First episode psychosis during the Covid-19 pandemic in Milan, Italy: Diagnostic outcomes at 1-year follow-up.

An influence of the Covid-19 pandemic on First Episode Psychosis (FEP) has been hypothesized. We previously reported an increase of FEP during the early stages of the pandemic in Milan, Italy. Here we report a 1-year follow-up of the same cohort and comparison with a FEP cohort from 2019. The higher proportion of non-chronic psychoses observed during the pandemic (58.62% in 2020 vs 43,75% in 2019) should be confirmed in larger cohorts over a longer follow-up period.

CardioMEMS monitoring system improves prognosis of patients with advanced heart failure in the real-world

Background: Despite several pharmacological advances, the morbidity and mortality in heart failure (HF) remain high, posing a problem for both patients and the National Health System. The natural history of this disease alternates phases of stability and phases of exacerbation, with a progressive decline in the patient's functional capacity and quality of life;this has led to the development of remote monitoring systems. These devices are emerging as an important tool for the effective HF management, even during the COVID-19 pandemic. Methods: We enrolled 6 patients with end-stage HF, who received the combined CardioMEMS / Levosimendan strategy to reduce the number of hospitalizations and optimize both tailored adjustment of home therapy and infusions of Levosimendan. Specifically, CardioMEMS is a wireless sensor that can be implanted in the pulmonary artery, where it detects cardiac filling pressures, an objective measure of the patient's hemodynamic congestion;these pressures increase two weeks before the onset of symptomatic congestion. Results: The 6 patients (72.25±4.60 years;33.33% female) who received the device did not have any complications related to the procedure. Patients were monitored daily by CardioMEMS;if the cardiologist detected a tendency for pulmonary artery diastolic pressure (PAPd) to rise, patients were contacted for home therapeutic changes. If no further changes were possible, the patient was hospitalized for the infusion of Levosimendan. In particular, following the implantation of CardioMEMS, a significant reduction in HF unscheduled hospital admissions was recorded (hospitalizations / month: pre-CardioMEMS 0.657±0.303 vs post-CardioMEMS 0.029±0.021, p 0.0313) (Figure 1). In addition, lower pulmonary arterial pressures were recorded at 6-months FU on CardioMEMS monitoring (pre vs post: PAPs: 51.25±2.56 vs 42.75±2.46 mmHg, p 0.0168;PAPd: 26.25±0.85 vs 20.25±0.85 mmHg, p 0.0034), a reduction in the echocardiographic E/e' ratio (20.86±1.77 vs 14.13±2.02, p 0.0057), an improvement in the quality of life (EQ5D 75.17±2.06 vs 108.60±8.70, p 0.0078) and a reduction in IL-6 levels (p 0.0211). Conclusions: In this study we present the first experience of serial infusions of Levosimendan guided by CardioMEMS. Our results support the usefulness of this device in remote management of the HF patient, especially during this pandemic.

Remote working during the COVID-19 pandemic: A study on the emotional and relational experience and on the well-being of Italian university scholars and clerks

The COVID-19 pandemic has had significant effects on people's well-being and also on their ordinary work activities. This study aims to investigate the emotions, relational experience and well-being of academic personnel who continued their activities in remote working, during the Italian lockdown period in the months of March and April 2020. For this purpose, 87 workers (55 % scholars and 45 % university clerks) filled out an online quali-quantitative questionnaire about their experiences of being in lockdown and doing their work remotely. Qualitative data were analyzed through Grounded Theory Methodology using the ATLAS.ti 8.4 software. From the coding process, the following macro-categories emerged: remote working, affects and interpersonal relationships in lockdown. Then cross-tabs intertwined the code groups emerged with work role and gender of participants. In the end, the frequencies in the cross-tabs were analyzed by Chi square test. Quantitative data were analyzed through Univariate Analysis of Variance (ANOVA) using SPSS 22 software. The results showed that scholars consider remote working mainly as a critical issue, while clerks see it more as a resource. Moreover, clerks more frequently report negative feelings of anxiety, fear and anger, while scholars more frequently report loneliness. Regarding interpersonal relationships, no significant differences between scholars and clerks were observed. Neither affects nor interpersonal relationships were associated with gender differences. Moreover, clerks reported lower economic and overall well-being compared to scholars. Finally, results highlighted the importance of the mattering role of human relations in work activities;this core category gives some practical implications that will be discussed extensively. © 2022 Sapienza Universita Editrice. All Rights Reserved.

The impact of the pandemic and the family relations on aggressive behaviours in adolescence

The aim of the study was investigating the association between the impact of the COVID-19 pandemic on the life of adolescents and their families and aggressive behaviour, moreover examining the moderating role of parental warmth. 1.053 adolescents completed online measures regarding: impact of the pandemic on individuals and family harmony, warmth, aggressive behaviour and perceived change of aggressive behaviour during the lockdown. Two structural equation models were tested to examine relations among variables. Results evidenced: a) the association between higher individual impact of the pandemic and higher levels of aggressive behaviours and their increase;b) the association between a higher impact of the pandemic on family harmony and the increase of aggressive bahaviours;c) the protective role of parental warmth. © FrancoAngeli

Well-Being and the COVID-19 Pandemic A Community Psychology Systematic Review

The purpose of this systematic review is to analyze the COVID-19 pandemic's effects through the lens of community psychology. Our study applied PRISMA methodology, and it was carried out using the PsycInfo, PubMed, Embase, and EBSCO databases utilizing the keywords "connectedness," "resilience," "shared action," "social action," "trust," "individual well-being," and "social well-being." We selected 12 of 216 eligible publications based on the inclusion criteria. The results indicated that the role of trust in institutions and others is a protective factor for communities that experience crises, such as the COVID-19 pandemic. Moreover, developing social actions promoted connections and social support and that, in the absence of in-person communication, online communication promoted connections and reduced psychological distress and isolation. Finally, the study revealed that some psychosocial factors stem from declines in people's well-being due to the pandemic and subsequent lockdowns. Furthermore, our findings highlighted the role of technology as a positive communication tool for promoting connectedness and social support, as well as the social function of trust in institutions. Our results suggested that community interactions at the local and virtual levels should be viewed as positive actions to support institutions in detecting the most effective social intervention measures to stimulate individual and community well-being during the pandemic. These findings may serve as a guide for health policymakers in their efforts to face the effects of the COVID-19 pandemic supporting beneficial strategies for social planning and effective public policies. Finally, both the strengths and limitations of the research will be discussed in depth.

Impact of the first Covid-19 pandemic wave on first episode psychosis in Milan, italy.

The ongoing Corona Virus Disease 2019 (COVID-19) pandemic appears to increase risk for mental illness, either directly due to inflammation caused by the virus or indirectly due to related psychosocial stress, resulting in the development of both anxious-depressive and psychotic symptoms. The purpose of the present study was to assess the frequency and characteristics of all patients with First Episodes Psychosis (FEP) without COVID-19 infection hospitalized in the first four months since lockdown in Milan. We recruited sixty-two patients hospitalized between March 8 to July 8, 2020 versus those first  hospitalized in the same period in 2019. The two subgroups were compared for sociodemographic variables and clinical characteristics of the episodes. Patients with FEP in 2020 were significantly older than patients with FEP in 2021, and presented with significantly less substances abuse. Interestingly, patients presenting with FEP in 2020 were significantly older than patients with FEP in 2019. These data are compatible with the greater vulnerability to stressful factors during the pandemic, as well as with the greater concern regarding a possible COVID-19 infection producing brain damage causing the FEP.

The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice.

Novel coronavirus 2019 is a single-stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non-technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.