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Objective: Distress during SARS‐CoV‐2 outbreak affected also cancer patients' well‐being. Aim of this study was to investigate patient' reactions and behavior (flexible‐adaptive vs. inflexible‐maladaptive) during the SARS‐CoV‐2 outbreak. Methods: A cross‐sectional survey was designed with a self‐report questionnaire, "the ImpACT questionnaire," developed for the study. Regression analysis was performed on data. Results: Four hundred and forty five cancer patients from 17 Italian regions participated in the study. 79.8% of participants were female (mean age of 58 years). 92.6% of participants reported feeling vulnerable to COVID‐19 contagion; 75.6% reported helpless, 62.7% sad, 60.4% anxious, and 52.0% anger. Avoidance of thinking about coronavirus is the principal maladaptive behavior that emerged. Participants who reported feeling anxious were more likely to have fear of staff being infected with COVID‐19 (OR = 3.01; 95% CI = 1.49–6.30) and to have disrupted sleep due to worry (OR = 2.42; 95% CI = 1.23–4.83). Younger participants reported more anxiety (OR = 0.97; 95% CI = 0.94–1.00); men reported feeling calm more than women (OR = 2.60; 95% CI = 1.27–5.43). Conclusions: Majority of cancer patients reported serious concerns regarding SARS‐CoV‐2 infection; reliable information and psychological support must be offers to respond to these needs. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is considered the commonest viral cause of sexually transmitted infections. The impact of social distance measures due to Covid-19 pandemic on HPV spread is unknown. Therefore, this study has analyzed the seven-year trend of HPV prevalence in all patients tested for HPV DNA at the Microbiology and Virology Unit at Bari Policlinico. Moreover, the HPV prevalence in 2020 has been compared with the previous year ones in order to evaluate the consequences of lockdown and social distancing measures on transmission risks. From 2013 to 2020, we retrospectively analyzed 64 anal swabs, 418 biopsies, 5925 cervical-vaginal swabs, 512 cervical swabs, 104 gland swabs, 154 oral swabs, 21 seminal fluids and 503 urethral swabs. HPV DNA detection was initially performed using nested-polymerase chain reaction (PCR) and subsequently multiplex real-time PCR assay. All statistical tests were carried out by the open-source environment R 4.0.3 (R Core Team). The data were analyzed according to yearly positivity rates, temporal trend and prevalence of HPV genotypes (HPV-6, HPV-11, HPV-16, HPV-18, high risk and low risk) by age category and sex. The number of patients increased steadily from 2016 to 2019 and then decreased in 2020. There were significant differences in prevalence between females and males for HPV-6 (6.16% in females Vs 30.80% in males), HPV-11 (0.82% Vs 7.16%) and HPV-16 (7.77% Vs 5.01%). The prevalence of HPV-6 and HPV-11 significantly increased in 2020 compared to 2013–2019 (15.72% Vs 8.52 and 3.18% Vs 1.44%). On the contrary, the overall prevalence of HPV DNA remained constant in 2020 (52.84% Vs 48.44%). Over time, the prevalence of HPV DNA (Coefficient=-0.020, p-value = 0.036) and particularly high-risk genotypes (Coefficient=-0.030, p-value = 0.005) decreased in females, while low-risk genotypes (Coefficient = 0.141, p-value= < 0.001) and the prevalence of HPV DNA increased in males (Coefficient = 0.068, p-value = 0.008). During the pandemic, the number of screened patients declined, although HPV prevalence compared to 2013–2019 remained constant or increased as in the case of low-risk genotypes. It can be assumed that the reduction of the screening coverage favored the emerging of the more symptomatic low-risk infections. In conclusion, nonpharmaceutical interventions due to Covid-19 pandemic did not reduce the risk of HPV infection but it likely caused a decrease in access to health services resulting in an increased risk of undiagnosed HPV. To decrease the impact of Covid-19 pandemic on the general population, several measures of social distancing were worldwide implemented potentially affecting sexual behaviors. Evaluating the impact of the social distancing measures on the risk of sexually transmitted infections, the published studies reached contradictory results showing the absence of a common epidemiological trend. The overall prevalence of HPV and some of its genotypes among female and male patients did not decrease in 2020 compared to the years 2013–2019. The risk of the HPV infection was not affected by the social distancing measures. [ABSTRACT FROM AUTHOR]

