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Internet usage increased globally during the COVID-19 pandemic. This study examined the role of online/offline relational resources to see whether the Internet improved well-being or amplified psychological distress, also considering the mediating role of Internet use motives. A sample of 573 Italian adults (Mean age = 40.28 years;SD = 16.43;64% women) reported their motives for Internet use during lockdown and completed standardized measures on loneliness, online social support, wellbeing and problematic Internet use (PIU). A path analysis showed that loneliness positively predicted PIU and negatively predicted well-being, whereas perceived online social support positively predicted well-being. Loneliness was significantly associated with social/coping motives, which in turn were associated with PIU. Moreover, loneliness mediated the relationship between online social support and PIU. No significant mediating role was found for knowledge and studying/working motives. These findings call for tailored efforts to blunt the impact of social isolation and foster social connectivity.
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Introduction: It is currently not well known if the incidence of type 1 diabetes (T1D) changed during COVID-19 pandemic. Objective(s): Basing on two population-based registries collecting data of new cases in Italy since 1989, we analyzed changes on incidence in a long and short period. Method(s): All new cases of T1D in children aged between 0.5 and 14, recruited by the Piedmont and Marche registries during 1989- 2021, were considered. Poisson regression was used to estimate the incidence trend, adjusted for age and sex, for the period 1989-2019 and to predict the incidence in the years 2020 and 2021. The observed rates in the years of the pandemic were compared with those predicted by the model and with those of the three-year prepandemic period 2017-2019. Result(s): Between 1989 and 2021, 4009 children diagnosed with T1D were observed, 2144 males (53.5%). The standardized incidence for the entire period was 16.9 (95%CI 14.4-17.5) per 100,000 personyears, 17.6 and 16.2 for males and females respectively. The incidence over time increased from 12.0 (95% CI 9.6-14.4) in 1989 to 20.9 (95% CI 17.5-24.9) in 2019, with an annual increasing trend of 1.9% (95% CI 1.5-2.2). The observed incidence rates in 2020 and 2021 were 21.6 (95% CI: 18.3-25.3) and 26.7 (95% CI 23.0-30.9) respectively, not significantly different from the ones predicted by the model, 21.6 (95%CI 20.3-23.0;p = 0.995) and 22.0 (95%CI 20.5- 26.6;p = 0.074). The mean incidence rate of T1D in the pre-pandemic 3 years, equal to 20.5 (95%CI 18.6-22.5), was not different from that of 2020, but significantly lower than that observed in 2021 (<0.001). Conclusion(s): The incidence of T1D < 15 years continues to increase over time. During 2020-2021, the observed incidence was in line with the expected trend 1989-2019. However, narrowing the analysis to 2017-2021, there was a higher incidence in 2021. Continuous observation of T1D in children is critical to better understanding the role of COVID-19 in influencing the disease.
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Rationale: Although mortality from COVID-19 increases with advanced age, most older adults survive a COVID hospitalization. Disability, or dependence in functional activities, is known to increase after a serious illness among older adults, with adverse consequences for patients, families, and society. Little is known about disability, and the factors associated with disability, after a COVID hospitalization among older adults. Methods: We enrolled 341 older (≥60 years) adults during their index COVID-19 hospitalization between 7/6/2020-6/24/2021 from five hospitals in the Yale-New Haven Health System. Upon enrollment, participants underwent an assessment of baseline (prehospitalization) disability, frailty, general health, social support, hearing, vision, mental health, and assessments of current (in-hospital) symptom burden and cognitive function. These assessments were linked to EMR data including demographics, SOFA score, comorbidities, biomarkers, respiratory support, pressors, length of stay, and COVIDspecific treatments. Disability was assessed at baseline and 1, 3, and 6 months by asking about dependence in 15 basic, instrumental, and mobility activities. The primary outcome was the disability count (0-15) over the 6 months after the COVID hospitalization. The analytic sample included 304 participants who survived their hospitalization and had at least one post-discharge follow-up. We determined the mean (SD) number of disabilities over the 6 months after discharge and evaluated 27 factors for their association with the 6-month disability count using backwards selection based on minimization of the Bayesian Information Criterion with a zero-inflated negative binomial distribution and adjustment for baseline disability count and months of follow-up. Results: The mean age was 71.2 years (SD 8.5), 158 (51.8%) were women, and 108 (35.5%) were of nonwhite race or Hispanic ethnicity (Table). The mean prehospitalization disability count was 2.2 (SD 3.4), and the mean disability count over the 6 months after the COVID hospitalization was 2.9 (SD 3.7). In the multivariable model, greater baseline disability, older age, higher BMI, higher comorbidity count, cognitive dysfunction, greater symptom burden during the hospitalization, and the need for advanced respiratory support were all associated with greater disability over the 6 months after a COVID hospitalization. Conclusions: Other than the need for advanced respiratory support, factors associated with disability after a COVID hospitalization among older adults reflect vulnerability at baseline (comorbidities, baseline disability, age, BMI) or during the hospitalization (symptom burden, cognitive dysfunction), rather than biomarkers or severity of illness. These factors may identify older adults for referral to Post-COVID clinic programs to improve the likelihood of functional recovery after discharge. (Table Presented).
