Sars-Cov 2 Pandemic and the Principles of Medical Ethics

During the coronavirus pandemic, it was clearly seen how vulnerable society is with its entire health and sanitary security system, how vulnerable medicine is to a biological attack (whether it was natural or manufactured in a laboratory) and how chaotically society reacts as a whole, when faced with an unknown danger.It was quickly seen that medical science and technology have its limits and risks, that they do not always serve the cause of the suffering man, that biotechnology and genetic manipulation pose a major danger to humanity and that, for the simple reason that it is the product of human reason, always doubtful and hesitant. It has gone so far as to the principles of medical ethics were breached, whether we are talking about non-maleficence or beneficence, decision-making autonomy or nondiscriminatory attitude toward access to resources, with serious damage to the individual -medical system relationship.

Fear of death and the pandemic

Introduction: Looking at the vast majority of mental disorders in the last year, we noticed that most of them were closely related to this feeling of fear but also to the restrictive measures that appeared with the pandemic. Exposure for a period of more than a year to this mental stress has led to the appearance of a large number of psychiatric patients, especially those who have undergone SARSCoV- 2 infection or who have had close people infected, some of whom have even died. Objective(s): In this paper I will highlight the post traumatic consequences in patients who have gone through the disease. Method(s): To complete this work I used medical articles, studies, and specialized information on the subject. Result(s): Patients who have gone through the disease developed sleeping problems, phobias, various anxiety and delusional disorders. Conclusion(s): These conditions create the need for a multidisciplinary approach among this particular category of patients.

Personal believes - Barriers to vaccination against Covid-19

Introduction: The ongoing global pandemic of Covid-19 had a huge pressure to accelerate the development process of Covid-19 vaccine. This acceleration of the vaccine appearance raised many concerns regarding the effectiveness and the adequate safety of the vaccine among general population. Objective(s): The aim of the study is to determine the reasons behind vaccine refusal among general population. Method(s): Online questionnaire with the subjects' agreement;The study included 61 participants aged between 18 and 40 years old. The study was effectuated in October 2021. Result(s): Most of the participants (n=60, 98.36%) declared that they knew some persons who have refused the Covid-19 vaccine. Moreover, a number of 29 participants (48.33%) declared that vaccine refusal among the people who refused the vaccine was due to personal believes. Conclusion(s): The success of the vaccination programs mainly depends on the proportion of the population that receive the vaccine. It is crucial to implement new strategies to increase the acceptability of Covid-19 vaccine.

Vaccine hesitancy among hospital workers

Introduction: Vaccine hesitancy is a serious issue and it affects the scientific achievements of health. This phenomenon has begun to be studied more often in health care workers, to find its determining factors. Objective(s): The aim was to determine the percentage of hospital workers who got vaccinated against the infection with SARS-CoV-2. Method(s): Beginning with October 2021, we conducted an online questionnaire in which 57 hospital workers participated. Preliminary results allowed us to assess the rate of vaccine hesitancy among this group. Result(s): Out of the 57 hospital workers, the majority were vaccinated (n=45, 78.94%) in comparison to less than a quarter (n=12, 21.05%) that refused vaccination. The group of hospital workers included mostly nurses ( n=21, 36.84%). Also, 12 psychologists (21.05%), 11 doctors (19.29%), and 10 students (17.54%) were included. Among the cases that did not accept getting vaccinated against COVID-19, the highest percentage was occupied by nurses (n=9, 15.78%). Moreover, there were only one doctor and one psychologist who did not get vaccinated. Conclusion(s): In the current pandemic times, the hesitancy and refusal of vaccination prove to be very challenging. It is important to explore their reasons and to promote health education programs.