Summary: Since the first lockdown of Spring 2020, the COVID‐19 contagion waves pervasively disrupted the sleep and mental health of the worldwide population. Notwithstanding the largest vaccination campaign in human history, the pandemic has continued to impact the everyday life of the general population for 2 years now. The present study provides the first evidence of the longitudinal trajectories of sleep disturbances and mental health throughout the pandemic in Italy, also describing the differential time course of age groups, genders and chronotypes. A total of 1062 Italians participated in a three‐time‐point longitudinal study covering two critical stages of the emergency (the first lockdown in April 2020 and the second partial lockdown in December 2020) and providing a long‐term overview 2 years after the pandemic outbreak (April 2022). We administered validated questionnaires to evaluate sleep quality/habits, insomnia, depression, stress and anxiety symptoms. Analyses showed a gradual improvement in sleep disturbances, depression and anxiety. Conversely, sleep duration progressively decreased, particularly in evening‐type and younger people. Participants reported substantial earlier bedtime and get‐up time. Stress levels increased during December 2020 and then stabilised. This effect was stronger in the population groups apparently more resilient during the first lockdown (older people, men and morning‐types). Our results describe a promising scenario 2 years after the pandemic onset. However, the improvements were relatively small, the perceived stress increased, and the re‐establishment of pre‐existing social/working dynamics led to general sleep curtailment. Further long‐term monitoring is required to claim the end of the COVID‐19 emergency on Italians' sleep and mental health. [ABSTRACT FROM AUTHOR]

In February 2020, Italy has been the first country in Europe fighting against COVID-19. In March 2020, Italian government declared national lockdown. Until May 4th, people stayed in home confinement and only the so-called essential works and activities were continued. Like in other countries, both for the disease severity and for the risk of death, the higher the age of people the higher the risk. In the first months of 2020, Italy saw a very high number of deaths related to COVID-19, with a huge age effect. There is an agreement on the view that there had been also an excess of mortality and on the role of mortality as a correct way to reflect the dynamics of the virus's spread. In this paper we briefly discuss the trends of mortality during the first 4 months of 2020 according to the data by the Italian National Institute of Statistics. [ABSTRACT FROM AUTHOR]

Objective: The aim was to estimate the perceived quality of life and its relationship with sociodemographic and professional factors, perception of susceptibility to COVID-19, and stress. Design: It was a longitudinal study. Subjects: Professionals, working in Italian centers for pediatric neurocognitive, speech, and psychomotor rehabilitation. Methods: Participants were interviewed online twice during the COVID-19 outbreak in Italy. The questionnaire included: (i) The measures of health-related quality of life to perform the Summary Index of Unhealthy Days, (ii) modified items from the "Standard questionnaire on risk perception of an infectious disease outbreak" and (iii) the items of the General Health Questionnaire. Results: One hundred and thirty professionals out of 130 participated in the first interview, while only 50 therapists took part in the second interview (dropout rate: 61%). The Summary Index of Unhealthy Days was 8 days at the first interview, and it decreased to 6 days at the second interview; however, the reduction was not significant (F = 3.22; p = 0.079). The multivariable analysis showed that the rehabilitation providers with moderate or severe stress level were more likely to have a negative perception of the quality of life (ORadj = 7.155; 95% CI: 2.8-18.2), and this result was confirmed at the second interview. Conclusions: Our results showed that in a severe public health emergency, the mental health and quality of life of rehabilitation professionals must be a topic of focus to enhance psychological resilience, to prevent burnout and to reduce rehabilitation errors. [ABSTRACT FROM AUTHOR]

Italy has been the first nation outside of Asia to face the COVID-19 outbreak. To limit viral transmission of infection, by March 10th, 2020, the Italian Government has ordered a national lockdown, which established home confinement, home (smart) working, and temporary closure of non-essential businesses and schools. The present study investigated how these restrictive measures impacted mothers and their pre-school children's behavioral habits (i.e., sleep timing and quality, subjective time experience) and psychological well-being (i.e., emotion regulation, self-regulation capacity). An online survey was administered to 245 mothers with pre-school children (from 2 to 5 years). Mothers were asked to fill the survey thinking both on their habits, behaviors, and emotions and on those of their children during the quarantine, and retrospectively, before the national lockdown (i.e., in late February). A general worsening of sleep quality and distortion of time experience in both mothers and children, as well as increasing emotional symptoms and self-regulation difficulties in children, was observed. Moreover, even when the interplay between the behavioral and psychological factors was investigated, the factor that seems to mostly impact both mothers' and children's psychological well-being was their sleep quality. Overall, central institutions urgently need to implementing special programs for families, including not only psychological support to sustain families with working parents and ameliorating children's management. [ABSTRACT FROM AUTHOR]

