anticorpos ao imunizante nos idosos quando comparados aos profissionais da instituicao, o que pode ser explicado pelos efeitos negativos provocados no sistema imunologico dos idosos pela imunosenescencia, visto que alguns autores acreditam que essa populacao pode ser mais suscetivel a inefetividade de vacinas desenvolvidas para populacoes jovens, de modo geral, e por isso necessitam de maior atencao. Conclusao: Este estudo demonstrou que a resposta imunologica, no periodo apos 30 dias, foi menor nos idosos institucionalizados, quando comparada ao grupo de individuos mais jovens, possivelmente devido a diversos fatores como idade, presenca de comorbidades e imunosenescencia. Copyright © 2022

Kinetics of Humoral Immune Response in Patients with Asymptomatic or Mild Covid-19: A Longitudinal Study Based in an in-House Indirect Elisa Method

Background: In the COVID-19 pandemic, individuals may be asymptomatic, with mild or severe symptoms associated with respiratory tract infections. Patients with COVID-19 have IgG antibodies on average two weeks after infection and persist at stable levels for a few months. The influence of the levels of these antibodies and the time in circulation, protection, and severity of the disease in reinfections, has not yet been completely elucidated. The objective of this work was to evaluate the titers of anti-SARS-CoV-2 IgG antibodies in asymptomatic patients or with mild symptoms in a period of six months. Method(s): In this longitudinal study, we selected 62 individuals (median age 42.5 years;IQR 33.3-52.0;59.7% female) tested positive for SARS-CoV-2 Immunoglobulin G (IgG) antibodies using a Fluorescence Immunoassay (FIA) (iChroma II, BioSys + Kovalent) from July 2020 (peak of the first wave) to March 2021 (begging of the second wave associated with transmission of the Gamma variant) in the state of Sergipe, Northeast Brazil. All participants included in the present study had a history of asymptomatic or mild COVID-19, were not vaccinated against the disease, and were selected from the EpiSERGIPE Project conducted in the state of Sergipe. An in-house indirect Enzyme-Linked Immunosorbent assay (ELISA)-based method was used to evaluate the serum titers of anti-nucleocapsid SARS-CoV-2 antibodies in three moments: baseline (D0), 90 days (D90), and 180 days (D180). Briefly, 96-microwell plates (Nunc, Thermo Fisher Scientific). Result(s): In D0, 79% (49 of 62) of individuals had a positive result for the presence of anti-nucleocapsid SARS-CoV-2 antibodies. In D90 and D180, the percentage of positive results was 69.3% (43 of 62) and 53.2% (33 of 62), respectively. We found a progressive decline in the levels of anti-nucleocapsid SARS-CoV-2 antibodies over time, ranging from 26.2 (Interquartile Range [IQR] 12.4-37.7) in D0 to 11.7 (IQR 5.6-18.2) in D180 (p<0.001). In addition, we found that individuals over 40 years old had higher levels of IgG antibodies to the SARS-CoV-2 nucleocapsid in D90, regardless of sex. However, an influence of sex and age was not observed on D0 and D180. Discussion(s): Studies describe that IgG levels remain for only 3-4 months in the body of individuals who have had previous contact with SARS-CoV-2, however in this study it was observed that most individuals had a significant and gradual decrease in anti-nucleocapsid SARS-CoV-2 antibodies circulating, even before completing three months after exposure to the virus. Conclusion(s): This study showed a progressive decline in the levels of anti-nucleocapsid SARS-CoV-2 antibodies during the first six months after SARS-CoV-2 infection among individuals with asymptomatic or mild COVID-19. Approximately 50% of individuals have no detectable antibodies six months after infection. Moreover, we found a potential influence of age on the humoral response against SARS-CoV-2. Copyright © 2022

