Anxiety and depression among nursing students during the COVID-19 lockdown: A cross-sectional correlational study.

AIMS AND OBJECTIVES: To determine the prevalence and levels of anxiety and depression symptoms among nursing students during the coronavirus lockdown, and to examine factors associated with higher levels of anxiety and depression on this population. BACKGROUND: Nursing students deal with diverse stressors during their university lives. Confinement measures during COVID-19 outbreak may have influenced students' mental health and well-being. Anxiety and depression are common among nursing students due to different factors. Evidence relating to anxiety and depression in nursing student population during SARS-CoV-2 pandemic is limited. DESIGN: A cross-sectional descriptive co-relational study during the lockdown due to the coronavirus outbreak in Spain was conducted. METHODS: An online questionnaire was developed by using google forms. Sociodemographic characteristics form, and the Spanish version of the Hospital Anxiety and Depression Scale (HADS) were used. Spanish nursing students across the country were enrolled. Data collection was performed between 4 April 2020 and 21 April 2020. A multivariate analysis was performed to determine the association between sociodemographic variables, COVID-19 and HADS scores. RESULTS: 1319 participants were enrolled. The sample was formed by 87.1% female students with a mean age of 22 years (SD ± 5.677). We found a mean score of 8.47 ± 4.104 on Scale HADS-Anxiety and 6.80 ± 2.988 on HADS-Depression. 31.6% students presented abnormal scores of anxiety symptoms, and only 11.4% participants revealed abnormal scores on HADS-Depression. CONCLUSIONS: The reported prevalence of anxiety and depression symptoms on nursing students during the COVID-19 lockdown is 56.4% and 38.2%, respectively. 43.6% of the sample scored normal anxiety levels, and 61.8% obtained normal depression levels. Higher anxiety and depression levels were statistically associated with being a first-year student, being a smoker, feeling fear, feeling stress and having any close family member infected. RELEVANCE TO CLINICAL PRACTICE: These data should be valuable for detection and for further treatment decision of this disorders at the initial stage and could be important to prevent further damages to mental health and promote physical, psychological and well-being among this population.

[Psychological Impact of COVID-19 on Health Workers During the Second Year of the Pandemic in Latin America: Cross-Sectional Survey Study]. / Impacto psicológico del COVID-19 en los trabajadores sanitarios durante el segundo año de pandemia en Latinoamérica: estudio de encuesta transversal.

Introduction: The coronavirus pandemic continues to affect the mental health of healthcare personnel in Latin America (LA). Objective: To estimate the prevalence of psychological disturbances and associated risk factors for mental health in healthcare personnel in LA during the second year of the COVID-19 pandemic. Method: This multicenter cross-sectional study included a total sample of 5437 healthcare professionals from Argentina, Bolivia, Chile, Colombia, Ecuador, and Peru. The PHQ-9, GAD-7, and a brief demographic questionnaire were used. The prevalence of anxiety and depression was estimated based on the cut-off points of the instruments. Two multivariate logistic regressions were performed. Results: A population burden of anxiety (40.1%) and depression (62.2%) was found in healthcare personnel in LA. Among professionals in Argentina (OR = 1.374; P<.001), those working in state hospitals (OR = 1.536; P<.003), frontline healthcare workers for COVID patients (OR = 1.848; P<.001), general practitioners (OR = 1.335; P<.001), and specialists (OR = 1.298; P<.001), a higher risk of experiencing mental disorders was observed. Among women, younger personnel, and administrative staff, a higher probability of experiencing anxiety and depression was identified. Conclusions: The burden of mental disorders on healthcare personnel in Latin America is alarming. Psychological support services are necessary, aimed at providing measures for professionals to develop healthy coping mechanisms that mitigate the impact of the pandemic on their well-being and facilitate post-crisis adjustment.