The present study focused on the mediating role of positivity in the relationship between emotional stability, conscientiousness, with positive affect, negative affect, and anxiety, among priests and religious sisters during the COVID-19 outbreak in Italy. We examined the role of positivity as a basic disposition predisposing individuals to a positive mode of viewing reality for priests and religious sisters during the quarantine. We used data from 205 religious participants, collected during the initial phase of the COVID-19 outbreak. Results revealed that emotional stability and conscientiousness significantly and indirectly predicted positive affectivity, but were significant and negative indirect predictors of negative affect, and state anxiety. This study emphasizes the protective role of positivity in the specific population of priests and religious sisters during a pandemic outbreak. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and analyze the impact of lockdown strategy due to coronavirus disease 2019 (COVID-19) on emergency general surgery (EGS) in the Milan area at the beginning of pandemic outbreak. Methods: A survey was distributed to 14 different hospitals of the Milan area to analyze the variation of EGS procedures. Each hospital reported the number of EGS procedures in the same time frame comparing 2019 and 2020. The survey revealed that the number of patients during the COVID-19 pandemic outbreak in 2020 was reduced by 19% when compared with 2019. The decrease was statistically significant only for abdominal wall surgery. Interestingly, in 2020, there was an increase of three procedures: surgical intervention for acute mesenteric ischemia (p = 0.002), drainage of perianal abscesses (p = 0.000285), and cholecystostomy for acute cholecystitis (p = 0.08). Conclusions: During the first COVID-19 pandemic wave in the metropolitan area of Milan, the number of patients operated for emergency diseases decreased by around 19%. We believe that this decrease is related either to the fear of the population to ask for emergency department (ED) consultation and to a shift towards a more non-operative management in the surgeons 'decision making' process. The increase of acute mesenteric ischaemia and perianal abscess might be related to the modification of dietary habits and reduction of physical activity related to the lockdown. [ABSTRACT FROM AUTHOR]

During the first phase of the COVID-19 outbreak, Italy experienced problems of public order and maladjusted behavior. This study assessed the role of negative affectivity, right-wing authoritarianism, and anxiety of COVID-19 infection in explaining a variety of the maladjusted behaviors (i.e., "China-phobic" discrimination, panic buying) observed with an Italian sample. Specifically, we examined the effect of Negative Affectivity and Right-Wing Authoritarianism on maladjusted behaviors, and the moderating role of anxiety of infection. Seven hundred and fifty-seven Italian participants completed an online survey between March 3rd to the 7th 2020, which was immediately before the lockdown. A moderated-mediation model was tested using a structural equation modeling approach. Results indicated that both Negative Affectivity and Right-Wing Authoritarianism were positively associated with COVID-19-related maladjusted behavior, and that Right-Wing Authoritarianism mediated the relationship between Negative Affectivity and maladjusted behavior. Furthermore, the effect of Right-Wing Authoritarianism on maladjusted behavior was greater for those with high anxiety of infection, and the indirect effect of Negative Affectivity on maladjusted behavior through Right-Wing Authoritarianism was moderated by infection anxiety. Findings highlight potential psychological paths that may inform communication strategies and public health initiatives aimed at promoting healthy behavior during an outbreak. [ABSTRACT FROM AUTHOR]

Italy and Spain are two representative examples on strict lockdown last March 2020, also suffering a high rate of mortality in Europe. The aim of this study is to examine their attitudes confronting death awareness during the Covid-19 outbreak. Moreover, Personality was also considered. Different sociodemographic, in situ questions related to attitudes and the brief Big Five of Personality were employed in a cross-sectional design. The main results suggested that Personality traits were stable across countries. A relationship was found between Fear to contagious diseases and Neuroticism and other attitudes during the Covid-19 outbreak, and two different clusters were identified with regards to attitudes, however these did not differ on Personality. Finally, a Cluster group, Neuroticism, Age and Sense of belonging to the Country did predict Fear to contagious diseases. Of note, no differences were found across countries during grief. [ABSTRACT FROM AUTHOR]