Associacao Dos Sistemas De Grupos Sanguineos Abo Com a Covid-19 Em Sergipe

Objetivos: Em 2019 foi descoberto o novo coronavirus (SARS-CoV-2), a doenca causada por esse virus foi denominada de COVID-19 e se espalhou rapidamente chegando ao status de pandemia. Algumas hipoteses relacionando a COVID-19 com os sistemas de grupos sanguineos foram aventadas, e apesar do desenvolvimento de diversos estudos acerca dessa relacao, ainda nao se comprovou de forma clara, a influencia do grupo sanguineo na sintomatologia desta doenca. Neste trabalho, objetivou-secorrelacionaros sistemas dos grupos sanguineos ABO durante a pesquisa da soroprevalencia da COVID-19 em Sergipe. Material e Metodos: Foram selecionados individuos participantes do projeto de avaliacao da soroprevalencia do SARS-CoV-2 em Sergipe - EPISERGIPE, no qual todos os individuos responderam a um questionario semiestruturado com a informacao sobre o grupo sanguineo.Apos triagem positiva no teste rapido (Wondfo-IgG/IgM), foram coletadas amostras de sangue periferico para analise sorologica de anti-SARS-CoV-2 IgG e IgM porimunoensaio fluorescente (FIA) utilizando o kit comercial IchromaTM COVID-19 Ab. Resultados: Foram analisados 6.305 questionarios, dos quais 2.155 participantes informaram o grupo sanguineo (ABO). Dos 2.155 participantes 1.382 (64,1%) eramdo sexo feminino, e 773 (35,9%)do sexo masculino. Deste total, 1.869 (86,73%) testaram negativo para COVID-19 e 286 (13,27%) testaram positivo. A grupo sanguineo "O" apresentou maior frequencia 1.164 (54%), seguido do grupo "A" com 725 (33,6%), grupo "B" 198 (9,2%) e "AB" 68 (3,1%). A frequencia de individuos negativospor grupo sanguineo, apresentou 88,2% (60) do grupo "AB";seguido de 88,1% (639) do grupo "A";87,4% (173) do grupo "B" e 85,6% (997) do grupo "O". Em relacao aos individuos positivos, 14,3% (167) eram do grupo "O", seguido de 12,6% (25) do grupo "B", 11,9% (86) do grupo "A"e 11,8% (8) do grupo "AB". Discussao: De acordo com este estudo, o grupo "AB" apresentou maior frequencia nos individuos com testes negativos e o grupo "O" nos individuos com testes positivos, sendo estes sintomaticos leves e assintomaticos. Estes resultados discordam daqueles obtidos por outros estudos realizados com objetivos semelhantes que demonstravam um menor risco de infeccao para pessoas do tipo sanguineo "O", e maior risco de infeccao para os grupos "A" e "AB". Conclusao: Este estudo sugere maior protecao a infeccao pelo SARS-CoV-2 em individuos dos grupos sanguineos "AB"e "B". Copyright © 2022

Linfohistiocitose HemofagocÍtica Familiar (Lhf3) Apresentando-Se Com Quadro De Colestase Neonatal Tratada Com Emapalumabe E Tcth

Introducao: Linfohistiocitose Hemofagocitica (LHH) e uma sindrome de ativacao do sistema imune que ocorre como desordem familiar ou condicao esporadica em associacao com uma variedade de "gatilhos". Caracteriza-se por condicao hiperinflamatoria, potencialmente fatal, causada por resposta imune altamente estimulada, mas ineficaz. Linfohistiocitose Hemofagocitica Familiar (LHF), e doenca genetica autossomica recessiva, afeta principalmente lactentes. Rapidamente fatal, mediana de sobrevida menor que dois meses apos diagnostico, se nao tratada. Pacientes que iniciam o quadro no periodo neonatal, associado a colestase e frequentemente fatal. Relato do caso: Fem, 4 dias vida, br, pais jovens nao consanguineos. Tranferida ao HMIMJ para avaliacao da Hepatologia - quadro de Colestase Neonatal com rapida evolucao. Na UTI: Corada, icterica +4/+4, hepato-esplenomegalia. Ex lab - 5 dias vida - Hb 14,4 Leuco 2.710 neutro 760 Plaq 26.000 cr 0.3 ur 34 BT 43 BD 37 BI 6 Fibrinog 106 TG 245 Colest 184 BT 43.4 BD 37.22 BI 6.25 TGO 261 TGP128 GGT 557 FA 122 DHL568 Ferritina 4.379. COVID-19 e sorologias neg. Mielograma - raros histiocitos hemofagociticos. HD - LHF em rapida evolucao, solicitado exoma. Plaq cada 12h e Ig EV - 1 g/kg em 10h - 2 dias. Dexametasona 10 mg/m2/dia - 14 dias, e apos 5 mg/m2/dia - mantida, aguardando o medicamento Emapalumabe (anticorpo anti IFN-gamma humano administrado com dexametasona). Melhora por 2 sem, piora com hipertrigliceridemia, Ferritina 54.039, hipofibrinogenemia e graves citopenias/20 dias vida - dexametasona 5 mg/m2/dia e iniciado Emapalumabe 1 mg/kg/dose - 2 x /sem, com aumento progressivo 3, 6 e 10 mg/m2/dia. A partir do 5degree dia Emapalumabe - melhora progressiva clinico-laboratorial/27 dias vida - Hb 9.5 Leuco 4.720 neutro 1650 Plaq 110.000 Coagulogr NL fibrinog 190 ur 36.6 cr 0.2 PT 6.2 Alb 3.7 BT 6.32 BD 4.56 BI 1.76 TGO 402 TGP 649 GGT 1.136 FA 284/39 dias vida - recebeu 7dose de Emapalumabe - Hb 8.2 Leuco 10.700 neutro 5.500 Plaq 111.000 Coagulogr NL Fibrinogenio 219 u 37.6 cr 0.2 PT 5.9 alb 3.3 BT 3.31 BD 2.18 BI 1.13 TGO 301 TGP 463 GGT 1.227 FA 301/42 dias vida - Hb 8.6 Leuco 9.340 neutro 4.550 Plaq 96.000 BD 1.69 BI 1.15 DHL 612 TGO 448 TGP 599 GGT 1.172 FA 370 fibrinog 201. Recebeu 9 doses de Emapalumabe. 16.03.21 - Exoma - Linfohistiocitose Hemofagocitica Familiar Tipo 3 (FHL3). Transferida ao ITACI - finalizou a medicacao e realizou TCTH. Boa evolucao ate 2 meses pos TMO, quando desenvolveu Doenca Veno-Oclusiva (VOD), evoluiu para obito. Discussao: Falencia hepatica aguda e rara em neonatos e evolui com elevadas taxas de mortalidade. A etiologia dessa condicao difere daquelas ocorrendo em criancas maiores. Diagnosticos diferenciais sao hemocromatose, LHF, infeccoes virais e alguns defeitos metabolicos. Existem alguns relatos de neonatos com LHF apresentando-se com hidropsia fetal e falencia hepatica fulminante. Conclusao: LHF e uma doenca rara cujas manifestacoes ocorrem principalmente nos dois primeiros anos de vida. A apresentacao neonatal e incomum. Na literatura, poucos casos sao relatados nas primeiras semanas de vida e com rapida evolucao para falencia hepatica aguda. A evolucao desses casos e frequentemente para obito. Entretanto, estabelecer o diagnostico tem importantes implicacoes para o aconselhamento genetico. Copyright © 2022

