PALLIATIVE CARE AND COVID-19 PANDEMIC BETWEEN HOSPITAL-CENTRIC BASED APPROACH AND DECENTRALISATION OF HEALTH SERVICES: A VALUABLE OPPORTUNITY TO TURN THE CORNER?

Italy was the first Western EU country to have dealt with the severe effects of the widespread Covid-19 virus since the pandemic began. Many healthcare services were negatively affected, and the delivery of palliative care has been no exception. The Italian healthcare system has suffered more than others due to public spending cuts. The hospital-based approach has not allowed all patients to receive appropriate care. This situation was brought about not only by the pandemic emergency but mainly by pre-existing shortages due to the cut in financial resources before the Covid-19 pandemic. For countries similar to Italy, it is necessary to develop territorialised health care, decongestion hospitals, and strengthen the Third Sector, particularly the voluntary sector. © EuroMediterranean Biomedical Journal 2023.

A Dialogue on making use of constructionism in different scenarios as a leverage for empowerment, motivation, and learning

The coronavirus pandemic forced Brazilian schools to move to an online environment rapidly. Consequently, many schools just took the traditional classroom approach to screens. This paper aims to reflect on our practices and share an innovative pedagogy that is adaptable to different scenarios and engages all learners. We will describe two cases to illustrate how a constructionist approach has sparked student agency and learning. We observed how a maker workshop contributed to a child with learning loss to complete his literacy process in the first one. In the second, we share the affordances of The Circle of Inventions practice, which allows for the implementation of constructionist moments in any learning environment. Ultimately, we aim to spark interest in more widespread constructionist practices in diverse learning contexts and leverage collaborations for new investigations, design, and implementation of innovative pedagogies in this field. © ISLS.

The impact of the covid-19 pandemic on the risk of social stigma

Introduction: Social stigma indicates a process of negative connotation of a person which results in discrimination. The victim of stigma experiences a condition of social exclusion that negatively affects his relationships. The COVID-19 pandemic has spread the fear of being contaminated, which has led to the discrimination of a part of population. Objective(s): The purpose of this work is to analyze which people have suffered from stigma due to the COVID-19 pandemic by examining the negative effects on their health during this period. Method(s): A literature review of peer-reviewed articles was performed on Pubmed NCBI database by inserting the keywords: stigma and COVID-19 in the period 2020-2021. Result(s): The data showed that the categories most at risk were positive patients and their families;healthcare workers in COVID- 19 wards;Asian people. Discrimination has included avoidance attitudes, physical or verbal abuse, hypersurveillance in public places. Negative effects on victims included anxiety, depression, feelings of rejection and shame, self-harm and suicide. COVID-19 patients attempted to hide the disease by avoiding access to hospital;health personnel developed risk of burnout;Asian restaurants experienced a drop in reservations, even after quarantine period. Conclusion(s): Social stigma is a public health problem and greater efforts are mandatory to reduce it including correct information, with the help of social and mass media;social interventions aimed at generating empathy;avoiding the use of negative language focused on stereotypes that could generate fear or discrimination. Such interventions are crucial to reduce discrimination in such a fragile period as COVID-19 pandemic.

Suicide presentation and the risk at the time of the mandatory quarantine for the SARS-Cov-2 pandemic: medico-legal and forensic aspects

Introduction: COVID-19 pandemic is the most important health emergency of the 21st century. Since the high number of infected people and as there is still no specific therapy worldwide, the pandemic has been countered through the application of prevention measures based on social distancing and home isolation. These elements are known risk factors for the development of various psychiatric conditions. From a forensic point of view, these pathologies are related to a high suicide rate. Objective(s): It is no coincidence that during the previous pandemics that have occurred in history there has been a significant increase in suicides. By this work, we therefore want to highlight the psychological consequencesofapandemicandthe importanceofpreventivestrategies. Method(s): It is important to focus not only on physical well-being but also on the psychological aspects that the pandemic produces in the daily life of each individual Results: If the infecting agent causes the death of millions of people around the world, the socio-economic context that is created indirectly determines as many deaths. Conclusion(s): Therefore it is necessary to underline how it is advisable to implement preventive measures in order to significantly reduce deaths from suicide, a problem with an important impact in the social and forensic fields.