After the analysis and forecast of COVID-19 spreading in China, Italy, and France the WHO has declared the COVID-19 a pandemic. There are around 100 research groups across the world trying to develop a vaccine for this coronavirus. Therefore, the quantitative and qualitative analysis of the COVID–19 pandemic is needed along with the effect of rapid test infection identification on controlling the spread of COVID-19. Mathematical models with computational simulations are the effective tools that help global efforts to estimate key transmission parameters and further improvements for controlling this disease. This is an infectious disease and can be modeled as a system of non-linear differential equations with reaction rates. In this paper, we develop the models for coronavirus disease at different stages with the addition of more parameters due to interactions among the individuals. Then, some key computational simulations and sensitivity analysis are investigated. Further, the local sensitivities for each model state concerning the model parameters are computed using the model reduction techniques: the dynamical models are eventually changed with the change of parameters are represented graphically. [ABSTRACT FROM AUTHOR]

Objective: To describe the trend in surgical volume in urology in Italy during the coronavirus disease 2019 (COVID‐19) outbreak, as a result of the abrupt reorganisation of the Italian national health system to augment care provision to symptomatic patients with COVID‐19. Methods: A total of 33 urological units with physicians affiliated to the AGILE consortium (Italian Group for Advanced Laparo‐Endoscopic Surgery; www.agilegroup.it) were surveyed. Urologists were asked to report the amount of surgical elective procedures week‐by‐week, from the beginning of the emergency to the following month. Results: The 33 hospitals involved in the study account overall for 22 945 beds and are distributed in 13/20 Italian regions. Before the outbreak, the involved urology units performed overall 1213 procedures/week, half of which were oncological. A month later, the number of surgeries had declined by 78%. Lombardy, the first region with positive COVID‐19 cases, experienced a 94% reduction. The decrease in oncological and non‐oncological surgical activity was 35.9% and 89%, respectively. The trend of the decline showed a delay of roughly 2 weeks for the other regions. Conclusion: Italy, a country with a high fatality rate from COVID‐19, experienced a sudden decline in surgical activity. This decline was inversely related to the increase in COVID‐19 care, with potential harm particularly in the oncological field. The Italian experience may be helpful for future surgical pre‐planning in other countries not so drastically affected by the disease to date. [ABSTRACT FROM AUTHOR]

Self-concept clarity reflects how confidently and clearly an individual defines the self-belief, and it is theorized to help individuals to be more resilient in the face of stressors. The present study aimed at investigating how self-concept clarity may be implicated in the stress process related to the COVID-19 outbreak, by examining its association with daily negative affect, as a short-term adaptational outcome. The impact of the total number of positive cases, as an objective index of COVID-19 spreading, on negative affect was also tested. Participants were 287 young Italian adults (52% female; Mage = 22.68 years, SDage = 2.62), who completed twelve daily diaries (of which five after the lockdown measure was introduced). Results from multilevel growth modeling showed that individuals low in self-concept clarity reported the highest levels of negative affect across the study period, compared to individuals high in self-concept clarity. Moreover, after the issuing of the lockdown measure, individuals high in self-concept clarity showed a steeper increase in their daily level of negative affect, compared to individuals low in self-concept clarity, indicating their responsiveness to the new situation. The total number of new cases was not related to daily negative affect. These findings attest the protective role of self-concept clarity and its impact on emotional responding to the lockdown measure in Italy. [ABSTRACT FROM AUTHOR]

On March 10, 2020, Italy announced its lockdown caused by the novel coronavirus (COVID-19) pandemic, and home confinement exposed individuals to a stressful situation of unknown duration. Our study aimed to analyze the emotional and cognitive experiences and the psychopathological symptoms of young Italian University students seeking help from our University student Counseling and Consultation Service during the COVID-19 lockdown. Also, our study aimed to identify the predictors of traumatic psychological distress, investigating variables that could influence the students' well-being, related to their socio-demographic and clinical condition, to the "exposition" to the social distancing, and related to their cognitive thinking style. One-hundred and three University students were included in our study. The traumatic impact was assessed by the Impact of Event Scale-Revised (IES-R). A digital platform was used in our study, focused on narrative dimensions analyses. Our results showed that 21.4% of our help-seeking students experienced lockdown as a traumatic experience. The main stressful factors reported by students were: adjustment to the new academic activities (23.3 %), lack of autonomy (19.4%), and conflicts with family members (6.8%). The three main areas impaired were: changes in the sleeping pattern (68%), difficulty in concentration (67%), and loss of energy (58.6%). Furthermore, 36% of our student sample reported being suffering from anxiety symptoms, whereas 26% showed depressive symptomatology. Students having previous psychological and psychiatric contacts with mental health services (23%) showed a more severe traumatic and depressive symptomatology. The problematic thinking style "all or nothing" was predominantly associated with psychological distress, anxiety, depression, and posttraumatic symptoms. "Everything Will Be Fine" could be identified by the "optimistic style" (27.2%), inversely correlated with the psychopathological measures and concentration problems. The results of the logistic regression analysis indicated that the length of home confinement (second month) seemed to increase by over 3 times the likelihood of experience posttraumatic symptomatology, and a thinking style "all or nothing" was the final strongest predictor increasing the risk by over 5 times. The implementation of psychological interventions to improve the mental health of vulnerable young subgroups to contain the structuring of psychopathological profiles represent a fundamental challenge. [ABSTRACT FROM AUTHOR]