Impacto psicológico del Covid-19 en los trabajadores sanitarios durante el segundo año de pandemia en Latinoamérica: Estudio de encuesta transversal Psychological Impact of Covid-19 on Health Workers during the Second Year of the Pandemic in Latin America: Cross-Sectional Survey Study

La pandemia del Coronavirus continúa afectando la salud mental del personal sanitario en Latinoamérica (LA). Objetivo. Estimar la prevalencia de las alteraciones psicológicas y los factores de riesgo asociados a la salud mental en el personal de salud de LA, durante el segundo año de pandemia del Covid-19. Método. Estudio transversal multicéntrico que incluyó una muestra total de 5437 profesionales de la salud de Argentina, Bolivia, Chile, Colombia, Ecuador y Perú. Se utilizó el PHQ-9, el GAD-7 junto a un cuestionario demográfico breve. Se estimó la prevalencia de ansiedad y depresión a partir de los puntos de corte de los instrumentos. Se realizaron 2 regresiones logísticas multivariantes. Resultados. Se encontró una carga poblacional de ansiedad (40,1%) y depresión (62,2%) en el personal sanitario de LA. En los profesionales de Argentina (OR=1,374;p<0,001), quienes trabajan en hospitales estatales (OR=1,536;p<0,003), de primera línea de atención de pacientes con Covid (OR=1,848;p<0,001), en los médicos generales (OR=1,335;p<0,001), especialistas (OR=1,298;p<0,001), se observó un mayor riesgo de sufrir trastornos mentales. A su vez, en las mujeres, el personal más joven y en los administrativos se identificó una mayor probabilidad para sufrir ansiedad y depresión. Conclusiones. La carga de trastornos mentales en el personal de salud de Latinoamérica es alarmante. Es necesario servicios de apoyo psicológico, orientados a proporcionar medidas para que los profesionales desarrollen mecanismos de afrontamiento saludables que mitiguen el impacto de la pandemia en su bienestar y faciliten el ajuste posterior a la crisis sanitaria.

Fulminant myocarditis following SARS-CoV-2 mRNA vaccination rescued with venoarterial ECMO: A report of two cases.

INTRODUCTION: Cases of myocarditis after COVID-19 messenger RNA (mRNA) vaccines administration have been reported. Although the majority follow a mild course, fulminant presentations may occur. In these cases, cardiopulmonary support with venoarterial extracorporeal membrane oxygenation (V-A ECMO) may be needed. RESULTS: We present two cases supported with V-A ECMO for refractory cardiogenic shock due to myocarditis secondary to a mRNA SARS-CoV2 vaccine. One of the cases was admitted for out-of-hospital cardiac arrest. In both, a peripheral V-A ECMO was implanted in the cath lab using the Seldinger technique. An intra-aortic balloon pump was needed in one case for left ventricle unloading. Support could be successfully withdrawn in a mean of five days. No major bleeding or thrombosis complications occurred. Whereas an endomyocardial biopsy was performed in both, a definite microscopic diagnosis just could be reached in one of them. Treatment was the same, using 1000mg of methylprednisolone/day for three days. A cardiac magnetic resonance was performed ten days after admission, showing a significant improvement of the left ventricular ejection fraction and diffuse oedema and subepicardial contrast intake in different segments. Both cases were discharged fully recovered, with CPC 1. CONCLUSIONS: COVID-19 vaccine-associated fulminant myocarditis has a high morbidity and mortality but presents a high potential for recovery. V-A ECMO should be established in cases with refractory cardiogenic shock during the acute phase.

Psychological disorders among Spanish Nursing students three months after COVID-19 lockdown: A cross-sectional study.

The COVID-19 pandemic had a notable impact on the psychological well-being of a large part of the population, putting them at risk of developing depressive symptoms, different levels of anxiety disorders, and posttraumatic stress disorder (PTSD). One group considered to be at high risk are Nursing students; they were affected as learning strategies changed and clinical practices were cancelled. This study attempts to assess the psychological impact COVID-19 pandemic had on Nursing students and to explore the sociodemographic differences that can be risk factors for mental health disturbance. The psychological impact was evaluated using the Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). The study took place 4 months after the state of alarm was declared over in Spain. From a total sample of 304 Nursing students, 26.7%, 39.8%, and 15.5% showed PTSD, anxiety, and depression symptoms, respectively. Severe levels of psychological impact have been associated with being a female, a smoker, and feeling fear and stress. Having a relative test positive has been linked to lower anxiety levels while being afraid or stressed to higher anxiety levels. Being a female, co-habit with friends and feeling stress have been associated with higher depression levels.

Psychological impact of COVID19 on community pharmacists and pharmacy technicians.