"Second victims" in Covid-19 pandemic: A crosssectional study among medical doctors of the Catanzaro Hospital

Introduction: Medical errors are a serious public health problem. The COVID-19 pandemic has caused further stress to doctors with the increase in patient mortality, the lack of definite guideline and growing work demands. In this scenario, the patient is not the only victim of the medical error. The "second victim" (SV) is defined as a health worker who was involved in an unforeseen and negative event for the patient, who suffers physically and psychologically, because he was traumatized by his own mistake and/or by the injuries caused to the patient. The SV phenomenon prevalence varies from 10.4% up to 43.3%. Objective(s): The aim of this study is to evaluate the second victim phenomenon during the COVID-19 pandemic among medical doctors of the Catanzaro University Hospital (Italy). Method(s): A cross-sectional study will be conducted by administering an anonymous questionnaire to the Catanzaro University Hospital medical doctors using SurveyMonkey software. Descriptive analysis will be performed. Result(s): The data collection is ongoing. Currently, 300 subjects are included in the sample. Conclusion(s): The second victim phenomenon has a negative impact on doctors, colleagues and patients. It is important to aid health workers involved in an adverse event by activating support networks and adopting appropriate strategies in order that the event is a source of learning and not of demotivation.

Clinical course of Coronavirus Disease-19 in patients with haematological malignancies is characterized by a longer time to respiratory deterioration compared to non-haematological ones: results from a case-control study.

BACKGROUND: We evaluated clinical features and risk factors for mortality in patients with haematological malignancies and COVID-19. METHODS: Retrospective, case-control (1:3) study in hospitalized patients with COVID-19. Cases were patients with haematological malignancies and COVID-19, controls had COVID-19 without haematological malignancies. Patients were matched for sex, age and time of hospitalization. RESULTS: Overall, 66 cases and 198 controls were included in the study. Cases had higher prior corticosteroid use, infection rates, thrombocytopenia and neutropenia and more likely received corticosteroids and antibiotics than controls. Cases had higher respiratory deterioration than controls (78.7% vs 65.5%, p = 0.04). Notably, 29% of cases developed respiratory worsening > 10 days after hospital admission, compared to only 5% in controls. Intensive Care Unit admission and mortality were higher in cases than in controls (27% vs 8%, p = 0.002, and 35% vs 10%, p < 0.001). At multivariable analysis, having haematological malignancy [OR4.76, p < 0.001], chronic corticosteroid therapy [OR3.65, p = 0.004], prior infections [OR57.7, p = 0.006], thrombocytopenia [OR3.03, p < 0.001] and neutropenia [OR31.1, p = 0.001], low albumin levels [OR3.1, p = 0.001] and ≥ 10 days from hospital admission to respiratory worsening [OR3.3, p = 0.002] were independently associated with mortality. In cases, neutropenia [OR3.1, p < 0.001], prior infections [OR7.7, p < 0.001], ≥ 10 days to respiratory worsening [OR4.1, p < 0.001], multiple myeloma [OR1.5, p = 0.044], the variation of the CT lung score during hospitalization [OR2.6, p = 0.006] and active treatment [OR 4.4, p < 0.001] all were associated with a worse outcome. CONCLUSION: An underlying haematological malignancy was associated with a worse clinical outcome in COVID-19 patients. A prolonged clinical monitoring is needed, since respiratory worsening may occur later during hospitalization.

Convalescent plasma for haematological patients with SARS-CoV-2 pneumonia and severe depletion of B-cell lymphocytes following anti-CD20 therapy: a single-centre experience and review of the literature

Convalescent plasma (CP) therapy might be effective in patients with haematological malignanciesand B-cell depletion. We report a single-centre experience of COVID-19 patients with non-Hodgkinlymphoma and absence of B-cells as a consequence of anti-CD20 therapy successfully treated withCP from October 2020 to May 2021. CP was given in the presence of pneumonia with respiratoryfailure despite standard treatment and consisted of three infusions on an alternate-day basis. A reviewof the current literature on this topic was also performed. Six patients were identified (medianage 59.5 years (range 50-73)). The last anti-CD20 drug administration occurred 60 days before infection(range 0-360). CP was administered after a median of 51 days (range 9-120) from SARS-CoV-2diagnosis, with an early improvement in all but one subject. We suggest a possible clinical benefitof convalescent CP treatment in COVID-19 patients with haematological malignancies and B-celldepletion having persistent/recurrent pneumonia.

Pandemic vulnerability, policy feedback and support for immigration: Evidence from Asia.

Past studies have shown that disease threat increases people's hostility towards immigrants. However, in our survey (N = 9571) conducted in five advanced Asian economies during the outbreak of COVID-19, we found that COVID-19 vulnerability was positively associated with support for immigration. Drawing on insight from policy feedback theories, we propose that the positive association is caused by the presence of widespread border crossing restrictions, which have changed the meaning and cost implications of COVID-19. As the outbreak expands, the pandemic has become not just a threat to people's health but also a barrier to globalization. Consequently, people who are worried about the disease may see globalization processes, including migration, as signs of pandemic relief. We find supportive evidence in our analysis. First, the positive association between COVID-19 vulnerability and support for immigration is more salient among respondents who considered restrictions on international travel to be stringent. Second, the positive association between COVID-19 vulnerability and immigration attitude was mediated by perceived economic threat from the pandemic and contribution by immigrants towards the containment of the pandemic. These findings suggest that disease control measures adopted at the global level may alter certain widely accepted effects of disease threat on immigration attitudes.