The consequences of the pandemic among patients with psychiatric history

Introduction Throughout this period we were confronted with news and information about the Corona virus and its consequences. Which led to the development of a huge sense of fear among people. Although fear has helped to maintain restrictions, it has also had a significant impact on mental health, especially among patients with a psychiatric history. Objectives In this paper I will highlight the consequences of the nocebo effect of the pandemic among people with a psychiatric history. Methods To complete this work I used medical articles, studies, and specialized information on the subject. Results The pandemic’s restrictions have made it difficult for psychiatric patients to be compliant treatment by avoiding regular psychiatric exams.Isolation and fear of infection has led to new decompensations in existing psychiatric pathologies. Conclusions The exacerbations of psychiatric pathology increased both in number and in their intensity, ultimately determined by the increase in the number of hospitalizations in psychiatric emergencies. Disclosure No significant relationships.

Social Resets and Suicides during Covid-19 Pandemic

Introduction. Well-known as a public health problem, suicide is known to cause many deaths during periods of economic and social unrest. Through the social changes imposed by the political and medical actors, the society knows old challenges, but also some completely new ones, which seem to influence the suicidal behavior among the population. Aim. The paper tries to present the effects of anti-Covid-19 social measures, especially those decided by the Romanian authorities between March 2020 and March 2021, on mental health and suicidal behavior. Also, by assessing the public polity intentions expressed publicly in European leadership circles for the medium-term future, we wanted to identify the impact on lifestyle and suicidal behaviour. Materials and method. The paper uses the medical literature in order to identify traditional or new risk factors for suicide, introduced into society by SARS-Cov-2 and the social restrictions that accompanied it. Also, sources from the domestic and international media are used to evaluate the future announced social resets and the possible impact on the suicidal behavior among the Romanian population. Results. The feeling of induced fear and the change of some social routines, imposed by the political factors in the context of the Covid-19 virus, are supposed to he accompanied by increases in the suicide rate. The new economic challenges and social antagonisms, predictable for the near future, bring with them the risk of increasing suicidal behavior among the world's population and Romania. Conclusion. In various countries, suicide rates have risen during the pandemic. New social measures are announced in authoritarian tones, with no intention of assessing the impact on the mental health of the population. Me implementation of these innovative measures should be done only after balancing the psychological and psychiatric impact. The alternative torch be the emergence of new epidemics of mental illness and suicide, which can unbalance society, as has never happened before.

Ethanol Dependence in the Context of the Covid-19 Pandemic. Comparative Study between January-March 2019-2021

In Romania, alcohol is the most used substance of abuse and at the same time the most culturally acceptable, the abusive consumption of ethanol by individuals has a significant role in increasing the number of presentations in psychiatric services. The objective of this paper is to establish a comparison in the dynamics of presentations of chronic alcohol users at the 'Elisabeta Doamna' Psychiatric Hospital in Galati, from January 1 to March 30, 2019-1 to Jarman, 30, March 2021. The retrospective study consists ire comparing the group of patients presented between January 1, 2019 and March 30, 2019 with the group of patients presented between January 1, 2021 and Man.h 30, 2021 in the 'Elisabeta Doamna' Psychiatriy Hospital in Galati. The inclusion criteria were: county, gender, age, date of presentation, time of presentation, environment of origin, disorders related to alcohol consumption (F10.0-F10.9). All patients with psychiatric diagnoses who did not have akohol-related disorders were excluded. The data was processed statistically ruing Microsoft Qflice-Excel, SOFA - Statistics Open For All version 1.5.4. Between January and March 2019 there were 671 presentations due to alcohol-related disorders, of which 222 (33.1%) patients from rural areas and 449 (66.9%) from urban areas, compared to the period January-Marl 2021, when the total number of presentations due to alcohol-related disorders was 660, of which 204 (31%) patients were from rural areas, and 456 (69%) came from urban areas.