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During the COVID-19 pandemic, Internet might influence daily functioning in both positive and negative ways. Within the conceptual framework of the semiotic cultural psycho-social theory, this study examines the meanings of being online during the COVID-19 pandemic based on narratives collected from Italian university students (Mean age = 22.78;SD = 2.70). Computer-assisted content analysis was used to map the main Dimensions of Meaning (DM) characterizing their texts;ANOVA was used to examine (dis)similarities between DM related to sociodemographic characteristics and connotations of Internet use;Pearson’s correlations were computed to examine the relationships between DM and well-being. Two DM emerged: (a) being online in daily life (‘rupture’ versus ‘continuity’) and (b) Internet functions during the pandemic (‘health emergency’ versus ‘daily activities’). Notably, participants high on the ‘daily activities’ polarity of Internet functions connoted the Internet as a resource and reported higher levels of well-being, whereas participants high on the opposite polarity of “health emergency” connoted the Internet as a refuge and reported lower levels of well-being. Findings suggest that Internet use and its impact on well-being during the pandemic relates to the personal and social cultural meanings attributed to being online. © 2020. by the Author(s);licensee Mediterranean Journal of Clinical Psychology, Messina, Italy. This article is an open access article, licensed under a Creative Commons Attribution 4.0 Unported License. Mediterranean Journal of Clinical Psychology, Vol. 10, No. 1 (2022).
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Background: Mortality from COVID increases with age, but most older adults survive. Little is known about disability after COVID hospitalization. Methods: We enrolled 341 adults ≥60 years during their index COVID hospitalization between 7/2020-6/2021 from 5 hospitals. Participants underwent assessment of baseline (pre-hospital) disability, frailty, general health, social support, hearing, vision, mental health, & in-hospital symptom burden and cognitive function. Assessments were linked to health record data, including comorbidities, SOFA score, biomarkers, respiratory support, & COVID-specific treatments. Disability in 15 functional activities was assessed again at 1, 3, and 6 months. The primary outcome was mean disability count over 6 months after discharge. The analytic sample included 304 participants with ≥1 post-discharge follow-up. We evaluated 27 factors for their association with the primary outcome using backward selection with a zero-inflated negative binomial distribution & adjustment for baseline disability & months of follow-up. Results: Mean age was 71.2 yrs (SD 8.5);52% were women and 36% of nonwhite race or Hispanic ethnicity. Mean baseline disability count was 2.2 (SD 3.4). Mean disability count over the 6 months after discharge was 2.9 (SD 3.7). Greater baseline disability, older age, higher BMI, higher comorbidity count, cognitive dysfunction, greater symptom burden, and need for advanced respiratory support were associated with greater post-hospitalization disability (Table). Conclusions: Baseline vulnerability factors as well as in-hospital symptom burden, cognitive dysfunction, and advanced respiratory support were associated with increased disability after a COVID hospitalization. There was no association with COVIDspecific treatments or biomarkers. These factors may identify older adults with the most potential to benefit from efforts to improve functional recovery.
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The cultural domination of capitalism and its influence on the construction of modern democracies could not have been possible without educational institutions becoming one of the main territories for discursive, material and power disputes. This fact has conditioned the existence of a model that educates "from fear" and that, based on this, has ensured the non-expansion of emancipatory and supportive subjectivities. To explore this idea further, and as an epilogue to this dossier "Social movements, activism and resistance from the school", we spoke with Professor Boaventura de Sousa Santos to reflect on the role of education in the context of the COVID-19 pandemic and what the main challenges are for building more democracy and educational justice through resistance and emancipation.
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Crisis standards of care have been widely developed by healthcare systems and states in the United States during the COVID-19 pandemic, and in some rare cases have actually been used to allocate medical resources. All publicly available U.S. crisis standards of care with a mechanism for allocating scarce resources make use of the Sequential Organ Failure Assessment (SOFA) score in hopes of assigning scarce resources to those patients who are more likely to survive. We reflect on the growing body of evidence suggesting that the SOFA score has limited accuracy in predicting mortality among patients hospitalized with COVID-19 and that the SOFA score systematically disfavors Black patients. Use of the SOFA score for allocating scarce resources may therefore result in Black patients with equal likelihood of survival being deprived of life-saving medical resources. There is also a risk of injustice for patients with non-COVID-19 diagnoses, for whom the SOFA score may be a more accurate prognostic score, but who might nevertheless be unfairly (de)prioritized when assessed alongside COVID-19 patients using the same scoring system. For these reasons we recommend that the SOFA score not be used for triage purposes during the COVID pandemic, and that a national effort be made to develop and empirically test crisis standards of care in advance of the next public health emergency.