BACKGROUND: The unique situation related to the COVID-19 outbreak and the consequent worldwide lockdown can have a psychological impact on specific populations. Community pharmacists and pharmacy technicians, as essential healthcare workers on the front line who continue to do their jobs during this pandemic, can also experience psychological distress. Few data are available on the mental health impact of the COVID-19 pandemics on this population. OBJECTIVES: This study aimed to assess the psychological impact of COVID-19 on Spanish community pharmacists and pharmacy technicians during lockdown, and to identify factors contributing to psychological distress. METHODS: A cross-sectional, quantitative, correlational study was designed including 1162 pharmacy team members. The Impact of Event Scale revised was used to assess the psychological impact. Data collection was performed by emailing the instrument to individuals or by using social networks. RESULTS: Overall participants, almost 70% revealed severe levels of psychological impact. The outbreak of COVID-19 has significantly affected community pharmacy workers, the degree of which is related to gender, age, and feelings of fear/stress. CONCLUSIONS: In the initial phase of the lockdown associated with the COVID-19 outbreak, the majority of the respondents rated the psychological impact as severe. Our findings allow for the identification of factors associated with a greater psychological impact.

Thrombocytopaenia and COVID-19 infection during pregnancy increases the risk of preeclampsia: a multicentre study.

RESEARCH QUESTION: Is a low platelet count related to an increased risk of severe disease in pregnant women with active severe acute respiratory syndrome coronavirus 2 infection? DESIGN: A cross-sectional multicentre study in pregnant women with COVID-19 confirmed by polymerase chain reaction, antigen test, antibody test, or all. RESULTS: A total of 153 pregnant women with COVID-19 were included in the study, of whom 12.4% had thrombocytopaenia. Pregnant women with thrombocytopaenia were on average 3.1 years older (95% CI 0.18 to 6.38) than women without thrombocytopaenia. Pregnant smokers had a higher risk of thrombocytopaenia than non-smokers (OR 6.55, CI 95% 1.29 to 33.13). B Rh negative (B Rh-) pregnant women had a much higher risk of thrombocytopaenia than pregnant women with other blood groups (OR 16.83, CI 95% 1.42 to 199.8). Pregnant women with thrombocytopaenia had a much higher risk of suffering from preeclampsia (OR 16.2, CI 95% 1.35 to 193.4). CONCLUSIONS: COVID-19 infection is not a risk factor for a low platelet count in pregnant women, although the risk is increased by smoking and in women with blood group B Rh-. In case of pregnancy with thrombocytopaenia, COVID-19 infection leads to an increased risk of preeclampsia.

Inter-Rater Variability in the Evaluation of Lung Ultrasound in Videos Acquired from COVID-19 Patients

Lung ultrasound (LUS) allows for the detection of a series of manifestations of COVID-19, such as B-lines and consolidations. The objective of this work was to study the inter-rater reliability (IRR) when detecting signs associated with COVID-19 in the LUS, as well as the performance of the test in a longitudinal or transverse orientation. Thirty-three physicians with advanced experience in LUS independently evaluated ultrasound videos previously acquired using the ULTRACOV system on 20 patients with confirmed COVID-19. For each patient, 24 videos of 3 s were acquired (using 12 positions with the probe in longitudinal and transverse orientations). The physicians had no information about the patients or other previous evaluations. The score assigned to each acquisition followed the convention applied in previous studies. A substantial IRR was found in the cases of normal LUS (kappa = 0.74), with only a fair IRR for the presence of individual B-lines (kappa = 0.36) and for confluent B-lines occupying < 50% (kappa = 0.26) and a moderate IRR in consolidations and B-lines > 50% (kappa = 0.50). No statistically significant differences between the longitudinal and transverse scans were found. The IRR for LUS of COVID-19 patients may benefit from more standardized clinical protocols.

Colchicine and the combination of rivaroxaban and aspirin in patients hospitalised with COVID-19 (ACT): an open-label, factorial, randomised, controlled trial.