Mass-Media Impact on non- and Post SARS COV2 Infection Anxious Disorders

How is the dependency Spiral triggered? It might start by looking either for pleasure or escape. In either case, the time spent in front of a screen leads to a pleasant, dopamine-mediated experience. The desire to repeat the use is further fuelled by the physiological process of tolerance and addiction. This is how things unfold in screen dependence (mass-media) when socialization, games, modes are concerned. Things look entirely different when the need for information is taken into consideration. What is the need for information's threshold? Information is not the same thin;as the learning process. The fourth power in the state is the MEDIA. In mass-media, information relies on amazement, emotional shock, jean Media feeds on powerful emotions. Are we all victims of such emotions? As of December 2019, until the present, mass-media information, focused on the medical and social issue of the coronavirus pandemics. How bate we been affected by this information? What was its impact on our anxiety? How was the perception on reality of the people who bad the disease altered? In order to get a few answers, we applied a series of questionnaires to a batch of 30 people who had the SARS . COV2 infection and to a batch of 20 people who haten't yet contracted the virus. USed material: - Coronavirus anxiety questionnaire www.researchcentral.ro - Mass-media dependency questionnaire www.researchcentral.ro - SRGS posttraumatic development scale;Crystal Park, Lawrence Cohen and Renee Murch The summarized data indicates that the people from the batch who was infected with cu SARS COV2 hate a high anxiety level,, a minimum kid of mass-media dependency and a maximum SRGS level. Ira the batch of people who have not contracted the disease, the majority has a medium towards maximum anxiety level, minimum mass-media dependency. The people in both batches unanimously asserted they felt oversaturated with the media information, although a year ago they could hate declared themselves as addicted to such type of information. Considering that the questioned people suffered minimum manifestation forms of the disease, the high scores obtained in SRGS could only be justified if this disease were correlated to a major psychic disease.

HOW THE COVID-19 PANDEMIC HAS CHANGED THE IMAGE OF PSYCHIATRY

Coronavirus disease (Covid-19) has brought the world at a standstill with unprecedented confinement measures and lockdowns in order to contain the novel virus. Negative effects of the pandemic on mental health are the main focal point. Social isolation, loneliness and the uncertainty of day to day living put a strain on the individual's psyche, therefore psychiatric intervention is highly needed. Mental health care providers are the key to help preserve and reconstruct a post-pandemic society. METHOD: Existing literature on the Covid-19 outbreak pertinent to mental health was retrieved from the PubMed database using as a main focal point the role of the psychiatrist in managing the angst caused by the already mentioned stressful factor. In times of uncertainty and fear, mental health care remains the major pillar as it has been for numerous years, with implications worldwide. CONCLUSION: There is a pressing need for developing healthy coping mechanisms during the current crisis and it is mandatory to acknowledge the role of the psychiatrist from an early stage in order to preserve a sense of stability for the individual.

COERCIVE MEASURES IN PANDEMIC PSYCHIATRIC CARE - RETROSPECTIVE STUDY

Coercion raises serious ethical and legal issues in psychiatric care. Coercive medical measures are applied in psychiatric institutions for protective purposes. Alcoholism is a social and medical problem because it especially affects the behavior of the individual. Alcohol consumption can catalyze exacerbations of mental illness and predispose to behaviors with an increased risk of violence. AIM: The purpose of this study is to illustrate medical and legal issues related to coercive measures in emergency psychiatric care during the pandemic. Methods: The study is retrospective, and the data were taken from the observation sheets of patients in the period between March 1, 2020-March 31, 2021, in acute section II in the Institute of Psychiatry "Socola" Iasi. RESULTS: Of those who required coercive measures during hospitalization, most were restraint for symptoms such as: self-aggression and aggression towards others. Mechanical restraint measures were also necessary in cases with hallucinatory-delusional symptoms, associated with self-aggression and aggression towards others. The share of hospitalized patients for alcohol abuse, who required coercive measures, was significantly higher during the pandemic. CONCLUSION: Manifestations of violence among patients with major mental disorders are rare. Mechanical restraint was necessary especially in those who had self-aggression and aggression towards others, symptoms secondary to alcohol consumption. Alcohol consumption amplifies the psychological imbalance in the context of the COVID-19 pandemic.

