Novel Coronavirus Outbreak and Career Development: A Narrative Approach Into the Meaning for Italian University Graduates.

INTRODUCTION: In times of economic crisis, the literature shows that young people have always been in the high-risk category. The COVID-19 outbreak and the consequence on the economic level have increased the sense of uncertainty and precariousness experienced by young people. The current scenario has forced young people at the school-to-work transition point to re-think their career plans. Although the difficulties of the school-to-work transition already lead to distress and mental health problems in young people, the slowdown imposed by the coronavirus could add up to these difficulties. The present study aimed to explore the process of career development and career planning in the coronavirus era. Twenty Italian university graduates were involved. METHODS: A quantitative measure was used to evaluate the affective (positive/negative) experience. A narrative prompt was used to understand the individual dimensions of career planning. Cluster analysis was carried out by an unsupervised ascendant hierarchical method to explore the themes of the narration. RESULTS: Italian young adults have tended to experience negative affects in the recent weeks of quarantine. The themes highlighted in the narratives showed that Italian young adults experience feelings of fear, uncertainty, and anxiety about the post-pandemic future. CONCLUSION: The results appear as a starting point to re-think possible interventions for this group post-lockdown and post-pandemic.

Self-control Mediates the Relationship between Psychosocial Strengths and Perceived Severity of COVID-19 among Frontline Healthcare Professionals of Pakistan: A Single Center Experience.

OBJECTIVE: To examine the relationship between psychosocial strengths (resilience, self-efficacy beliefs and social support) and perceived severity of COVID-19 and also to gauge the mediating role of self-control among frontline health care professionals of Pakistan. METHODS: A cross-sectional research design was utilized from March to April 2020 from one medical teaching hospital of South Punjab. As it was a single center experience so all the doctors were approached and asked to participate in this research. In total, 284 doctors (out of 300 approx.) completed online survey. The data were collected through online google forms consisting of self-report measures i.e. Brief Resilience Scale, Short General Self Efficacy Scale, Brief Scale for Social Support, Risk Behavior Diagnostic Scale and Brief Self-Control Scale. RESULTS: The results were analyzed by using SmartPLS (3.0), direct effect of psychosocial strengths on perceived severity of COVID-19 and indirect effect of self-control were assessed through path coefficients, t-values and r-square values. The results confirmed that there was significant negative relationship between psychosocial strengths and perceived severity of COVID-19 (ß = -0.854, t =14.279) with 72% variance in perceived severity due to psychosocial strengths. Further, the results also suggest that self-control proved significant mediator between psychosocial strengths and perceived severity (ß = -0.604, t = 11.004, variance in perceived severity is 74%). CONCLUSION: In the time of pandemic, medical professionals are working as frontline force and can have several uncertainties regarding the risk associated with outbreak of COVID-19. This study concludes psychosocial strengths can play a significant role in subsiding the risk associated with severity of disease. Whereas, self-control can significantly contribute to buffer the negative influence of COVID-19 among frontline medical professionals. In line with findings of this study, there is a dire need to initiate psychotherapeutic studies for medical professionals to boost up their psychosocial strengths that would make them resilient against COVID-19.

[I don't know whether I'm coming or going-Challenges of part-time students during the COVID-19 pandemic]. / Wo steht mir der Kopf? ­ Herausforderungen von berufsbegleitend Studierenden während der COVID-19-Pandemie.

BACKGROUND: Due to the COVID-19 pandemic, universities had to switch to online teaching as quickly as possible. Part-time students who work in the healthcare sector have to manage the balancing act between an invariably online education and a mandatory physical attendance in a profession that maintains the system. AIM: The aim of the study was to explore the challenges faced by part-time students working in the healthcare sector, to identify the need for change and to derive recommendations for action for the university. METHODS: The data were collected using an open response online questionnaire. The obtained data were evaluated according to the qualitative content analysis of Mayring. RESULTS: Probably the greatest challenges that part-time students have to deal with, are the self-organized learning or the (on time) accomplishment of work assignments, which are often perceived as too extensive, and the independent development of teaching content. Furthermore, part-time students reported about the difficultness to reconcile e­learning and work and/or family. CONCLUSION: These perceived challenges are not new but since additional family commitments and uncertainty of daily work routine are added, these challenges are gaining in importance during COVID-19. Therefore, learning environments, which are currently offered to part-time students, must be understood as caring spaces. In addition to new didactic concepts, universities should invest in the promotion of students' personal and social competencies.

Surgical or radiological treatment for varicoceles in subfertile men.