BACKGROUND: COVID-19 disease is accompanied by a dysregulated immune response and hypercoagulability. The Anti-Coronavirus Therapies (ACT) inpatient trial aimed to evaluate anti-inflammatory therapy with colchicine and antithrombotic therapy with the combination of rivaroxaban and aspirin for prevention of disease progression in patients hospitalised with COVID-19. METHODS: The ACT inpatient, open-label, 2 × 2 factorial, randomised, controlled trial was done at 62 clinical centres in 11 countries. Patients aged at least 18 years with symptomatic, laboratory confirmed COVID-19 who were within 72 h of hospitalisation or worsening clinically if already hospitalised were randomly assigned (1:1) to receive colchicine 1·2 mg followed by 0·6 mg 2 h later and then 0·6 mg twice daily for 28 days versus usual care; and in a second (1:1) randomisation, to the combination of rivaroxaban 2·5 mg twice daily plus aspirin 100 mg once daily for 28 days versus usual care. Investigators and patients were not masked to treatment allocation. The primary outcome, assessed at 45 days in the intention-to-treat population, for the colchicine randomisation was the composite of the need for high-flow oxygen, mechanical ventilation, or death; and for the rivaroxaban plus aspirin randomisation was the composite of major thrombosis (myocardial infarction, stroke, acute limb ischaemia, or pulmonary embolism), the need for high-flow oxygen, mechanical ventilation, or death. The trial is registered at www. CLINICALTRIALS: gov, NCT04324463 and is ongoing. FINDINGS: Between Oct 2, 2020, and Feb 10, 2022, at 62 sites in 11 countries, 2749 patients were randomly assigned to colchicine or control and the combination of rivaroxaban and aspirin or to the control. 2611 patients were included in the analysis of colchicine (n=1304) versus control (n=1307); 2119 patients were included in the analysis of rivaroxaban and aspirin (n=1063) versus control (n=1056). Follow-up was more than 98% complete. Overall, 368 (28·2%) of 1304 patients allocated to colchicine and 356 (27·2%) of 1307 allocated to control had a primary outcome (hazard ratio [HR] 1·04, 95% CI 0·90-1·21, p=0·58); and 281 (26·4%) of 1063 patients allocated to the combination of rivaroxaban and aspirin and 300 (28·4%) of 1056 allocated to control had a primary outcome (HR 0·92, 95% CI 0·78-1·09, p=0·32). Results were consistent in subgroups defined by vaccination status, disease severity at baseline, and timing of randomisation in relation to onset of symptoms. There was no increase in the number of patients who had at least one serious adverse event for colchicine versus control groups (87 [6·7%] of 1304 vs 90 [6·9%] of 1307) or with rivaroxaban and aspirin versus control groups (85 [8·0%] vs 91 [8·6%]). Among patients assigned to colchicine, 8 (0·61%) had adverse events that led to discontinuation of study drug, mostly gastrointestinal in nature. 17 (1·6%) patients assigned to the combination of rivaroxaban and aspirin had bleeding compared with seven (0·66%) of those allocated to control (p=0·042); the number of serious bleeding events was two (0·19%) versus six (0·57%), respectively (p=0·18). No patients assigned to rivaroxaban and aspirin had serious adverse events that led to discontinuation of study drug. INTERPRETATION: Among patients hospitalised with COVID-19, neither colchicine nor the combination of rivaroxaban and aspirin prevent disease progression or death. FUNDING: Canadian Institutes for Health Research, Bayer, Population Health Research Institute, Hamilton Health Sciences Research Institute, Thistledown Foundation. TRANSLATIONS: For the Portuguese, Russian and Spanish translations of the abstract see Supplementary Materials section.

The impact of vaccination upon dental clinic avoidance and the cessation of individual protection measures

The aim of this study was to analyze the evolution of germ aversion, to perceived infectability and to the fear of COVID-19 from the beginning of the pandemic until the arrival of the vaccines. A repeated measures design was used with three time points during the pandemic. The survey consisted of: Scale of perceived vulnerability to disease;Scale of fear of COVID-19;They were asked if they were vaccinated and if that vaccination is complete. They were asked if they would avoid the dental clinic through fear of COVID-19;and if they have reduced preventive practice in response to COVID-19. A T0-T1 increase in perceived infectability and germ aversion was reported. However, fear of COVID-19 decreased at T1-T2. The vaccinated experienced a greater reduction than the unvaccinated and a greater relaxation of their preventive practice. The frequency of dental avoidance decreased in the vaccinated group from T1 to T2 by 68.3% while in the non-vaccinated this reduction was only 4.9%;X2 = 18.58 (p < 0.01). In summary, vaccination has had an impact in the reduction of perceived infectability and in reducing fear of COVID-19. Nevertheless, germ aversion has remained stable and independent of vaccination. Empirical support is found for the affirmation that vaccination can reduce certain preventive behavior and dental avoidance.