In this study, we tested a theoretical model with moral disengagement, a mediator, and generalized social trust (GST), a mediator and a moderator of the relationship between personality traits and rule-respecting behaviors (i.e., social distancing and stay-at-home), during the coronavirus disease 2019 (COVID-19) outbreak in Italy. The data were collected on 1520 participants (61% males). General results are threefold: (1) moral disengagement mediated the relationship between emotional stability, narcissism, psychopathy, and social distancing; (2) among components of GST, trust in Government mediated the relationship between psychopathy and social distancing; trust in known others mediated the relationship between emotional stability, agreeableness, and Machiavellianism with total number of exits; trust in unknown others mediated the relationship of emotional stability, agreeableness, conscientiousness, and psychopathy with average daily number of exits; (3) GST moderated the indirect effect of personality traits on rule-respecting behaviors through moral disengagement. The theoretical and practical importance of these results is discussed. [ABSTRACT FROM AUTHOR]

• The knowledge of essential insights into Marche, Italy in particular to virus transmission dynamics. • Geographical characteristics, and the imposing of mitigation measures to fight against the COVID-19 outbreak. • The outbreak SI distribution Marche region is estimated R0 is 1.852 (0.6–2.3) with 95% CI. • The prediction of cumulative incidences of four-week projection with 95% CI was 12 (7–), 31 (18–), 63 (21–), and 121 (26–) respectively. COVID-19 disease is becoming a global pandemic and more than 200 countries were affected because of this disease. Italy is one of the countries is largely suffered with this virus outbreak, and about 180,000 cases (as of 20 April 2020) were registered which explains the large transmissibility and reproduction case numbers. In this study, we considered the Marche region of Italy to compute different daily transmission rates (R t) including five provinces in it. We also present forecasting of daily and cumulative incidences associated after the next thirty days. The Marche region is the 8th in terms of number of people infected in Italy and the first in terms of diffusion of the infection among the 4 regions of the center of Italy. Epidemic statistics were extracted from the national Italian Health Ministry website. We considered outbreak information where the first case registered in Marche with onset symptoms (26 February 2020) to the present date (20 April 2020). Adoption of incidence and projections with R statistics was done. The median values of R t for the five provinces of Pesaro and Urbano, Ancona, Fermo, Ascoli Piceno, and Macerata, was 2.492 (1.1–4.5), 2.162 (1.0–4.0), 1.512 (0.75–2.75), 1.141 (1.0–1.6), and 1.792 (1.0–3.5) with 95% of CI achieved. The projections at end of 30th day of the cumulative incidences 323 (95% CI), and daily incidences 45 (95% CI) could be possible. This study highlights the knowledge of essential insights into the Marche region in particular to virus transmission dynamics, geographical characteristics of positive incidences, and the necessity of implementing mitigation procedures to fight against the COVID-19 outbreak. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic is burning all over the world. National healthcare systems are facing the contagion with incredible strength, but concern regarding the psychosocial and economic effects is growing quickly. The PsyCovid Study assessed the influence of psychosocial variables on individual differences from the perceived impact of the Covid-19 outbreak on the issues of health and economy in the Italian population. Italian volunteers from different regions completed an online anonymous survey. The main outcomes were the perceived impact of the Covid-19 outbreak on health and the economy. A two-way MANOVA evaluated differences in the main outcomes, with geographical area (northern, central, and southern regions) and professional status (healthcare workers or not) as factors. We then tested the relationship linking psychosocial variables (i.e. perceived distress and social isolation, empathy, and coping style) to the main outcomes through two different mediation models. 1163 responders completed the survey (835 females; mean age: 42 ± 13.5 y.o.; age range: 18-81 y.o.) between March 14 and 21, 2020. Healthcare workers and people living in northern Italy reported a significantly worse outbreak impact on health, but not on the economy. In the whole sample, distress and loneliness were key variables influencing the perceived impact of the Covid-19 outbreak on health, while empathy and coping style affected the perceived impact on the economy. The Covid-19 pandemic is a worldwide emergency in terms of psychological, social, and economic consequences. Our data suggests that in the Italian population, actual differences in individual perception of the Covid-19 outbreak severity for health are dramatically modulated by psychosocial frailty (i.e., distress and loneliness). At the same time, problem-oriented coping strategies and enhanced empathic abilities increase people's awareness of the severity of the impact of the Covid-19 emergency on economics. There is an immediate need for consensus guidelines and healthcare policies to support interventions aimed to manage psychosocial distress and increase population resilience towards the imminent crisis. [ABSTRACT FROM AUTHOR]