THE EFFECT OF USING FACEBOOK ON ELDERLY PEOPLE DURING COVID-19 PANDEMIC

The use of the Facebook communication network during the pandemic Coronavirus by the elderly was beneficial because it played a role in connecting family and friends, when physical encounters could not take place. Social media has presented numerous benefits on mental health, such as: developing skills in using new technologies that delay cognitive impairment, lower levels of loneliness and positive visions of the future. Many users said that in addition to being close to family, they learned about the pandemic and what it means, but they also expanded their list of friends in the virtual environment. Through the video call option, they were able to communicate with the loved ones and managed to overcome social isolation and the feeling of loneliness. Therefore, the use of Facebook has been beneficial among the elderly, giving them a pleasant environment of social and emotional connection with the loved ones, communication with virtual friends has been developed, and self-confidence has increased. Facebook communication network users obtained a higher score when assessing social satisfaction and increased confidence in technology.

PREVALENCE OF BURNOUT IN MEDICAL STUDENTS IN ROMANIA DURING COVID-19 PANDEMIC RESTRICTIONS (PRELIMINARY DATA)

Medical student burnout can cause emotional exhaustion and detachment from educational objectives. The objectives of this study were to evaluate burnout using the Maslach Burnout Inventory-General Survey for Students (MBI-GS(S)) associated with online education and pandemic restrictions. METHODS: The MBI-GS (S) was administered to final-year medical students at Romania's most prominent medical faculties from June to July 2021. Descriptive statistics and the internal consistency of the MBI-GS (S) were assessed. In addition, mean MBI-SG (S) subscale scores for burnout were calculated for cynicism (CY), emotional exhaustion (EE), and academic efficacy (AE). RESULTS: 50 medical students completed the online survey, and 42% reported self-perceived burnout. The MBI-GS(S) subscale scores were higher for cynicism (CY) (52%) and low professional efficacy (PE) (60%), and almost half of the students (48%) reported emotional exhaustion (EE). CONCLUSIONS: Recent studies have found strong associations between burnout in medical students and disappointment in their studies, fear of inadequate professional training, not having necessary skills to enter medical practice, being less than satisfied with the educational system and social support, optimism, and motivation in pursuing a medical career. We suggest the continuation of burnout studies to overcome the limitations of a cross-sectional research design. In addition, measuring burnout in the medical student population could be extended to all study years and how adequate educational strategies and wellness initiatives could ameliorate burnout.

Dynamics of Ethanolic Intoxications between the 15th of March 2020 to the 15th of March 2021 in the Context of the Covid-19 Pandemic

In Romania, the consumption of alcoholic beverages has been and still is a cultural mechanism for socializing and reducing anxiety. regardless of age and gender. This paper evaluates the trends related to people diagnosed with acute intoxication (F10.0) and harmful use (F10.1) at the 'Elisabeta Doamna' Psychiatriy Hospital in Galati, during the pandemic, in the period between the 15th of March 2020 and the 15th of March 2021. We analysed the data base of discharges from the 'Elisabeta Dona' Psychiatric Hospital from the 15th of Mani.) 2020 to the 15th of March 2021. ICD-10 (Classification of mental and behavioural disorders) was used for diagnosis of psychiatric disorders. We selected outpatients with the codes for acute intoxication (F10.0) and harmful use (F10.1) and excluded all patients with other psychiatric diagnoses. The data were statistically processed using: Microsoft Office-Excel, The jamovi project (2021) jamoti (Version 1.6) [Computer Software]. During the analysed period, there were 7614 discharges : from the "Elisabeta Dona' Psychiatriy Hospital of which 1465 (20.08%) disorders were related to alcohol consumption. Disorders related to intoxication and alcohol use represent 13.14% (957 cases) of the total discharges and 65.46% of the total number of disorders related to alcohol. Disorders related to harmful use (F10.1) represent 30.31% (442 cases), and a percentage of 35.15% (515 cases) with disorders due to acute intoxication (F10.0) out of the total cases were related to alcohol consumption. From the view of the dispersion of the number of eases, there is a fluctuation in the tendency to follow the restrictions imposed by the authorities.