A tale of two city-states: A comparison of the state-led vs civil society-led responses to COVID-19 in Singapore and Hong Kong.

The East Asian experience in tackling COVID-19 has been highly praised, but this high-level generalisation neglects variation in pandemic response measures adopted across countries as well as the socio-political factors that shaped them. This paper compares the early pandemic response in Singapore and Hong Kong, two Asian city-states of similar sizes, a shared history of SARS, and advanced medical systems. Although both were able to contain the virus, they did so using two very different approaches. Drawing upon data from a cross-national, probability sample Internet survey conducted in May 2020 as well as media and mobility data, we argue that the different approaches were the result of the relative strength of civil society vs. the state at the outset of the outbreak. In protest-ridden Hong Kong, low governmental trust bolstered civil society, which focused on self-mobilisation and community mutual-help. In Singapore, a state-led response model that marginalised civil society brought early success but failed to stem an outbreak among its segregated migrant population. Our findings show that an active civil society is pivotal to effective outbreak response and that trust in government may not have been as important as a factor in these contexts.

Risk perceptions, anxiety and the future of international trade: a cross-national study of public trade preferences in Asia under COVID-19

The COVID-19 pandemic has stalled the world's economic activities and obscures the future of economic and trade. Many observers concern that the pandemic would result in growing protectionist attitudes in trade. This article provides one of the first systematic assessments to examine the impact of the COVID-19 pandemic on the public's trade preferences. Using original cross-national surveys in six key and highly integrated economies in Asia – Hong Kong, Japan, Singapore, South Korea, Taiwan, and Thailand – we found that most people support establishing closer trade relationships with foreign countries. However, most people prefer to buy more domestic products than foreign products. We test a behavioural model of trade preferences to understand the psychological impacts of COVID-19 pandemic. Consistent with prior studies, we found that a greater level of anxiety is negatively associated with support for trade and foreign product preference, after controlling for the effects of ethnocentrism, education and other socioeconomic factors. Job and health insecurities reduced public preference for buying more foreign products, but it stimulated more support for trade with other countries. This study contributes to the behavioural theory of international political economy and sheds light on the future of economic globalization. [ABSTRACT FROM AUTHOR] Copyright of Journal of Elections, Public Opinion & Parties is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

When to be vaccinated? What to consider? Modelling decision-making and time preference for COVID-19 vaccine through a conjoint experiment approach (preprint)

How do citizens choose COVID-19 vaccines, and when do they wish to be vaccinated? A choice-based conjoint experiment was fielded in Hong Kong to examine factors that shape citizens preference toward COVID-19 vaccines and their time preference to be vaccinated, which is overlooked in extant literature. Results suggest people are most concerned about vaccines efficacy and severe side-effects, and that cash incentives are not useful in enhancing vaccine appeal. The majority of respondents show low intention for immediate vaccination, and many of them want to delay their vaccination. Further analysis shows that their time preference is shaped more by respondent characteristics than vaccine attributes. In particular, confidence in the vaccine, trust in government, and working in high-risk professions are associated with earlier timing for vaccine uptake. Meanwhile, forced COVID testing would delay vaccination. The findings offer a novel view in understanding how people decide whether and when to receive new vaccines, which have pivotal implications for a head start of any mass vaccination programs.

Stress symptoms and reactions to COVID-19: A multinational survey from six Asian regions (preprint)

People may experience a heightened level of stress reactions during a pandemic event and in an isolated social environment. A multi-national survey about such mental health information about COVID-19 was conducted in May 2020 across six Asian regions: Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand. Data were collected from a population representative sample of 11,895 adults on their stress symptoms and reactions to COVID-19 and the related public health measures. 59.1% of the respondents showed at least one substantial stress symptom. The situation was particularly worrying in South Korea, where 75% of the respondents reported substantial stress symptoms. Respondents who were young, educated, lived in an urban area, had a high socio-economic status, had a history of chronic illness or mental illness, or who lived with a pregnant woman, elderly or children were most vulnerable to stress during the pandemic. Stress reactions showed a positive relationship with the amount of time spent following news about the COVID-19 outbreak. Asian adults coped with their stress by preparing safety equipment and extra daily commodities (62.4%) and by following government-issued public health measures (60.1%). Most Asian (71%) also frequently checked on the safety of family members and friends to keep each other safe. The COVID-19 pandemic and the associated stringent public health measures have largely increased the prevalence of substantial stress symptoms across multiple Asian regions. Governments should prepare this mental health pandemic and the associated social repercussions.