Prevalencia y factores asociados con las quejas cognitivas subjetivas del personal sanitario latinoamericano durante la pandemia de COVID-19 Prevalence and factors associated with subjective cognitive complaints in Latin American health workers during the COVID-19 pandemic

Introducción y objetivos: Se ha observado un incremento de alteraciones emocionales y quejas sobre el rendimiento cognitivo en el personal sanitario latinoamericano durante la pandemia de SARS-CoV-2;lo cual puede afectar a las capacidades de atención y aumentar los niveles de estrés y burnout de estos profesionales. El objetivo es analizar las quejas cognitivas subjetivas (QCS) y los factores asociados en el personal sanitario durante la pandemia de COVID-19 en 5 países de América Latina. Métodos: Estudio transversal multicéntrico que incluyó a 3.738 profesionales de Colombia, Chile, Argentina, Ecuador, Bolivia y Perú. Se utilizó la Escala de Trastorno de Ansiedad Generalizada (GAD-7) y el Patient Health Questionnaire (PHQ-9) para valorar la depresión y el Mini-Z para evaluar el burnout. Para las QCS se usó un ítem sobre preocupaciones cognitivas en atención y memoria. Resultados: Se observó una prevalencia de queja cognitiva del 69,2%. Los factores asociados con un mayor riesgo de QCS fueron las puntuaciones en GAD-7, PHQ y Mini-Z, además de ser parte del personal de salud del Ecuador. Conclusiones: La prevalencia de QCS en el personal sanitario es alta y está modulada por estados emocionales y estrés.

Emotional Burden among Pharmacists and Pharmacy Technicians during the COVID-19 Lockdown: A Cross Sectional Study.

This study aims to investigate the prevalence of depression and anxiety symptoms among Spanish community pharmacists and pharmacy technicians during the coronavirus disease 2019 (COVID-19) lockdown. A descriptive cross-sectional quantitative study was designed. An online survey was administered to participants from 4 to 21 April 2020 using a questionnaire assessing sociodemographic information and the Spanish version of the Hospital Anxiety and Depression Scale (HADS). Informed consent to participate was requested. Participants comprised 1162 pharmacy staff from Spain with an average age of 39.15 ± 9.718, from 20 to 65 years old, of whom 83% were women, and 50.6% were married. More than half of the participants expressed symptoms of depression (62.7%) and anxiety (70.9%). An important prevalence of anxiety and depression symptoms has been detected among Spanish pharmacists and pharmacy technicians during the COVID-19 lockdown. Being a woman, smoking, feeling fear, feeling stress and believing that pharmacists/pharmacy technicians are very exposed to COVID-19 seem to be associated with higher HADS scores.

The impact of the COVID-19 pandemic on mortality: life expectancy reduction and geographical disparities in Argentina.

OBJECTIVE: To assess the impact of the COVID-19 pandemic on mortality in Argentina, considering temporal trends in life expectancy at birth and premature mortality rate during 2010-2020. METHODS: Based on demographic projections, this ecological time-series study compares a "normal" versus a "COVID-19" mortality scenario for 2020 over a set of 11 Argentine provinces. Annual life expectancy at birth and age-standardized rates of premature mortality were estimated from 2010 to 2020. Joinpoint regression and multilevel models were used. RESULTS: A potential reduction in life expectancy at birth (a gap between scenarios >1 year) was observed. A significant (negative) point of inflection in temporal trends was identified for the country and most of the provinces, under the COVID-19 mortality scenario. However, our findings reveal disparities between provinces in the estimated life expectancy reduction toward 2020 (values range from -0.63 to -1.85 year in females and up to -2.55 years in males). While men showed more accentuated declines in life expectancy at birth in 2020 (a national gap between scenarios of -1.47 year in men vs. -1.35 year in women), women experienced more unfavorable temporal trends of premature mortality. In the absence of COVID-19, an improvement in both indicators was estimated toward 2020 in both sexes, while a return to levels reported in the past was observed under the COVID-19 scenario. CONCLUSION: The COVID-19 pandemic might seriously affect the trends of mortality and exacerbate health disadvantages in Argentina. A temporal and contextual perspective of health inequities merits special attention in the COVID-19 research.