This study explored the experiences of nursing students with respect to learning processes and professional development during internships with COVID-19 patients to build a novel theoretical model. The COVID-19 outbreak had a profound impact on the worldwide learning system and it interrupted the internship experiences of nursing students. After the second wave of COVID-19, to balance academic activities with COVID-19 containment, some Italian universities allowed nursing students' internships in COVID-19 units. This new experience may have influenced nursing students' learning processes and professional development, but this is yet to be investigated. A qualitative study using a constructivist grounded theory (CGT) approach. Nursing students were recruited from two hospitals in northern Italy between January and April 2021. Data are gathered from interviews and a simultaneous comparative analysis were conducted to identify categories and codes, according to Charmaz's (2006) theory. The sample consisted of 28 students. The results suggested the core category, that is the 'Students' sense of belonging to the nursing profession' and four main categories: (1) From knowledge to know-how, (2) A new relationship modality, (3) Sharing and socialisation and (4) Responsibilization. Finally, a premise and a corollary, respectively (5) Motivation and the (6) Circularity of the process, were identified. Our study proposed a new theory of nursing students' learning processes in clinical contexts during internships with COVID-19 patients. Despite significant difficulties, the nursing students developed a unique learning process characterised by motivation. Therefore, our study provided insight into the learning process during a pandemic and investigated the support needed for nursing students to continue their internships. [ABSTRACT FROM AUTHOR]

Population ageing and the higher prevalence of multimorbidity in later life are increasing the demand for Long-Term Care (LTC) worldwide; this has been exacerbated by the COVID-19 pandemic. As in Europe and beyond, the bulk of care for frail older people is carried out by informal caregivers. This study aimed at understanding the factors affecting the overall worsening health of informal caregivers of older people with LTC needs living in Germany and Italy during the outbreak. To this purpose, 319 informal caregivers (149 in Germany and 173 in Italy) were surveyed online in 2020-2021. A logistic regression analysis was performed by country, to obtain an adjusted estimate of the risk of worsening of caregivers' health. This risk increased by 42% for German caregivers compared to Italian ones, despite the former receiving more formal services. This may depend on different quality standards of LTC services and caregivers' expectations, and on differing policies concerning migrant care workers (MCWs) during the outbreak, who could not enter Germany and were "trapped" at care recipients' homes in Italy. Results call for in-home care reforms and policies guaranteeing more effective caregiver support, home care services and fairer working condition for MCWs in both countries.