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Background: Several evidence have identified the role of Interleukin- 6 (IL-6) in the cytokine storm induced by CoViD-19 pneumonia. Interestingly, the correlation between the serum levels of IL-6 and the plasma aldosterone has already been demonstrated in patients affected by primary aldosteronism (PA). Therefore, we suppose that aldosteronism may increase IL-6 levels in CoViD-19. Presentation of the case:We report a case of a 47-year-old female CoViD-19 patient who had developed severe pneumonia complicated by Guillain-Barre syndrome (GBS). The blood test revealed high levels of IL-6 (serum IL-6: 402 pg/mL) and of its soluble receptor (soluble IL-6 receptor >1900pg/mL) and she required mechanical ventilation for severe hypoxemia. Furthermore, evidence of right adrenal adenoma, resistant hypertension, severe hypokalemia and high serum levels of aldosterone with high aldosterone/renin ratio were also consistent with diagnosis of PA. Thus, tocilizumab and spironolactone were administered with rapid improvement in clinical condition. Finally, she was diagnosed with acute motor sensitive neuropathy and began the rehabilitation phase. Conclusions: Increased aldosterone levels in PA may be associated with more severe forms of CoViD-19 by stimulating IL-6 production. This association could have a synergic effect in development of complications such as GBS. Increased aldosterone activity/levels could be involved in CoViD-19 patients with secondary aldosteronism. Further studies are needed to.
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In this context globally known as the Coronavirus Pandemic and the mandatory virtual education in which the school year in Argentina has developed, the debates on educational inequality deepened and the right to access to connectivity was one of the main issues at stake. Faced with this situation, and in dialogue with our educational community, from Wikimedia Argentina we had to readapt the existing proposals to the new modality;thus, the series "Teaching with Wikipedia" was born, five educational booklets that seek to work with Wikimedia tools from a critical perspective. In this paper, we present a preliminary analysis of the use of this material through the analysis of a survey carried out among teachers who received it. As main results, the broad connectivity difficulties stand out, especially in the students' homes;the need to think of ways of working on digital literacy from strategies without connectivity;and how teachers train and use available materials. We are particularly interested in highlighting the role of teachers as critical producers of their classes and materials and the place of digital literacy in providing them with the tools to do so.
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The current presidential administration of Brazil has implemented a legislative agenda aimed at weakening protections of Indigenous peoples, in line with an ideological discourse and the direct participation of the armed forces in this process. This agenda has enabled invasions of Indigenous lands and a much higher COVID-19 mortality rate for Indigenous peoples when compared to non-Indigenous people. A bill recently approved by the Chamber of Deputies aims to extinguish all Indigenous lands established by the Brazilian government from 1988 onwards. This bill represents the official opening for violation of the rights of Indigenous peoples by the Bolsonaro administration and facilitates invasion of Indigenous lands. The president's multiple efforts to weaken or deny protection of these peoples, to usurp their lands and to deny their rights to consultation on projects that affect them need to be judged by Brazil's Federal Supreme Court, the UN Human Rights Council, the Inter-American Commission on Human Rights (IACHR), the Inter-American Court of Human Rights (IACtHR) and the International Criminal Court.
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Mast cells play important roles in the maintenance of many physiological functions as well as in the pathophysiology of diseases. Mast cells are involved in the inflammatory mechanisms of many systemic diseases. In this pandemic period, their role in physiological and pathological host inflammatory reactions in tissue disruption following SARS-CoV-2 infection has been stressed. A review of the literature was carried out by entering the key words "Mast Cells" AND "Oral Diseases" AND "Role of Mast Cells in Periodontitis". The results show us that mast cells are definitely involved in many oral diseases including periodontitis. Further in vivo and in vitro studies are needed to further investigate the specific role of the cells in physiological and pathological inflammation.
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Mastocitos/citología , Periodontitis , COVID-19 , Humanos , InflamaciónRESUMEN
The President of Brazil has adopted an anti-environmental stance since taking office in January 2019, weakening the rights of indigenous peoples and environmental legislation and militarizing the environmental and indigenous agencies. The president's stance on the COVID-19 pandemic gives priority to economic development rather than to saving lives. The administration's environment minister even suggested taking advantage of the media's attention being focussed on the pandemic as an 'opportunity' to weaken environmental legislation. Here we argue that both the pandemic and the militarization of Brazil's environmental protection have served as smokescreens to weaken environmental protections, and have also put Brazil's indigenous peoples at risk and violated their rights.