Inventory of Sources of Stress During Medical Education - Further Validation

Introduction: The Inventory of Academic Sources of Stress in Medical Education (IASSME) evaluates the presence and intensity of the main sources of academic stress for Portuguese Medicine students in five dimensions: Course demands/CD, Human demands/HD, Lifestyle/LS, Academic competition/AC, and Academic adjustment/AA. Objective(s): To further validate the ISSME using Confirmatory Factor Analysis and to analyze[ATP1] the psychometric properties of a new version including additional sources of stress. Method(s): Participants were 666 Portuguese medicine (82.6%) and dentistry (17.4%) students (81.8% girls);they answered an online survey including the ISSME and other validated questionnaires: Maslach Burnout Inventory - Students Survey (MBI-SS) and Depression Anxiety and Stress Scales (DASS). Result(s): Confirmatory Factor Analysis showed that the second order model composed of five factors (the original structure by Loureiro et al. 2008), but excluding item 11 (loading=.371), presented good fit indexes (chi2 /df=3.274;RMSEA=.0581, p<.001;CFI=.917;TLI=.904, GFI=.919). The Cronbach's alfas were alpha=.897 for the total and from alpha=.669 (F2-HD) to alpha=.859 (F1-CD) for the dimensions. The expanded version, including two additional items related to lack of interest in medicine/dentistry (F6, alpha=.543) and two additional COVID-19 stress-related-items (F7, alpha=.744) also showed acceptable fit indexes (chi2 /df=3.513;RMSEA=.061, p<.001;CFI=.88.;TLI=.866, GFI=.892). This new version's alpha was of .896. Pearson correlations between ISSME and the other measures were significant (p<.01) and high: >.55 with DASS and >.50 with MBI-SS. Girls presented significantly higher ISSME scores. F6 score was significantly higher in dentistry students. Conclusion(s): This further validation study underlines that IASSME presents good validity (construct and convergent) and reliability.