Exactly one year ago, between February and March 2020, the COVID-19 infection went from an epidemic confined to China to a worldwide pandemic that was particularly lethal in Italy. This study examined the media accounts during that period by analysing the representation of death-related constructs in Corriere della Sera, the most widely read newspaper in Italy. A textual and thematic analysis of articles published between period A (epidemic: 23 January–22 February 2020) and period B (pandemic: 23 February–31 March 2020) was conducted using Nvivo-11. A total of 141 articles comprising 48,524 words were collected. The most utilised words and meanings linked to COVID-19 were computed. In the rank distribution, 'China' and 'virus' were the terms most frequently used in both periods. The terms 'death' and 'dead' were completely absent in period A and appeared in the 535th position in period B. The term 'dead' was used primarily to indicate the number of deceased. From a Terror Management Theory perspective, it is possible that the minimal reference to death-related issues was a reflection of death denial and a manifestation of efforts to deny death to manage terror. These findings highlight the ambiguities and ambivalence surrounding any issue pertaining to death; on the one side, undue alarmism may provoke exaggerated reactions, such as moral panic, while on the other denial-based messages that minimise references to mortality may reduce safe behaviour during a pandemic. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the impact of distance education (DE) on mental health, social cognition, and memory abilities in a sample of university students during the national COVID-19 lockdown in Italy and to identify the predictors of academic performance., Methods: Two hundred and three students (76.4% women, mean age 24.3, SD ± 4.9) responded to an anonymous online cross-sectional survey between July 15 and September 30, 2020, on DE experience and cognitive and social-cognitive variables. A short version of the Beck Depression Inventory-II, ten images from the Eyes Task, and five memory vignette stimuli were included in the survey. Descriptive, one-way ANOVA, correlation, and logistic regression analyses were conducted., Results: Half of the student sample reported significant impairment in concentration and learning abilities during DE. Regarding psychological health, 19.7%, 27.1%, and 23.6% of the sample reported mild, moderate, and severe depressive symptoms, respectively. Correlation analyses showed a statistically significant negative association between depression and the overall subjective evaluation of DE (r =  - 0.359; p < 0.000). Changes in one's study context and habits, i.e., studying alone at one's parents' home instead of studying with colleagues or alone in a university "social place" (e.g., the university library), seemed to increase the likelihood of poor academic performance by almost 3 times (O.R. 3.918; p = 0.032). This predictor was no longer statistically significant in the subsequent step when the individual impairment predictors were entered. Learning concentration impairment during DE (O.R. 8.350; p = 0.014), anxiety about COVID-19 contagion for oneself or others (O.R. 3.363; p = 0.022), female gender (O.R. 3.141; p = 0.045), and depressive symptomatology (O.R. 1.093; p = 0.047) were ultimately determined to be the strongest predictors of poor academic performance, whereas the appreciation of DE represented a protective variable (O.R. 0.610; p < 0.000)., Conclusions: The study showed a negative impact of DE on the mental health of students presenting depressive symptoms and impairment in concentration and learning, the latter identified as the strongest predictors of poor academic performances. The study confirms the emerging need to monitor the impact of DE, which occurred during the 2019/2020 academic year and will continue in the coming months, to refine educational offerings and meet students' psychological needs by implementing psychological interventions based on the modifiable variables that seem to compromise students' psychological well-being and academic outcomes., (© 2021. The Author(s).)

Background : The University was among the first structures to be hit by the health emergency, transferring all its teaching and research activities remotely. It was not easy for teachers and students to find themselves suddenly shifted into different teaching and socializing context. Results : This article describes and analyzes the online teaching experience carried out for the course of Microscopy Techniques for Forensic Biology offered as a part of the Master's degree program in Biology at the University of Calabria (Italy). A cross-sectional survey (pilot study) was designed to investigate the accessibility of distance learning along with an evaluation of adjustments needed for the conversion from offline to online instruction. Particular attention has been paid to learning material and lesson duration, with specific emphasis on practical activities. Conclusions : The author's intent is that of opening a comparison between the strengths and weaknesses that emerged in this experience, highlighting, in particular, how the educational relationship between teacher and student has changed., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 Brunelli E and Macirella R.)