BACKGROUND: Varicoceles are associated with male subfertility; however, the mechanisms by which varicoceles affect fertility have yet to be satisfactorily explained. Several treatment options exist, including surgical or radiological treatment, however the safest and most efficient treatment remains unclear.  OBJECTIVES: To evaluate the effectiveness and safety of surgical and radiological treatment of varicoceles on live birth rate, adverse events, pregnancy rate, varicocele recurrence, and quality of life amongst couples where the adult male has a varicocele, and the female partner of childbearing age has no fertility problems. SEARCH METHODS: We searched the following databases on 4 April 2020: the Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO, and CINAHL. We also searched the trial registries and reference lists of articles. SELECTION CRITERIA: We included randomised controlled trials (RCTs) if they were relevant to the clinical question posed and compared different forms of surgical ligation, different forms of radiological treatments, surgical treatment compared to radiological treatment, or one of these aforementioned treatment forms compared to non-surgical methods, delayed treatment, or no treatment. We extracted data if the studies reported on live birth, adverse events, pregnancy, varicocele recurrence, and quality of life. DATA COLLECTION AND ANALYSIS: Screening of abstracts and full-text publications, alongside data extraction and 'Risk of bias' assessment, were done dually using the Covidence software. When we had sufficient data, we calculated random-effects (Mantel-Haenszel) meta-analyses; otherwise, we reported results narratively. We used the I2 statistic to analyse statistical heterogeneity. We planned to use funnel plots to assess publication bias in meta-analyses with at least 10 included studies. We dually rated the risk of bias of studies using the Cochrane 'Risk of bias' tool, and the certainty of evidence for each outcome using the GRADE approach. MAIN RESULTS: We identified 1897 citations after de-duplicating the search results. We excluded 1773 during title and abstract screening. From the 113 new full texts assessed in addition to the 10 studies (11 references) included in the previous version of this review, we included 38 new studies, resulting in a total of 48 studies (59 references) in the review providing data for 5384 participants. Two studies (three references) are ongoing studies and two studies are awaiting classification. Treatment versus non-surgical, non-radiological, delayed, or no treatment Two studies comparing surgical or radiological treatment versus no treatment reported on live birth with differing directions of effect. As a result, we are uncertain whether surgical or radiological treatment improves live birth rates when compared to no treatment (risk ratio (RR) 2.27, 95% confidence interval (CI) 0.19 to 26.93; 2 RCTs, N = 204; I2 = 74%, very low-certainty evidence). Treatment may improve pregnancy rates compared to delayed or no treatment (RR 1.55, 95% CI 1.06 to 2.26; 13 RCTs, N = 1193; I2 = 65%, low-certainty evidence). This suggests that couples with no or delayed treatment have a 21% chance of pregnancy, whilst the pregnancy rate after surgical or radiological treatment is between 22% and 48%. We identified no evidence on adverse events, varicocele recurrence, or quality of life for this comparison. Surgical versus radiological treatment We are uncertain about the effect of surgical versus radiological treatment on live birth and on the following adverse events: hydrocele formation, pain, epididymitis, haematoma, and suture granuloma. We are uncertain about the effect of surgical versus radiological treatment on pregnancy rate (RR 1.13, 95% CI 0.75 to 1.70; 5 RCTs, N = 456, low-certainty evidence) and varicocele recurrence (RR 1.31, 95% CI 0.82 to 2.08; 3 RCTs, N = 380, low-certainty evidence). We identified no evidence on quality of life for this comparison. Surgery versus other surgical treatment We identified 19 studies comparing microscopic subinguinal surgical treatment to any other surgical treatment. Microscopic subinguinal surgical treatment probably improves pregnancy rates slightly compared to other surgical treatments (RR 1.18, 95% CI 1.02 to 1.36; 12 RCTs, N = 1473, moderate-certainty evidence). This suggests that couples with microscopic subinguinal surgical treatment have a 10% to 14% chance of pregnancy after treatment, whilst the pregnancy rate in couples after other surgical treatments is 10%. This procedure also probably reduces the risk of varicocele recurrence (RR 0.48, 95% CI 0.29, 0.79; 14 RCTs, N = 1565, moderate-certainty evidence). This suggests that 0.4% to 1.1% of men undergoing microscopic subinguinal surgical treatment experience recurrent varicocele, whilst 1.4% of men undergoing other surgical treatments do. Results for the following adverse events were inconclusive: hydrocele formation, haematoma, abdominal distension, testicular atrophy, wound infection, scrotal pain, and oedema. We identified no evidence on live birth or quality of life for this comparison. Nine studies compared open inguinal surgical treatment to retroperitoneal surgical treatment. Due to small sample sizes and methodological limitations, we identified neither treatment type as superior or inferior to the other regarding adverse events, pregnancy rates, or varicocele recurrence. We identified no evidence on live birth or quality of life for this comparison. Radiological versus other radiological treatment One study compared two types of radiological treatment (sclerotherapy versus embolisation) and reported 13% varicocele recurrence in both groups. Due to the broad confidence interval, no valid conclusion could be drawn (RR 1.00, 95% CI 0.16 to 6.20; 1 RCT, N = 30, very low-certainty evidence). We identified no evidence on live birth, adverse events, pregnancy, or quality of life for this comparison. AUTHORS' CONCLUSIONS: Based on the limited evidence, it remains uncertain whether any treatment (surgical or radiological) compared to no treatment in subfertile men may be of benefit on live birth rates; however, treatment may improve the chances for pregnancy. The evidence was also insufficient to determine whether surgical treatment was superior to radiological treatment. However, microscopic subinguinal surgical treatment probably improves pregnancy rates and reduces the risk of varicocele recurrence compared to other surgical treatments. High-quality, head-to-head comparative RCTs focusing on live birth rate and also assessing adverse events and quality of life are warranted.