The Evolution of Mental Health in Patients with Psoriasis during the COVID-19 Pandemic

Introduction: The aim of this study was to assess the impact of the Covid-19 pandemic on mental health on a sample of 37 patients with psoriasis in Braila County. Methods: A cross-sectional study on a sample of 37 patients with psoriasis was conducted by questionnaires e-mailed to patients. The study was conducted between November 20th, 2020 - January 15th, 2021. Mental health was measured using the Hamilton Anxiety Assessment Scale (HAS). Data collected on predictors included, but were not limited to, sex, age, background, marital status, level of education, smoking, alcohol consumption, comorbidities, period of self-isolation, severity of psoriasis, and type of treatment for psoriasis. Results: There were 37 participants included. Factors associated with poor mental health were: place of origin (54% from urban areas), sex (62.1% women), age (67.5% between 65 and 80 years old), period of self-isolation (81% in self-isolation for more than 14 days), comorbidities (75.6% with multiple comorbidities) and form of treatment for psoriasis (48.6% are systemically administered treatment for psoriasis). Conclusions: In this sample of patients with psoriasis from Braila County who isolate or socially distance themselves, urban patients, women, elderly, those with comorbidities and those who are systemically administered treatment for psoriasis were associated with a high score on the Hamilton anxiety assessment scale. However, we have to admit that our research has some limitations. First, the number of participants included in the study was small. Secondly, we used an online way to conduct the study. Thirdly, we used a self-assessment scale to assess the anxiety symptoms of psoriasis patients, which might have some deviation from the outcome. Looking beyond the current situation, it is essential to evaluate and restructure the way we think about patient's care.

Looking into Pandora's Box between "Everything" and "But" -Depression, Pain of Losses the Next Pandemic of Humanity?

This Article seeks to give an overview of how the pandemic has affected society throughout this period, which can be a source of many mental health problems. As in the Spanish influenza pandemic, the COVID-19 pandemic and the imposition of measures of social separation, isolation and limitation of contact with other people were, and are still, a major stress factor. The stress associated with this period disrupted the functioning of people both individually and socially, being the main factor of the phenomenon called compensation.Under the current circumstances, people have a predisposition for emotional disorders such as: Anxiety, depression, stress, insomnia, anger, Emotional depletion and including post-traumatic symptoms of disorder, according to recent studies by the Lancet analyzing the psychological effects of quarantine.The COVID-19 crisis has a wide range of effects on our mental and emotional health: From negative emotions with greater intensity and duration, such as anxiety and depression, to unfinished emotional mourning, linked both to the loss of loved ones and even to emotional and relational disconnection. Also, all that has happened in recent times makes us live in "collective pain" , we have lost our right to travel without restrictions or the freedom to participate in sad events or family and community joy, we have lost family or friends.In many cases of these losses, the strands of the dollar are also being cut, which is why people need additional support. We need to find solutions to this, because we have to deal with the natural grief caused by human disappearance, as we know it, but also an isolation characteristic of the suffering process that now overlaps the physical isolation imposed by the epidemic.Another important aspect is to prevent instability in the psycho-social element of the human Community. It is clear that there is a need to impose safety measures both jointly and individually. Psychological aspects should be addressed early, so that measures can be taken to reduce the psychological costs of pandemic, perceived isolation and to address uncertainties that can give rise to anxiety and depression. Addressing psychological issues has effects not only in the short term, motivating adherence to pandemic measures, but also in the long term, through lower incidence of post-traumatic stress, anxiety, depression, substance abuse, etc. The fastest change expected after this crisis will be the individual one, each crisis is a chance for every person to look further.

Emotional Exhaustion and Professional Satisfaction During Covid-19 Pandemic at the Level of Emergency Department Staff