Introduction: Following the severe consequences of the coronavirus disease 2019 (COVID-19) outbreak, on March 9th, 2020 the Italian Government implemented extraordinary measures to limit viral transmission, including restrictive quarantine measures. Psychological distress represents the seizure-precipitating factor most often reported by patients with epilepsy. To date, no studies have analyzed the role played by the different dimensions of psychological distress quarantine-induced in patients with epilepsy., Materials and Methods: We included a total of 40 patients, 18 suffered from generalized, and 22 from focal epilepsy. The patients previously seen in the outpatient clinic during the pre-lockdown period between January and February 2020 were reevaluated after the lockdown period. Psychological distress was evaluated by using the three subscales of Impact of Event Scale-Revised (IES-R). Finally, we employed logistic regression analyses to explore the demographic and clinical features associated to high scores on IES-R., Results: Patients with higher scores on IES-R Intrusion and IES-R Avoidance subscales demonstrated an increased number of epileptic attacks compared to prelockdown period. Multivariate logistic regression analyses showed that a specific subgroup of patients (i.e., older, female with more anxious symptoms) are at higher risk of increased seizure frequency., Conclusions: Our study confirmed that the frequency of epileptic seizures increased during lockdown when compared to pre-lockdown period. The early identification of patients more vulnerable to worsening is crucial to limit the risk of requiring hospital or clinical treatment during the COVID-19 outbreak., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Millions of people have been infected worldwide in the COVID-19 pandemic. In this study, we aim to propose fourteen prediction models based on artificial neural networks (ANN) to predict the COVID-19 outbreak for policy makers., Methods: The ANN-based models were utilized to estimate the confirmed cases of COVID-19 in China, Japan, Singapore, Iran, Italy, South Africa and United States of America. These models exploit historical records of confirmed cases, while their main difference is the number of days that they assume to have impact on the estimation process. The COVID-19 data were divided into a train part and a test part. The former was used to train the ANN models, while the latter was utilized to compare the purposes. The data analysis shows not only significant fluctuations in the daily confirmed cases but also different ranges of total confirmed cases observed in the time interval considered., Results: Based on the obtained results, the ANN-based model that takes into account the previous 14 days outperforms the other ones. This comparison reveals the importance of considering the maximum incubation period in predicting the COVID-19 outbreak. Comparing the ranges of determination coefficients indicates that the estimated results for Italy are the best one. Moreover, the predicted results for Iran achieved the ranges of [0.09, 0.15] and [0.21, 0.36] for the mean absolute relative errors and normalized root mean square errors, respectively, which were the best ranges obtained for these criteria among different countries., Conclusion: Based on the achieved results, the ANN-based model that takes into account the previous fourteen days for prediction is suggested to predict daily confirmed cases, particularly in countries that have experienced the first peak of the COVID-19 outbreak. This study has not only proved the applicability of ANN-based model for prediction of the COVID-19 outbreak, but also showed that considering incubation period of SARS-COV-2 in prediction models may generate more accurate estimations.

We conducted a survey to investigate to what extent the fear of COVID-19 has influenced the patients decision to undergo or to cancel endoscopic procedures. We collected data from 847 patients from 13 centres. The main indication for endoscopy was anemia, followed by pain and unexplained weight loss. The percentage of not presenters progressively increased throughout the three weeks of study, from 15.1% at the beginning to 48.2% at the end. 37 (34.2%) upper GI endoscopies and 112 (56.3 %) colonoscopies showed an organic cause explaining the symptoms presented by the patients, respectively; 5 cases of gastric cancer (4.6%) and 16 cases of colorectal cancer (CRC) (6.0%), respectively, were detected; during the second week the percentage of organic diseases found at upper endoscopy was 19 (33.3%) with 5 cancer (8.7%), and 61 (49.1% ) at colonoscopy, with 2 CRC (1.6%); finally, during the third week the corresponding figures were 19 (48.7%) for upper GI examinations, with 3 gastric cancers (7.7%), and 43 (60.5%) with 4 (6.5%) CRC cases found.We conclude that patients weighted the fear of having a clinically relevant disease with the fear of becoming infected by coronavirus, and a relevant percentage of them (29.4%) decided not to attend the endoscopy suites at the scheduled date., Competing Interests: Conflict of interest None., (Copyright © 2020. Published by Elsevier Ltd.)

Background: Till 31 March 2020, 105,792 COVID-19 cases were confirmed in Italy including 15,726 deaths which explains how worst the epidemic has affected the country. After the announcement of lockdown in Italy on 9 March 2020, situation was becoming stable since last days of March. In view of this, it is important to forecast the COVID-19 evaluation of Italy condition and the possible effects, if this lock down could continue for another 60 days., Methods: COVID-19 infected patient data has extracted from the Italian Health Ministry website includes registered and recovered cases from mid February to end March. Adoption of seasonal ARIMA forecasting package with R statistical model was done., Results: Predictions were done with 93.75% of accuracy for registered case models and 84.4% of accuracy for recovered case models. The forecasting of infected patients could be reach the value of 182,757, and recovered cases could be registered value of 81,635 at end of May., Conclusions: This study highlights the importance of country lockdown and self isolation in control the disease transmissibility among Italian population through data driven model analysis. Our findings suggest that nearly 35% decrement of registered cases and 66% growth of recovered cases will be possible., Competing Interests: Declaration of Competing Interest No author does not have any conflicts of interest., (Copyright © 2020. Published by Elsevier B.V.)