Scientific impact in a changing world.

Measuring scientific success has traditionally involved numbers and statistics. However, due to an increasingly uncertain world, more than ever we need to measure the effect that science has on real-world scenarios. We asked researchers to share their points of view on what scientific impact means to them and how impact matters beyond the numbers.

At a crossroads: coronavirus disease 2019 recovery and the risk of pulmonary vascular disease.

PURPOSE OF REVIEW: The coronavirus disease 2019 (COVID-19) pandemic has led to almost 3,000,000 deaths across 139 million people infected worldwide. Involvement of the pulmonary vasculature is considered a major driving force for morbidity and mortality. We set out to summarize current knowledge on the acute manifestations of pulmonary vascular disease (PVD) resulting from COVID-19 and prioritize long-term complications that may result in pulmonary hypertension (PH). RECENT FINDINGS: Acute COVID-19 infection can result in widespread involvement of the pulmonary vasculature, myocardial injury, evidence of persistent lung disease, and venous thromboembolism. Post COVID-19 survivors frequently report ongoing symptoms and may be at risk for the spectrum of PH, including group 1 pulmonary arterial hypertension, group 2 PH due to left heart disease, group 3 PH due to lung disease and/or hypoxia, and group 4 chronic thromboembolic PH. SUMMARY: The impact of COVID-19 on the pulmonary vasculature is central to determining disease severity. Although the long-term PVD manifestations of COVID-19 are currently uncertain, optimizing the care of risk factors for PH and monitoring for the development of PVD will be critical to reducing long-term morbidity and improving the health of survivors.

The relationship between fear of COVID-19 and health anxiety among families with COVID-19 infected: The mediating role of metacognitions, intolerance of uncertainty and emotion regulation.

The current study aimed to investigate the mediating role of metacognitions, intolerance of uncertainty and emotion regulation in the relationship between fear of COVID-19 (FC-19) and health anxiety, among families with COVID-19 infected. Participants were 541 individuals from family members of patients with COVID-19 (F = 52.3%, mean age = 41.3 ± 13.2 years). Data were collected with a packet including sociodemographic and risk factors, the Fear of COVID-19 Scale, the Short Health Anxiety Inventory, the Metacognitions Questionnaire 30, the Intolerance of Uncertainty Scale-12 and the Emotion Regulation Questionnaire. Structural equation modelling analyses revealed a full mediation of metacognitions (i.e., positive beliefs about worry, negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence and beliefs about the need to control thoughts), intolerance of uncertainty and expressive suppression in the relation between FC-19 and health anxiety. Moreover, the strongest indirect links were found between FC-19 and health anxiety through negative beliefs about thoughts concerning uncontrollability and danger and intolerance of uncertainty. These associations were independent of gender and risk status. The final model accounted for 71% of the variance of health anxiety. These findings suggest that particularly metacognitions, intolerance of uncertainty and expressive suppression play a full mediational role in the relation between FC-19 and health anxiety.

Development of a Salutogenesis Workshop for SPPs to Help Them, Their Athletes, and the Athlete's Entourage Better Cope With Uncertainty During the COVID-19 Pandemic.