Review of the Quality of YouTube Videos Recommending Exercises for the COVID-19 Lockdown.

BACKGROUND: The world is experiencing a pandemic caused by COVID-19. Insufficient physical activity can increase the risk of illness. Trying to replicate a normal search that any user/patient could do in YouTube, the objective of this study was to evaluate the quality of YouTube videos related to home exercises during lockdown and their adherence to World Health Organization (WHO) recommendations. METHODS: A simple search was carried out on YouTube. The first 150 videos were selected. After applying exclusion criteria, 68 videos were analyzed and evaluated. Two statistical analyses based on machine learning techniques were carried out. Videos were classified according to principal component analysis (PCA) models as 'Relevant' and 'Non-Relevant'. Popularity was assessed using the video power index (VPI). Information's quality and accuracy were gauged using the DISCERN scale and global quality score (GQS). Reliability and credibility of information that can be found on health-related websites was assessed using the Health On the Net Code (HONCode). Exercises were evaluated according to WHO recommendations. RESULTS: DISCERN, HONCode, and GQS scored a mean of 2.29, 58.95, and 2.32, respectively. The PCA calculation allowed videos to auto-classify into high- and low-quality videos. CONCLUSIONS: The quality of YouTube videos recommending exercises during lockdown is low and doesn't reflect WHO recommendations. Effective strategies and tools capable of indicating the quality of this information are needed to filter out erroneous or non-rigorous information that may affect people's health. These tools should help any user/viewer to distinguish videos of high and low quality.

Anthropogenic Infection of Domestic Cats With SARS-CoV-2 Alpha Variant B.1.1.7 Lineage in Buenos Aires.

SARS-CoV-2 reverse zoonosis, particularly to domestic animals, and the potential role of infected animals in perpetuating the spread of the virus is an issue of increasing concern. In this case report, we identified the natural infection of two cats by SARS-CoV-2, in Argentina, whose owner had been previously infected by SARS-CoV-2. Viral genetic material was detected in feline oropharyngeal (OP) and rectal (R) swab by RT-qPCR, and sequence analysis revealed that the virus infecting the owner and one cat were genetically similar. The alpha variant (B.1.1.7 lineage) was identified with a unique additional mutation, strongly suggesting human-to-cat route of transmission. This study reinforces the One Health concept and the importance of integrating human, animal, and environmental perspectives to promptly address relevant health issues.

Behavior Modification Techniques on Patients with Chronic Pain in the Context of COVID-19 Telerehabilitation: An Umbrella Review.

The aim of this systematic review (SR) of SRs was to assess the effectiveness of telerehabilitation based on behavior modification techniques (t-BMT) in patients with chronic musculoskeletal pain. We searched in PubMed, PEDro, Web of Science, CINAHL, PsycINFO, and Google Scholar (January 2022). The outcome measures were pain intensity, disability, psychological distress, pain-related fear of movement, disease impact, depressive symptoms, anxiety symptoms, and physical function. This review was previously registered on the international prospective register of systematic reviews PROSPERO (CRD42021262192). Methodological quality was analyzed using the AMSTAR and ROBIS scales, and the strength of evidence was established according to the Physical Activity Guidelines Advisory Committee grading criteria. Four SRs with and without meta-analyses covering 25 trials and involving 4593 patients were included. Of the three SRs that assessed pain intensity, two reported a significant decrease compared to usual care. Contradictory results were also found in the management of psychological distress, and of depressive and anxiety symptoms. However, two reviews found that t-BMT has significant effects on disability, and one review found that t-BMT seems to be effective for improving pain-related fear of movement and disease impact. Finally, one review found that t-BMT does not seem to be an effective modality to improve physical function. The quality of evidence was limited for all outcomes assessed. The results obtained showed that t-BMT was effective in improving disability, disease impact, and pain-related fear of movement, but it was not effective in improving physical function in patients with chronic pain. Mixed evidence was found for pain intensity, psychological distress, and depressive and anxiety symptoms, with a limited quality of evidence.