COVID-19 Pandemic: Another Source of Stress for Medical Students

Introduction: The COVID-19 pandemic has completely changed the experience of higher education with potentially negative consequences for students' wellbeing. Objective(s): To compare medicine/dentistry students' depression/ anxiety/stress levels before versus during the pandemic and to analyse the role of COVID-19-related stressors in their psychological distress. Method(s): Students from the Faculty of Medicine University of Coimbra answered socio-demographic and personality questionnaires and the Depression, Anxiety and Stress Scale/DASS before (academic years 2016-2017-2018-2019 - SAMPLE1;n=1000) and during (September-December 2020 and January-March 2021 - SAMPLE2;n=650) the COVID-19 pandemic. Mean age (21.12+/-3.75), personality traits scores, and gender proportions (75% girls) did not significantly differ between samples. SAMPLE2 also filled in the Fear of COVID-19 Scale and a new version of the Inventory of Sources of Stress During Medical Education/ISSDME, containing a COVID-19 -related dimension (restrictions on training and on socializing with friends/colleagues). Result(s): SAMPLE2 presented significantly higher mean scores of depression (3.89+/-3.55vs.3.33+/-3.34), anxiety (3.27+/-4.08vs.2.86+/-3.29), stress (7.07+/-5.72vs.6.18+/-4.59) and total DASS (12.28+/-10.55vs.13.65+/-11.13) than SAMPLE1 (all p<.05). Fear of COVID-19 was a significant predictor of DASS score (adjusted R2=2.9%, p<.001). COVID-19-related stressors continued explaining significant increments of DASS variance after controlling for each of the ISSDME dimensions: Course demands (R2 Change=1.8%), Human demands (2.5%), Lifestyle (2.3%), Academic competition (5.5%), and Academic adjustment (5.2%) (all p<.001). Conclusion(s): This study adds to the evidence of the negative impact of COVID-19 on students and emphasizes its pernicious role on medical students' psychological distress, which is already higher due to the individual and academic stressors to which they are more exposed.

Adherence to the Recommendations from the Portuguese General Directorate of Health (GDH) during the COVID-19 pandemic: fear or prosocial behaviour?

Introduction: During a public health crisis, preventive measures are essential. However, to make them effective, all citizens must be engaged. Objective(s): To analyse the differential role of individual and contextual variables in the adherence to public health recommendations. Method(s): 1376 adults (70.5% female;mean age=35.55+/-14.27) completed a survey between September/2020 and May/2021 with: Adherence Scale to the Recommendations during COVID-19 (ASR-COVID19;evaluates three dimensions of adherence), Fear of Covid-19 Scale (FC19S) and Toronto and Coimbra Prosocial Behaviour Questionnaire (ProBeQ;assesses empathy and altruism). Result(s): Adherence did not differ between individuals with or without personal or family history of COVID-19 infection. ASRCOVID19 and all dimensions were positively correlated to ProBeQ's altruism and empathy (from r=.32 to r=.54);FCV19S correlated positively to total adherence score and house sanitation (from r=.18 to r=.26;all p<.01). Linear regressions revealed that altruism and empathy (first model), as well as fear of Covid-19 (second model), were significant predictors of adherence;however, while the first model explained ffi28% of its variance, the second (FCV19S as independent variable) only explained ffi3%. Regression models performed in a subsample of participants with personal or family history of COVID-19 revealed that only empathy, but not altruism, was a significant predictor of adherence;in this subsample, fear was no longer a significant predictor of adherence, except for lockdown and use of teleservices. Conclusion(s): Based on our results, we suggest health care providers and public health campaigns should take into consideration social solidarity and altruism, as well as previous experiences, when appealing to public's engagement in health behaviour.

From Perceived Vulnerability to Disease to Psychological Distress in times of COVID19 pandemic

Introduction: Perceived vulnerability to disease/PVD may influence psychological reactions to COVID-19 pandemic. Objective(s): To analyse the role of PVD in psychological distress/PD during the COVID-19 pandemic, testing whether it is mediated by perceived risk of COVID-19, fear of COVID-19 and repetitive negative thinking/RNT. Method(s): Participants (N=413 adults;69.2% women) were recruited from September until December 2020, via social networks. They completed the following self-report validated questionnaires: Perceived Vulnerability to Disease Questionnaire/ PVDQ;Perceived Risk of COVID-19 Scale, Fear of COVID-19 Scale;Perseverative Thinking Questionnaire and Depression Anxiety and Stress Scale. As women had significantly higher levels of PVD, COVID-19 perceived risk and fear, RNT, and psychological distress/PD, gender was controlled in mediation analysis (using PROCESS macro for SPSS;Hayes 2018). Result(s):All the variables significantly (p<.01), moderately (r>.20) and positively correlated. The serial mediation model 6 with the three sequential mediators resulted in significant total effect (c=.326, se=.0791, p<.001, CI:.1702-.4814), non-significant direct effect (c'=.111, se=.065, p=.087, CI:-.0162 to .2380), significant total indirect effect (.2149, se=.065, CI:.1079-.3278);most indirect effects were significant, including the indirect 7 (.0144, se=.0077, CI=.0017-.0320), that goes through all mediators (PVD->COVID19 perceived risk->COVID19 fear->RNT->PD), meaning full mediation. Conclusion(s): The effect of PVD on psychological distress operates by increasing the perception of risk and the fear of COVID-19, which intensify related worries and ruminations in times of pandemic. People with high perceived threat, aversion and discomfort in situations associated with increased risk of infection should be helped to decrease dysfunctional cognitive contents and processes in times of pandemic.