The COVID-19 pandemic is also called a crisis of uncertainty because of so many unforeseeable events like canceled qualification competitions, loss of training facilities, and postponement of the Olympic games. Athletes and their entourage experience this uncertainty as stressful. Sport psychology practitioners (SPPs) are in a key position to support athletes in coping with these unforeseeable stressors. However, SPPs are similarly affected by the COVID-19 pandemic and simultaneously have to cope with stress. Salutogenesis, which describes how to manage stress and to stay well, provides a theoretical approach to how to cope with uncertainty. The salutogenetic approach aims at strengthening individuals' sense of coherence (SoC) and consists of three components, namely comprehensibility, manageability, and meaningfulness. Although it is known that the SoC can be enhanced via psychological skills training, so far, this approach has not been systematically applied to the elite sport context. Athletes have been advised to see SPPs for help; thus, the question of how SPPs handle the time of uncertainty while supporting others emerges. The aim of this contribution was to outline how the salutogenetic approach can be applied to strengthening SPPs' SoC via a single-day four-part workshop. Additionally, we applied the workshop to N = 26 volleyball coaches and evaluated the workshop's effects on participants' psychological aspects [i.e., the Sense of Coherence-Leipziger short version (SoC-L9), resilience (RS-13): coping with uncertainty, affective response, and stress via semantic differentials] and the workshop's quality ratings (i.e., Quality Questionnaire for Sport Psychological Coaching, QS-17). The evaluation provides results that show a positive impact on a descriptive level of the participants' SoC, uncertainty, affect, and stress perception; however, the results show no significant main effect of time [F(8, 10) = 1.04, p = 0.467, η p 2 = 0.454]. Workshop quality (on average, 3.60 ± 0.35 out of 4.00) and skill acquisition (on average, 3.00 ± 0.64 out of 4.00) were positively evaluated; 82.00% of the participants would use the learned tools in the future. Thus, we outline how this workshop might help strengthen SPPs' SoC and at the same time empower them to strengthen their athletes' SoC. Overall, we add a theoretical (i.e., salutogenesis in sports) and a practical perspective (i.e., coping techniques based on salutogenesis) on how to cope with the COVID-19 pandemic for SPPS, athletes, and their support network.

Identifying Variables That Predict Depression Following the General Lockdown During the COVID-19 Pandemic.

This study aimed to define the psychological markers for future development of depression symptoms following the lockdown caused by the COVID-19 outbreak. Based on previous studies, we focused on loneliness, intolerance of uncertainty and emotion estimation biases as potential predictors of elevated depression levels. During the general lockdown in April 2020, 551 participants reported their psychological health by means of various online questionnaires and an implicit task. Out of these participants, 129 took part in a second phase in June 2020. Subjective loneliness during the lockdown rather than objective isolation was the strongest predictor of symptoms of depression 5 weeks later. Younger age and health related worry also predicted higher non-clinical levels of depression and emotional distress. The results support the diathesis-stress model, which posits that a combination of preexisting vulnerabilities along with stressors such as negative life events are among the factors affecting the development of psychopathology. Moreover, our results correspond with those of previous studies conducted worldwide during the COVID-19 pandemic. Taken together, these findings call for focusing on psychological factors, especially among younger people, to identify individuals at risk for future development of depression and to promote new strategies for prevention.

The Indirect Effect of Parental Intolerance of Uncertainty on Perinatal Mental Health via Mindfulness During COVID-19.

OBJECTIVES: The COVID-19 pandemic is associated with mental health difficulties, especially during pregnancy and early postpartum. Intolerance of uncertainty (IU) and reduced capacity for mindfulness-a protective factor for child-bearers-may be particularly relevant factors driving mental health problems given the unpredictable nature of the pandemic. The current study aims to shed light on modifiable paths to perinatal psychological distress by testing whether there is an indirect effect of IU on psychological symptoms through a perceived reduction in mindfulness during the pandemic. METHODS: Pregnant individuals (67%, n = 133) and new mothers within 6 months postpartum (33%, n = 66) participated in a cross-sectional online survey assessing IU, current and retrospective pre-pandemic mindfulness (FFMQ), and psychological symptoms (anxiety, depression, somatization; BSI). Perceived change in mindfulness was captured by including retrospective mindfulness as a covariate in the PROCESS macro used for analyses. RESULTS: Tests of the direct association between mindfulness, IU, and psychological symptoms showed significant effects of IU (b = 0.46, SE = 0.064; p < .001) and perceived decrease in mindfulness during the pandemic (b = - 0.72, SE = 0.08, p < .001) on psychological symptoms (R 2 = .21-.34; F[2, 197] = 51.13-52.81, p < .001). The indirect effect of IU on symptoms via perceived decrease in mindfulness during the pandemic (b = 0.13, SE = 0.043, 95%CI [.060, .226]) was significant (R 2 = .41, F[3, 195] = 45.08, p < .001). CONCLUSIONS: Results suggest that mothers who are less able to tolerate uncertainty experience more psychological symptoms, in part due to perceived reduction in mindfulness during the pandemic. Future research should examine whether IU is a screening risk marker and target for mindfulness-based interventions to improve maternal well-being and family outcomes.

Implications of early respiratory support strategies on disease progression in critical COVID-19: a matched subanalysis of the prospective RISC-19-ICU cohort.