One Year of COVID-19 in Spain, Longitudinal Study on Mental and Physical Health.

The objective of this longitudinal study carried out with the same participants, with two repeated measurements, the first taken in March 2020 (M1) and the second measurement in March 2021 (M2), is to investigate the impact of the COVID-19 pandemic throughout one year on the levels of Affect, Psychological Well-being, Depression and Mental and Physical Health, as well as to learn about the evolution of those levels from M1 to M2. Comparison of the mean scores of the variables analyzed between the two measurements (M1 and M2) show significant differences in the following scales: Positive Affect (PANAS), with lower scores at M2; Total Depression (BDI-II) and the two Cognitive-Affective and Somatic-Motivational factors, with higher scores at M2; the physical and mental health scales (SF-36) of Physical Functioning, Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health, and the two Physical and Mental Health components, with lower scores at M2 in all of them; and the Purpose in Life (PWB) scale, with a lower score at M2. We can conclude that the one-year pandemic situation has affected all the variables analyzed in this work, showing a decrease in positive affect, an increase in the score of the depression inventory, worse physical and mental health, and less psychological well-being. Throughout the pandemic year, the results show that age has a moderation effect on the Somatic-Motivational factor and on the Total Depression, Physical Functioning, Vitality, and Role Emotional scales. Gender shows no moderation effect on any of the four variables analyzed.

[Knowledge and attitudes of health workers' hands hygiene during Covid-19's pandemic: an observational study]. / Conoscenze e atteggiamenti nell'igiene delle mani del personale sanitario durante la pandemia Covid-19: uno studio osservazionale.

INTRODUCTION: the infections correlated to the assistance represent the most common adverse events and sets up a world public sanity problem. Preventative behaviour, such as proper hand hygiene, are based on the knowledge and attitudes of care staff. Valuing health workers' knowledge and attitudes becomes fundamental for the individuation of any cognitive gaps. METHODS: a cross sectional study has been conducted in a healthcare authority, during the first lockdown of Covid-19 pandemic. The knowledge's' data have been collected using the World Health Organization's Hand Hygiene Knowledge Questionnaire in its italian version and, for exploring attitudes, questions have been created on the basis of scientific literature. RESULTS: a sample of 363 healthcare workers was enrolled in this study. The 60% of respondent showed a sufficient level and 26.3% were at a good level of knowledge and all the personnel present good attitudes. There has been found an association between knowledge, gender and work area and between attitude, work area and presence of the alcoholic product in the structure. CONCLUSIONS: healthcare workers showed a knowledge level from sufficient to good, and positive attitudes towards hands hygiene. There still remains some cognitive gaps that have to be fixed with formative courses for prevent infections according to the principles of the patient safety program "Clinic Care in Safer Care" of the World Health Organization.

Effectiveness of Telematic Behavioral Techniques to Manage Anxiety, Stress and Depressive Symptoms in Patients with Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis.

Anxiety, depressive symptoms and stress have a significant influence on chronic musculoskeletal pain. Behavioral modification techniques have proven to be effective to manage these variables; however, the COVID-19 pandemic has highlighted the need for an alternative to face-to-face treatment. We conducted a search of PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, APA PsychInfo, and Psychological and Behavioural Collections. The aim was to assess the effectiveness of telematic behavioral modification techniques (e-BMT) on psychological variables in patients with chronic musculoskeletal pain through a systematic review with meta-analysis. We used a conventional pairwise meta-analysis and a random-effects model. We calculated the standardized mean difference (SMD) with the corresponding 95% confidence interval (CI). Forty-one randomized controlled trials were included, with a total of 5018 participants. We found a statistically significant small effect size in favor of e-BMT in depressive symptoms (n = 3531; SMD = -0.35; 95% CI -0.46, -0.24) and anxiety (n = 2578; SMD = -0.32; 95% CI -0.42, -0.21) with low to moderate strength of evidence. However, there was no statistically significant effect on stress symptoms with moderate strength of evidence. In conclusion, e-BMT is an effective option for the management of anxiety and depressive symptoms in patients with chronic musculoskeletal pain. However, it does not seem effective to improve stress symptoms.