Relationship between personality, adherence to (mental) health behaviours and psychological distress during the COVID-19 pandemic

Introduction: Public health authorities around the world have been disseminating messages to support mental health and psychosocial well-being during the COVID-19 pandemic. Based on the Portuguese guidelines, we have developed the Adherence Scale to the RecommendationsforMental Health during the COVID-19 Pandemic (ASR-MH-COVID19) to better understand this health behaviour. Objective(s): To analyse the relationship between sociodemographics, personality traits, Adherence (to the Recommendations for Mental Health during the COVID-19 Pandemic) and psychological distress. Method(s): 413 individuals (69.2% female;mean age=31.02+/-14,272) completed an on-line survey, in September-December 2020, including sociodemographic questions, ASR-MH-COVID19, NEO-FFI-20 and Depression Anxiety Stress Scale (DASS-21) and Health Perception Scale. Result(s):Adherence scores did not significantly differ by gender, age and years of education. Women presented higher DASS and Neuroticism scores (p<.01). Adherence were negatively correlated with Neuroticism (r=-.247) and with Depression/Anxiety/Stress (all r.- 200), positively with Openness to Experience (r=.174), Conscientiousness (r=.194) and Perceived Health (Physical, r=.173 and Psychological, r=.215) (all p<.01). Mediation analysis (Hays' Macro Process - Model 4) revealed that Adherence is a partial mediator between Openness and DASS and Conscientiousness and DASS;when considering Neuroticism, only the direct effect was significant. The effect of Perceived Health (both Physical and Psychological) on DASS was also mediated by Adherence. Conclusion(s): The Health Behaviour Model proposes a pathway linking personality and health that applies to these results about adherence and psychological distress during the COVID-19 pandemic. Personality and perceived health (also a trait) influence both adherence to mental health behaviours and psychological distress. Understanding personality is vital for health care providers.

Adherence Scale to the Recommendations for Mental Health during the COVID-19 pandemic from the Portuguese General Directorate of Health (ASR-MHCOVID19) - Development and validation

Introduction: The COVID-19 crisis has generated an increasing stress throughout the population. Objective(s): To develop and validate the Adherence Scale to the Recommendations for Mental Health during the COVID-19 pandemic from the Portuguese General Directorate of Health (GDH) (ASR-MH-COVID19). Method(s): The items content was based on the GDH guides for the prevention of mental health and psychosocial well-being of the general population during the COVID-19 outbreak. After content and facial validity analysis, the preliminary version of the ASR-MHCOVID19 (8 items to be answered on a Likert scale) was completed by 413 individuals (69.2% female;mean age=31.02+/-14,272), in September-December 2020 (Sample1) and then by 967 (70.9% female;mean age=34.02+/-14,272), in February-May 2021 (Sample2). Sample1 was randomly divided in two sub-samples. Sample1A was used for exploratory factor analysis/EFA and Sample1B for confirmatory factor analysis/CFA;CFA was then replicated with Sample2. The online surveys also included the Adherence Scale to the Recommendations of Portuguese GDH to minimize the impact of COVID-19 (ASR-COVID-19;Pereira et al. 2020). Result(s): CFAs were informed by EFA and showed that the unidimensional model presented acceptable-good fit indexes (Sample1B: chi2 /df=2.747;RMSEA=.0980, p<.001;CFI=.973;TLI=.918, GFI=.972;Sample2: chi2 /df=3.327;RMSEA=.0490, p<.001;CFI=.993;TLI=.983, GFI=.990). Cronbach's alfas were alpha<.850. Pearson correlations between ASR-MH-COVID19 and ASR-COVID19 were significant (p<.01) and moderate-high for the total (r=.753) and dimensional scores (Distance and respiratory hygiene, r=.739;House and personal hygiene, r=.584;Use of remote services and isolation r=.425). Conclusion(s): The new ASR-MH-COVID19 has shown validity and reliability, allowing the investigation of this (mental) health behaviour.