BACKGROUND: Uncertainty about the optimal respiratory support strategies in critically ill COVID-19 patients is widespread. While the risks and benefits of noninvasive techniques versus early invasive mechanical ventilation (IMV) are intensely debated, actual evidence is lacking. We sought to assess the risks and benefits of different respiratory support strategies, employed in intensive care units during the first months of the COVID-19 pandemic on intubation and intensive care unit (ICU) mortality rates. METHODS: Subanalysis of a prospective, multinational registry of critically ill COVID-19 patients. Patients were subclassified into standard oxygen therapy ≥10 L/min (SOT), high-flow oxygen therapy (HFNC), noninvasive positive-pressure ventilation (NIV), and early IMV, according to the respiratory support strategy employed at the day of admission to ICU. Propensity score matching was performed to ensure comparability between groups. RESULTS: Initially, 1421 patients were assessed for possible study inclusion. Of these, 351 patients (85 SOT, 87 HFNC, 87 NIV, and 92 IMV) remained eligible for full analysis after propensity score matching. 55% of patients initially receiving noninvasive respiratory support required IMV. The intubation rate was lower in patients initially ventilated with HFNC and NIV compared to those who received SOT (SOT: 64%, HFNC: 52%, NIV: 49%, p = 0.025). Compared to the other respiratory support strategies, NIV was associated with a higher overall ICU mortality (SOT: 18%, HFNC: 20%, NIV: 37%, IMV: 25%, p = 0.016). CONCLUSION: In this cohort of critically ill patients with COVID-19, a trial of HFNC appeared to be the most balanced initial respiratory support strategy, given the reduced intubation rate and comparable ICU mortality rate. Nonetheless, considering the uncertainty and stress associated with the COVID-19 pandemic, SOT and early IMV represented safe initial respiratory support strategies. The presented findings, in agreement with classic ARDS literature, suggest that NIV should be avoided whenever possible due to the elevated ICU mortality risk.

Predicting personal protective equipment use, trauma symptoms, and physical symptoms in the USA during the early weeks of the COVID-19 lockdown (April 9-18, 2020).

The COVID-19 pandemic created a complex psychological environment for Americans. In this study, 450 MTurk workers completed measures of sociodemographic characteristics, perceived risk for COVID-19, general perceived vulnerability to disease, intolerance of uncertainty, and psychological flexibility. These variables were used to predict COVID-19 preventive health behaviors (PPE use), psychological distress, and physical symptoms. The surveys were completed between April 9, 2020 and April 18, 2020 which is a period that corresponded to the first 2-3 weeks of lockdown for most participants. A demographically diverse sample of participants was recruited. A substantial number of participants reported a reduction employment status and 69% were in self-isolation. Participants reported a high degree of perceived vulnerability to COVID-19. PPE mask wearing was variable: 16% "not at all," 20% "some of the time," 42% "a good part of the time," and 26 "most of the time." Using clinical cutoff on the post-trauma scale, 70% of the sample would be considered to have symptoms consistent with PTSD. Physical symptom reporting was also high. Intolerance of uncertainty and psychological inflexibility were significant predictors of psychological distress and physical symptoms. Psychological flexibility moderated the relationship between intolerance of uncertainty and psychological distress/physical symptoms. The relationship between intolerance of uncertainty and psychological distress/physical symptoms was stronger among participants with lower levels of psychological flexibility. These findings indicate psychological flexibility can reduce distress associated with COVID-19. Additionally, these results support the workability of the Unified Flexibility and Mindfulness Model as a framework for studying health behavior.

Corticosteroids in SARS-COV2 infection: certainties and uncertainties in clinical practice.

INTRODUCTION: The SARS-COV-2 pandemic is a worldwide public health problem due to the large medical burden and limited number of therapies available. Corticosteroids have a rather unclear efficacy in viral non-SARS-COV-2 pneumonias and therefore their use is not universally recommended. In SARS-COV-2 pneumonia however, it is expected that they can reduce the deleterious consequences of the virus-related systemic inflammation. AREAS COVERED: a MEDLINE search covering the period 1995-2020 was completed to identify relevant papers. SARS-COV-2 pathogenesis is very complex and is represented by the interplay of many cytokine-driven inflammation pathways. Its most severe form so called cytokine storm, is an exaggerate reaction of the host infected by the virus rapidly resulting in multiple organ dysfunction (MODS). Corticosteroids have the potential to blunt the inflammation response in such patients, but their efficacy is not the same for all patients. Further on the certainties and uncertainties regarding the efficacy of this therapy in SARS-COV-2 pneumonia are discussed. EXPERT OPINION: In patients with severe SARS-COV-2 pneumonia, corticosteroids can be efficacious, but it is still not clear if they can be safely used in patients with comorbid cardiovascular disease or how the optimal duration of therapy can be established.

A qualitative examination of graduating nurses' response to the Covid-19 pandemic.

