Dramatic increase of suicidality in children and adolescents after COVID-19 pandemic start: A two-year longitudinal study

The COVID-19 pandemic has impacted the mental health of the youngest, worsening their emotional well-being. The demand for care in psychiatric emergencies may indirectly reflect the mental health state of children and adolescents and the emotional consequences of the pandemic. Moreover, suicidality can be considered a marker of severity in this population group. Therefore, we have aimed to longitudinally describe the number of children and adolescents attended in the psychiatry emergency department due to suicidal ideation or attempts and, to explore differences in suicidality according to gender and age. A retrospective study was carried out in the University Hospital of San Juan, Alicante, Spain, from 01.01.2018 to 31.12.2021. A total of 138 participants under 18 years requesting psychiatric care due to suicidal ideation or attempts were included. The sample was composed by 35% of males and the mean age was 14.8 years old (SD = 2.2). The number of cases per year range from 10 in 2018 to 88 in 2021. Attendances were significantly higher between 2021 and the three previous years. Besides, the number of attentions registered in the last 9 months of 2021 equals those that occurred in the entire previous period. Most of the cases were girls and middle adolescents. Suicide ideation or attempts have skyrocketed in children and adolescents. This alarming increase presents a one-year lag peak from the COVID-19 outbreak and continues until the end of 2021. Girls and those over 12 years have been identified as risk groups to present suicidal ideation or attempts.

How the pandemic affected Filipinx Americans: Analysis on enculturation levels, health care work, and mental health outcomes

The COVID-19 pandemic resulted in numerous adverse mental health effects and subsequent disparities for many both in the United States and worldwide, which have been exacerbated in underrepresented and minoritized populations in the United States. The Filipinx American population makes up 4% of registered nurses in the United States, and more than half of the registered nurses of color who have died were FilAms. Given this disproportionate COVID-19 impact on the FilAm community, there is a need for disaggregated data of the diverse Asian American and Pacific Islander (AAPI) community. In our sample of 332 FilAms, we explored the relationships between the levels of enculturation, COVID-19 traumatic stress, and depression and anxiety. We found significant high levels of depression and anxiety within our sample. Multiple linear regressions were used to analyze the relationship between dimensions of enculturation (connection to homeland, interpersonal norms, conservatism) and mental health outcomes. Results indicated significant associations between COVID-19 fears and connection to homeland and interpersonal norms, and traumatic economic stress and isolation and disturbed routine with interpersonal norms. However, we found significant indirect relationships between conservatism and two dimensions of the COVID-19 traumatic stress (COVID-19 fears and isolation and disturbed routine). Results also predicted positive associations between interpersonal norms with depression and anxiety, but an indirect relationship with conservatism. This study underscores the importance of disaggregated AAPI health data and addressing the needs of the underrepresented FilAm community. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement The findings of this study have theoretical and applied implications with regard to how community leaders, clinicians, and researchers decrease the gaps in health disparities and identify potential risk factors to increase well-being for Filipinx Americans. Aside from providing major contributions to the discipline of psychology, we hope that our findings will lead to advocacy work in disaggregating data for Asian Americans and subsequent development of public health policies to address mental health concerns for Filipinx Americans. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Closing the digital divide: Developing a platform to conduct training, outreach, and education for employment skills.

El Paso, Texas, like many communities along the United States/Mexico border, suffers from a lack of access to many social determinants of health, especially in low-income neighborhoods. These long-standing problems have only been exacerbated by the COVID-19 pandemic. The Texas Tech University Health Sciences Center El Paso Health Education and Awareness Team (EP-HEAT) is an organization that was established with a focus on disseminating health information to the community. EP-HEAT received funding from Microsoft Corporation to facilitate technology education workshops for underserved populations. These workshops were held in English and Spanish and attempted to improve social determinants of health in the community which can be negatively exacerbated by a lack of digital inclusion. Community members who attended workshops completed a LinkedIn Learning Path, or both were offered an anonymous post-course survey with a mixed method questionnaire on how their knowledge of basic technology or job skills was improved by engaging with the provided workshops and learning paths. Overall, 80% of community members who participated in the workshops reported learning a new skill, and 91% of participants who started a LinkedIn Learning Path were able to finish. The workshops were well received by the community and highlighted the potential for these programs to enhance digital skills and upward workforce mobility.