Introduction: Burnout is a syndrome conceptualized as result of the chronic stress at the work place which wars not successfully managed. The possible negative effects on the medical staff the patients and the health institutions have generated interest and motivated the research to understand the possible causes, these ejects also influence the burnout predictors. The medical services suppliers within the emergency department have had one of the greatest exhaution occurences even before the pandemic. Being in the first line in contact with the suspected patients or confirmed with COVID-19 infection intensifies this fact. Both the working . factors (working hours, years of practice, number of treated patients, professional development activities) and the socio- demographic factors (age, sex. civil status, income. education) are associated with the exhaustion at the work place. Material and methods: I have studied a total of 120 participants, receiving 115 valid questionnaires, the answering ratio being 95,83%.This was a descriptive, multicentre, transversal study of the medical and the auxiliary staff within the department UPU-SMURD of the County Clinic Emergency Hospital "Sf. Ap. Andrei" Galati. The staff gave their consent and attended a combined interview which consisted of a pilot questionnaire and a demographic questionnaire. Results and discussions: The average score of exhaustion at the staff =level was 3.25, a great percentage of the doctors- within the ED (45.8%), (n=24) indicates an increased level of exhaustion, only 26.8% (n=80) of nurses show an increased level of exhaustion. The average score o f the stress level shown bt the staff is 3.1, 66.6% (n=24) among which the doctors with an increased stress level 9.1% (n=9) auxiliary staff, 23.8% (n=80) of nurses. Conclusions: The results show us a high exhaustion, stress and depression ratio at the emergency doctors in comparison with the other professional categories within the ED. A high level of professional satisfaction is accompanied by an increased level of stress and of self-esteem.

Assessment of Depression in Patients with COVID-19

The COVID-19 pandemic is probably the greatest natural disaster of our generation and the 21st century with a great impact on mental health. The present study aims to quantify, with the help of the Beck questionnaire, the degree of depression in a group of 109 patients with moderate forms of COVID-19, hospitalised in the Second Clinic of the Clinical Hospital for Infectious Diseases St. Cuv. Parascheva Galati during the period: 1.01-30.03.2021. Of these, 35 patients (32.11%) had raging degrees of depression, and had an age and body mass index statistically significantly higher than those without depression. These patients also had statistically significantly higher Charism scores of cumulative comorbidities and required longer hospitalization than patients without depression. The severity of COVID-19 and the parentage of favorable prognosis did not show statistically significant differences between the two groups. Our study reveals a lower incidence of depression among patients with COVID-19 compared to existing studies in the literature. This can be explained the, by act that our study is conducted at the end of the first year of the pandemic when antiviral therapy schemes stabilised and population vaccination began. The high, genetic variability of the tints, which can determine at any time the appearance of new strains with greater aggression, contagion or with mutations on the spike protein, maintains the need to keep non-specific preventive measures and the mental tension related to this pathology. Thus, intrepandemic psychiatric disorders remain a major public health problem and require strong government prevention and control measures.

Comparative Study of Ethanol Intoxications in the Context of Covid-19 Pandemic Reported to the Year of 2019

Excessive alcohol consumption that causes disorders of soda/conduct, causes a rejection reaction with the intervention of the authorities. The paper compares trends related to people with the diagnosis of acute intoxication (F10.0) admitted to the "Elisabeta Doamna" Psychiatry Hospital in Galati, from the 1st of january to the 31th of December 2020 with the period from the 1st of january to the 31th of December 2019. In the retrospective study we selected people discharged with acute intoxication, code (F10.0), and harmful use (F10.1), excluding all patients with other psychiatric diagnoses from the database of the "Elisabeta Doamna" Psychiatry Hospital from 2020 to 2019. ICD-10 (Classification of mental and behavioral disorders) was used for diagnosis of psychiatric disorders. The data was processed statistically using Microsoft Office-Exceh The Jamovi Project (2021). jamovi (Version 1.6) [Computer Software]. In 2020 there were 39.58% fewer discharges by a total of (7973 cases) compared to (13197 cases) in 2019. In 2020, acute intoxication (F10.0) accounted for 7.41% of total discharges compared to a percentage of (8 27%) in 2019, shaming a decline by a parentage of 45.92%. Comparing the . years 2020 with 2019 by gender (of the total number of discharges with acute intoxication (F10.0), them is an increase in the parentage of discharges by 1.16% (from 86.98% in 2019 to 88.14% in 2020), while in the female gender, the percentage trend has decreased by a parentage of 1.16% (from 13.02% in 2019 to 11.86% in 2020).