BACKGROUND: Currently, graduating nurses face pandemic-related uncertainty including gaps in risk perception, unexpected Covid-19 moral dilemmas, and distress surrounding personal health risk. RESEARCH QUESTION/AIM/OBJECTIVES/METHOD: The purpose of this basic qualitative descriptive study is to describe the willingness of graduating nurses to provide care during the Covid-19 pandemic. PARTICIPANTS AND RESEARCH CONTEXT: One week prior to graduation, students were required to submit a written assignment describing willingness to practice in light of the ongoing pandemic. ETHICAL CONSIDERATIONS: This study was approved by an Institutional Review Board. FINDINGS/RESULTS: Eighty-four (n = 84) assignments were used for analysis. Of these, 82% (n = 69) of the graduating nurses describe a willingness to voluntarily care for Covid-19 patients. After summarizing narrative responses, two themes emerged including self-assessment of personal and familial risk and conflicting obligations. DISCUSSION: The assessment of risk to self and family are key in determining whether graduating nurses will care for Covid-19 patients. Conflicting obligations may contribute to stress and uncertainty potentially leading to early burnout. CONCLUSION: Findings from this study can inform academicians of the need to adequality prepare graduating nurses for Covid-19-associated risks and ethical decision making. Organizations should alter residencies and orientation to support the needs of new nurses.

Working through an "infodemic": The impact of COVID-19 news consumption on employee uncertainty and work behaviors.

Uncertainty is a defining feature of the COVID-19 pandemic. However, because uncertainty is an aversive state, uncertainty reduction theory (URT) holds that employees try to manage it by obtaining information. To date, most evidence for the effectiveness of obtaining information to reduce uncertainty stems from research conducted in relatively stable contexts wherein employees can acquire consistent information. Yet, research on crises and news consumption provides reasons to believe that the potential for information to mitigate uncertainty as specified by URT may break down during crises such as the COVID-19 pandemic. Integrating URT with research on crises and news consumption, we predict that consuming news information during crises-which tends to be distressing, constantly evolving, and inconsistent-will be positively related to uncertainty. This in turn may have negative implications for employee goal progress and creativity; two work outcomes that take on substantial significance in times of uncertainty and the pandemic. We further predict that death anxiety will moderate this relationship, such that the link between employees' news consumption and uncertainty is stronger for those with lower levels of death anxiety, compared to those with higher levels. We test our theorizing via an experience-sampling study with 180 full-time employees, with results providing support for our conceptual model. Our study reveals important theoretical and practical implications regarding information consumption during crises such as the COVID-19 pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review.