What about mental health after one year of COVID-19 pandemic? A comparison with the initial peak.

A psychiatric epidemic has accompanied the COVID-19 pandemic and specific vulnerable populations have been identified. We aimed to explore the presence of anxiety, acute stress and depression among these vulnerable groups after a year of pandemic and relate them to our previous results obtained with the same methodology during the initial peak of the pandemic in Spain. A total of 2182 participants conducted a national survey, starting on March 2021. Sociodemographic information and clinical symptoms were assessed. The sample was divided into four groups in order to develop four substudies with these results: 1) Healthcare workers presented lower anxiety, acute stress, and depression than non-Healthcare workers (p < 0.001), being nurses the most affected. 2) People with mental disorders experienced higher anxiety, acute stress, and depression than people without (p < 0.001), as well as a higher rate of COVID cases (14% vs. 9.3%, p = 0.041). 3) People ≥60 years old presented lower anxiety and acute stress than people <60, (p < 0.05) and a weaker depressive syndrome (p = 0.003). 4) Males presented lower anxiety, acute stress and depression than females (p < 0.001). According to the results obtained during the initial peak, Healthcare workers have developed efficient coping strategies, while elders have managed to maintain their previously emotional balance. Notwithstanding, women and people with mental disorders continue to be vulnerable to emotional distress after a year of pandemic. Women and people with mental disorders continue to be especially vulnerable to emotional distress after a year of pandemic.

The PANDORA Study: Prevalence and Outcome of Acute Hypoxemic Respiratory Failure in the Pre-COVID-19 Era.

OBJECTIVES: To establish the epidemiological characteristics, ventilator management, and outcomes in patients with acute hypoxemic respiratory failure (AHRF), with or without acute respiratory distress syndrome (ARDS), in the era of lung-protective mechanical ventilation (MV). DESIGN: A 6-month prospective, epidemiological, observational study. SETTING: A network of 22 multidisciplinary ICUs in Spain. PATIENTS: Consecutive mechanically ventilated patients with AHRF (defined as Pao2/Fio2 ≤ 300 mm Hg on positive end-expiratory pressure [PEEP] ≥ 5 cm H2O and Fio2 ≥ 0.3) and followed-up until hospital discharge. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Primary outcomes were prevalence of AHRF and ICU mortality. Secondary outcomes included prevalence of ARDS, ventilatory management, and use of adjunctive therapies. During the study period, 9,803 patients were admitted: 4,456 (45.5%) received MV, 1,271 (13%) met AHRF criteria (1,241 were included into the study: 333 [26.8%] met Berlin ARDS criteria and 908 [73.2%] did not). At baseline, tidal volume was 6.9 ± 1.1 mL/kg predicted body weight, PEEP 8.4 ± 3.1 cm H2O, Fio2 0.63 ± 0.22, and plateau pressure 21.5 ± 5.4 cm H2O. ARDS patients received higher Fio2 and PEEP than non-ARDS (0.75 ± 0.22 vs 0.59 ± 0.20 cm H2O and 10.3 ± 3.4 vs 7.7 ± 2.6 cm H2O, respectively [p < 0.0001]). Adjunctive therapies were rarely used in non-ARDS patients. Patients without ARDS had higher ventilator-free days than ARDS (12.2 ± 11.6 vs 9.3 ± 9.7 d; p < 0.001). All-cause ICU mortality was similar in AHRF with or without ARDS (34.8% [95% CI, 29.7-40.2] vs 35.5% [95% CI, 32.3-38.7]; p = 0.837). CONCLUSIONS: AHRF without ARDS is a very common syndrome in the ICU with a high mortality that requires specific studies into its epidemiology and ventilatory management. We found that the prevalence of ARDS was much lower than reported in recent observational studies.

Impact of a pharmaceutical intervention on influenza vaccination in patients receiving treatment with biological medicines.