BACKGROUND: Convalescent plasma and hyperimmune immunoglobulin may reduce mortality in patients with viral respiratory diseases, and are being investigated as potential therapies for coronavirus disease 2019 (COVID-19). A thorough understanding of the current body of evidence regarding benefits and risks of these interventions is required.  OBJECTIVES: Using a living systematic review approach, to assess whether convalescent plasma or hyperimmune immunoglobulin transfusion is effective and safe in the treatment of people with COVID-19; and to maintain the currency of the evidence. SEARCH METHODS: To identify completed and ongoing studies, we searched the World Health Organization (WHO) COVID-19 Global literature on coronavirus disease Research Database, MEDLINE, Embase, the Cochrane COVID-19 Study Register, the Epistemonikos COVID-19 L*OVE Platform, and trial registries. Searches were done on 17 March 2021. SELECTION CRITERIA: We included randomised controlled trials (RCTs) evaluating convalescent plasma or hyperimmune immunoglobulin for COVID-19, irrespective of disease severity, age, gender or ethnicity. For safety assessments, we also included non-controlled non-randomised studies of interventions (NRSIs) if 500 or more participants were included. We excluded studies that included populations with other coronavirus diseases (severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS)), as well as studies evaluating standard immunoglobulin. DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methodology. To assess bias in included studies, we used the Cochrane 'Risk of Bias 2' tool for RCTs, and for NRSIs, the assessment criteria for observational studies, provided by Cochrane Childhood Cancer. We rated the certainty of evidence, using the GRADE approach, for the following outcomes: all-cause mortality, improvement and worsening of clinical status (for individuals with moderate to severe disease), development of severe clinical COVID-19 symptoms (for individuals with asymptomatic or mild disease), quality of life (including fatigue and functional independence), grade 3 or 4 adverse events, and serious adverse events. MAIN RESULTS: We included 13 studies (12 RCTs, 1 NRSI) with 48,509 participants, of whom 41,880 received convalescent plasma. We did not identify any completed studies evaluating hyperimmune immunoglobulin. We identified a further 100 ongoing studies evaluating convalescent plasma or hyperimmune immunoglobulin, and 33 studies reporting as being completed or terminated. Individuals with a confirmed diagnosis of COVID-19 and moderate to severe disease Eleven RCTs and one NRSI investigated the use of convalescent plasma for 48,349 participants with moderate to severe disease. Nine RCTs compared convalescent plasma to placebo treatment or standard care alone, and two compared convalescent plasma to standard plasma (results not included in abstract). Effectiveness of convalescent plasma We included data on nine RCTs (12,875 participants) to assess the effectiveness of convalescent plasma compared to placebo or standard care alone.  Convalescent plasma does not reduce all-cause mortality at up to day 28 (risk ratio (RR) 0.98, 95% confidence interval (CI) 0.92 to 1.05; 7 RCTs, 12,646 participants; high-certainty evidence). It has little to no impact on clinical improvement for all participants when assessed by liberation from respiratory support (RR not estimable; 8 RCTs, 12,682 participants; high-certainty evidence). It has little to no impact on the chance of being weaned or liberated from invasive mechanical ventilation for the subgroup of participants requiring invasive mechanical ventilation at baseline (RR 1.04, 95% CI 0.57 to 1.93; 2 RCTs, 630 participants; low-certainty evidence). It does not reduce the need for invasive mechanical ventilation (RR 0.98, 95% CI 0.89 to 1.08; 4 RCTs, 11,765 participants; high-certainty evidence). We did not identify any subgroup differences.  We did not identify any studies reporting quality of life, and therefore, do not know whether convalescent plasma has any impact on quality of life. One RCT assessed resolution of fatigue on day 7, but we are very uncertain about the effect (RR 1.21, 95% CI 1.02 to 1.42; 309 participants; very low-certainty evidence).  Safety of convalescent plasma We included results from eight RCTs, and one NRSI, to assess the safety of convalescent plasma. Some of the RCTs reported on safety data only for the convalescent plasma group.  We are uncertain whether convalescent plasma increases or reduces the risk of grade 3 and 4 adverse events (RR 0.90, 95% CI 0.58 to 1.41; 4 RCTs, 905 participants; low-certainty evidence), and serious adverse events (RR 1.24, 95% CI 0.81 to 1.90; 2 RCTs, 414 participants; low-certainty evidence).  A summary of reported events of the NRSI (reporting safety data for 20,000 of 35,322 transfused participants), and four RCTs reporting safety data only for transfused participants (6125 participants) are included in the full text. Individuals with a confirmed diagnosis of SARS-CoV-2 infection and asymptomatic or mild disease We identified one RCT reporting on 160 participants, comparing convalescent plasma to placebo treatment (saline).  Effectiveness of convalescent plasma We are very uncertain about the effect of convalescent plasma on all-cause mortality (RR 0.50, 95% CI 0.09 to 2.65; very low-certainty evidence). We are uncertain about the effect of convalescent plasma on developing severe clinical COVID-19 symptoms (RR not estimable; low-certainty evidence).  We identified no study reporting quality of life.  Safety of convalescent plasma We do not know whether convalescent plasma is associated with a higher risk of grade 3 or 4 adverse events (very low-certainty evidence), or serious adverse events (very low-certainty evidence). This is a living systematic review. We search weekly for new evidence and update the review when we identify relevant new evidence. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review. AUTHORS' CONCLUSIONS: We have high certainty in the evidence that convalescent plasma for the treatment of individuals with moderate to severe disease does not reduce mortality and has little to no impact on measures of clinical improvement. We are uncertain about the adverse effects of convalescent plasma. While major efforts to conduct research on COVID-19 are being made, heterogeneous reporting of outcomes is still problematic. There are 100 ongoing studies and 33 studies reporting in a study registry as being completed or terminated. Publication of ongoing studies might resolve some of the uncertainties around hyperimmune immunoglobulin therapy for people with any disease severity, and convalescent plasma therapy for people with asymptomatic or mild disease.

Testing Invariance of Measures of Internalizing Symptoms Before and After a Major Life Stressor: The Impact of COVID-19 in an Adolescent and Young Adult Sample.

There are reports of increases in levels of internalizing psychopathology during the COVID-19 pandemic. However, these studies presume that measurement properties of these constructs remained unchanged from before the pandemic. In this study, we examined longitudinal measurement invariance of assessments of depression, anxiety, and intolerance of uncertainty (IU) in adolescents and young adults from ongoing longitudinal studies. We found consistent support for configural and metric invariance across all constructs, but scalar invariance was unsupported for depression and IU. Thus, it is necessary to interpret pandemic-associated mean-level changes in depression and IU cautiously. In contrast, mean-level comparisons of panic, generalized, and social anxiety symptoms were not compromised. These findings are limited to the specific measures examined and the developmental period of the sample. We acknowledge that there is tremendous distress accompanying disruptions due to the COVID-19 outbreak. However, for some instruments, comparisons of symptom levels before and during the pandemic may be limited.

Treatment of severe acute ulcerative colitis in SARS-CoV-2 infected patients: report of three cases and discussion of treatment options.