OBJECTIVE: The aims of this study were twofold - to determine the impact of a health education intervention led by a hospital pharmacy department on influenza vaccination take-up in patients diagnosed with immune-mediated diseases. Patients were receiving treatment with biological medicines. Secondly, to compare those rates with the vaccination percentages of another hospital pharmacy with similar characteristics in which no educational intervention was conducted. METHODS: This was a retrospective cohort study of adult patients with immune-mediated diseases receiving treatment with biological medicines. The medicines were dispensed by the hospital pharmacy departments of two hospitals between 1 January 2019 and 31 December 2020. In Cohort A (intervention group), a health education strategy was implemented with regards to influenza vaccination. Cohort B acted as a control group. The influenza vaccination rates obtained in both cohorts during 2019 and 2020 were compared. RESULT: A total of 355 patients took part in the study - 148 (41.7%) in Cohort A and 207 (58.3%) in Cohort B. The hospital pharmacy department in Cohort A implemented a health education strategy after which the vaccination percentage during the 2020 campaign increased by 38 patients (45.7%), compared with a 10 patient (5.8%) increase in Cohort B (p<0.001). CONCLUSIONS: The health intervention by the pharmacy department had a positive impact. This included an opportunity to improve vaccination take-up and is a strategy to consider when implementing a vaccination programme. Health education is a fundamental objective of healthcare. In our case it led to an increase in vaccination and had a positive impact on public health. It also provides opportunities for pharmacists to work in a multidisciplinary way with other healthcare professionals.

Innovation and Dynamic Capabilities to Face the Threat of COVID-19: Spain's Hotel Sector Study

The aim of this research is to explore the effect of dynamic capabilities on firm performance in Spanish hotels to further expand our current knowledge of management strategies in a turbulent environment. It also embraces novel aspects by linking uncertain changes with the current literature on the COVID-19 pandemic. This research also emphasizes the mediation effect of innovation capability as a key hotel strategy in today's world. The final sample is composed of 212 hotels in Spain. The results reveal a positive and significant relationship between dynamic capabilities and hotel performance, which is mediated by innovation capability (partial mediation effect). The practical implications of this research can help navigate the economic consequences of the COVID-19 pandemic.

Mental health in elderly Spanish people in times of COVID-19 outbreak

Background: We aim to assess COVID-19 outbreak-related emotional symptoms, identify gender differences, and study the relationship between the emotional state and environmental features in the elderly. Methods: We conducted a cross-sectional study starting on March 29 to April 5, 2020 based on a national online survey using snowball sampling techniques. Symptoms of anxiety (Hamilton Anxiety Scale), depression (Beck Depression Inventory) and acute stress (Acute Stress Disorder Inventory) were compared between people over and under 60 years old. Gender differences and the relationship of loneliness, regular exercise, economic losses and use of anxiolytics on the mental state were evaluated. Results: One thousand six hundred thirty-nine (150 [9.2%] aged >= 60) participants completed the survey. The greater than or equal to 60 group showed lower mean (SD) BDI levels than the less than 60 group (3.02 [3.28] versus 4.30 [4.93]);and lower mean (SD) acute stress disorder inventory scores than the less than 60 group (3.68 [3.20] versus 4.45 [3.06]). There were no gender differences in any of the clinical measures. The presence of economic losses as well as the increase in the use of anxiolytics was significantly associated with higher emotional distress in the elderly compared to the younger group. Conclusions: Older people have shown less emotional distress, with no differences between men and women. Economic loss and substance use should be monitored to guarantee the emotional well-being of the elderly. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Different emotional profile of health care staff and general population during the COVID-19 outbreak.