In the wake of the coronavirus disease 2019 (COVID-19) pandemic, it is unclear how asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-infected patients who present with acute severe ulcerative colitis (UC) can be treated effectively and safely. Standard treatment regimens consist of steroids, immunomodulatory drugs, and biological therapies, but therapeutic decision-making becomes challenging as there are uncertainties about how to deal with these drugs in patients with COVID-19 and active UC. Importantly, guidelines for this particular group of patients with UC are still lacking. To inform therapeutic decision-making, we describe three consecutive cases of patients with active UC and COVID-19 and discuss their treatments based on theoretical knowledge, currently available evidence and clinical observations. Three patients were identified through our national inflammatory bowel disease network [Initiative on Crohn's and Colitis (ICC)] for whom diagnosis of SARS-CoV-2-infection was established by reverse transcription-polymerase chain reaction (RT-PCR) testing in nasopharynx, stools, and/or biopsies. Acute severe UC was diagnosed by clinical parameters, endoscopy, and histopathology. Clinical guidelines for SARS-CoV-2-negative patients advocate the use of steroids, calcineurin inhibitors, or tumor necrosis factor alpha (TNF-α)-antagonists as induction therapy, and experiences from the current three cases show that steroids and TNF-α-antagonists could also be used in patients with COVID-19. This could potentially be followed by TNF-α-antagonists, vedolizumab, or ustekinumab as maintenance therapy in these patients. Future research is warranted to investigate if, and which, immunomodulatory drugs should be used for COVID-19 patients that present with active UC. To answer this question, it is of utmost importance that future cases of patients with UC and COVID-19 are documented carefully in international registries, such as the SECURE-IBD registry.

The impact of COVID-19 on pregnant womens' experiences and perceptions of antenatal maternity care, social support, and stress-reduction strategies.

BACKGROUND: The COVID-19 pandemic has impacted on maternity care, supports and women's mental health. AIM: The aim of this study was to assess pregnant women's satisfaction with antenatal care and social support and to examine stress-reduction strategies women used during the pandemic. METHODS: An online survey was conducted between June and July 2020. Pregnant women, aged over 18 years were recruited. The survey included closed and open-ended questions to assess women's perceptions and satisfaction with their antenatal care, social support, and stress-reduction strategies. Descriptive statistics and multivariate analysis were used for quantitative analyses; qualitative content analysis was used for open-ended questions. FINDINGS: 573 pregnant women completed the survey. Women reported low levels of social support which was predicted by women's mental health and demographic factors and was related to public health and maternity service restrictions. Women reported that restrictions implemented in the maternity services limited their face-to face interactions with healthcare professionals and meant their partners could not attend antenatal appointments or support them in the postpartum period in the maternity setting. The lack of information on COVID-19 and pregnancy meant women had greater uncertainty about pregnancy and birth. DISCUSSION: Our findings indicate how the lack of access to antenatal care and reduced perceived social support as a result of the restrictions implemented in response to the COVID-19 pandemic, potentially intensifies pregnancy specific stress. CONCLUSIONS: There is a need for the provision of supportive care, both formally and informally, particularly with women who may be more vulnerable during a pandemic.

Illness uncertainty among patients with COVID-19 in the Mobile Cabin Hospital.

AIMS: To investigate the status and influencing factors of illness uncertainty among patients with coronavirus disease 2019 (COVID-19) in the mobile cabin hospital. DESIGN: A cross-sectional study. METHODS: 114 patients with COVID-19 admitted to a mobile cabin hospital in Wuhan, Hubei Province, in February 2020 were enrolled by a convenience sampling method. The Chinese version of the Mishel Illness Uncertainty Scale (MUIS) was used to assess patients' degree of illness uncertainty, and multiple regression analysis was used to explore the influencing factors. RESULTS: The average total score of MUIS (Chinese version) was 52.22 ± 12.51, indicating a moderate level of illness uncertainty. The dimension unpredictability turned out to have the highest mean score: 2.88 ± 0.90. The multiple stepwise regression analysis showed that female (t = 2.462, p = .015), monthly family income not less than RMB 10,000 (t = -2.095, p = .039), and disease duration of 28 days or more (t = 2.249, p = .027) were independent influencing factors of illness uncertainty. CONCLUSION: Patients with COVID-19 are at a moderate level of illness uncertainty. Medical staffs should pay more attention to female patients, patients with lower monthly family income, patients with the prolonged disease, and take targeted interventions to help them reduce illness uncertainty. IMPACT: Facing the brand new and unknown infectious disease, patients confirmed of COVID-19 suffer from immense physical and psychological stress, where illness uncertainty is a major stressor that troubles patients. The present study surveys illness uncertainty among patients with COVID-19 in the mobile cabin hospital with results revealing a moderate level. Study results will benefit nurses in any setting where care for patients with COVID-19 is provided, public policymakers and future researchers.