OBJECTIVE: The aims of this study were to assess COVID-19 outbreak-related emotions, to identify vulnerable groups within health care workers (HCW) and to study the relationship between the emotional state and some environmental features. METHOD: We conducted a cross-sectional study on March 29 to April 5, 2020 based on a national online survey using snowball sampling techniques. A list of emotional states was compared in HCW and non-HCW and within HCW roles. The relationship between COVID-19 related symptoms, information, and protective measures and the emotional state was analyzed. RESULTS: Fear (p < .001, φc = .11), irritability (p = .001, φc = .08), frustration (p < .001, φc = .10), anger (p = .013, φc = .06), and helplessness (p < .001, φc = .13) appear significantly more frequently in HCW compared to non-HCW. Within HCW, a higher percentage of physicians, especially the less experienced, significantly perceived uncertainty and frustration (p = .001, φc = .13 and p = .025, φc = .10, respectively), while a higher percentage of nurses significantly experienced sadness (p = .024, φc = .10). Having a confirmatory diagnosis of the disease was related to hypochondria sensation (p = .026, φc = .10). Sadness (p = .035, φc = .09), intolerance (p = .058, φc = .09), anger (p = .024, φc = .10), and helplessness (p = .028, φc = .10) appeared as the most relevant emotions when information was perceived as insufficient. CONCLUSIONS: The knowledge of the most prevalent different emotional patterns in HCW, as well as in the general population, will allow the detection of subjects at risk for the development of mental disorders and the implementation of therapeutic approaches in future similar situations of pandemic or outbreak of the current one. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The impact on mental health patients of COVID-19 outbreak in Spain.

Public health studies warn of the vulnerability of people with mental disorders during the COVID-19 outbreak. Thus, the aims of this study were to (1) explore the presence of symptoms of anxiety, depression and acute stress among people with a mental disorder (MD); (2) evaluate the rate of COVID-19 infection between MD and non-MD, and (3) study the relationship between the emotional state of people with a mental disorder and some environmental variables. A cross-sectional study starting on March 29 to April 5, 2020 based on a national online survey using snowball sampling techniques was conducted. Symptoms of anxiety (Hamilton Anxiety Scale), depression (Beck Depression Inventory) and acute stress (Acute Stress Disorder Inventory) were compared in MD and non-MD. The rate of COVID-19 confirmed cases among MD and non-MD was compared as well as the relationship between some environmental variables and the emotional state within MD. Up to 1839 [201 (10.9%) MD] participants completed the survey. MD showed significant higher mean (SD) in anxiety [24.7 (11.8) vs. 17 (10.3); p = 0.001], depression [7.9 (6.0) vs. 4.2 (4.2); p = 0.001] and acute stress [6.3 (3.2) vs. 4.4 (3.1); p = 0.001] scores than non-MD. The COVID-19 confirmed cases rate was higher in MD participants than in non-MD (3.5% vs. 0.4%; p < 0.001). Among the MD group, being a COVID-19 confirmed case, the lack in basic needs coverage, the rpesence of violence, drug use and the absence of physical excercise were associated with more severe depressive symptoms. Findings suggest that the COVID-19 has an impact on the emotional state of people with mental disorders.

Gender differences in emotional response to the COVID-19 outbreak in Spain.

OBJECTIVE: We aim to explore the differential presence of symptoms of anxiety, depression, and acute stress between men and women during the COVID-19 outbreak, and to study the relationship between these symptoms and two environmental variables, coexistence, and violence. METHODS: We conducted a cross-sectional study starting on March 29 to April 5, 2020, based on a national online survey using snowball sampling techniques. Symptoms of anxiety (Hamilton Anxiety Scale), depression (Beck Depression Inventory), and acute stress (Acute Stress Disorder Inventory) were assessed. Differences in the presence of symptoms and the relationship of coexistence and domestic violence were evaluated from a gender perspective. RESULTS: Men showed significant lower mean (SD) in anxiety, depression, and acute stress levels than women [HARS, 14.1 (9.8) versus. 18.4 (10.2), F = 56.2, p < .001; BDI 3.4 (3.9) versus 4.5 (4.3), F = 16.6, p < .001, and ASDI 3.6 (2.9) versus 4.7 (3.1), F = 39.0, p < .001, respectively), as well as a weaker depressive syndrome (28.1% males versus 39.9% females, χ2  = 25.5, p < .001). In addition, an interaction Gender × Coexistence was found in anxiety (F = 56.2, p < .001) and acute stress (F = 3.52, p = .06) and, according to depressive symptoms, an interaction Gender × Violence was found marginally significant (F = 3.3, p = .07). CONCLUSIONS: Findings indicate that women present greater severity in symptoms of anxiety, depression, and acute stress. Moreover, loneliness and violence specifically worsen the emotional state in women. These results can undoubtedly guide better healthcare planning adopting a gender perspective.