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Background: University counselling services assume a fundamental support function for students who are facing moments of crisis during their academic career. Such services often aim to reduce drop-out rates and achieve improvement in terms of psychological well-being. COVID-19 contagion containment measures have also had an impact on the psychological health of university students and their ability to cope with important developmental tasks. It has become necessary, therefore, to offer online counselling services which has become, however, the means of choice to support students during the university course in the pandemic era, as a complementary intervention to the traditional face-to-face approach. Methods: In a clinical and health psychology perspective, this study aims to analyze the efficacy of 13 online counselling groups involving 66 underachieving students, lagging with their studies. The intervention has adopted the methodology of the Narrative Mediation Path, which aims at promoting mentalization, academic engagement and psychological well-being in order to have an impact on students’ academic performance and prevent university dropouts. At the beginning and end of counselling the following measures were administered: a) Reflective Functioning Questionnaire, b) Psychological General Well-Being Index Short Form, c) Academic Performance Inventory, d) University Student Engagement Inventory, e) Group Climate Questionnaire. Results: The results showed that online counselling groups enabled an overall improvement in all the variables considered. Conclusion: Overall, the present study showed the efficacy of the online group counselling service in supporting students during the pandemic period and in coping with the difficulties encountered during the academic career.

Introduction: Long-COVID-19 impacts health-related quality of life (HR-QoL) but data is scarce. The aim of this study was to describe and prospectively assess the prevalence and risk factors for long-COVID-19 after hospital discharge, and to evaluate its impact on patient HR-QoL. Methods: Single-centre longitudinal study including all COVID-19 patients discharged between December 2020 and February 2021. Patients were contacted remotely at three, six and nine months. Data were collected as follows: 1) Long-COVID-19 symptoms were self-reported; 2) HRQoL were assessed using the 3-level EuroQoL-5D (EQ-5D-3L) questionnaire. Pregnant women, demented, bedridden, and non-Portuguese-speaking patients were excluded. Results: The three-, six- and nine-month assessments were completed by 152, 117 and 110 patients (median age: 61 years; male sex: 56.6%). Long-COVID-19 (≥ 1 symptom) was reported by 66.5%, 62.4% and 53.6% of patients and HR-QoL assessment showed impairment of at least some domain in 65.8%, 69.2% and 55.4% of patients at three, six and nine months, respectively. Fatigue was the most common long-COVID-19 symptom. Anxiety/depression domain was the most frequently affected in all three time-points, peaking at six months (39%), followed by pain/discomfort and mobility domains. Long-COVID-19 was associated with the impairment of all EQ-5D-3L domains except for self-care domain at each time-point. Neither intensive care unit admission nor disease severity were associated with long-COVID-19 nor with impairment of any EQ-5D-3L domain. After adjusting for sex, age, frailty status, and comorbid conditions, long-COVID-19 remained significantly associated with HR-QoL impairment at three (OR 4.27, 95% CI 1.92 – 9.52, p < 0.001), six (OR 3.46, 95% CI 1.40 – 8.57, p = 0.007) and nine months (OR 4.13, 95% CI 1.62 – 10.55, p = 0.003) after hospital discharge. In a longitudinal analysis, patients reporting long-COVID-19 at three months had an EQ-5D-3L index value decreased by 0.14 per visit (p < 0.001) compared to those without long-COVID-19 and both groups had a non-significant change in mean EQ-5D-3L index over the nine-month period (time-point assessment, Z = 0.91, p = 0.364). Conclusion: Clinical sequelae associated with long-COVID-19 can persist for at least nine months after hospital discharge in most patients and can impair long-term HR-QoL in more than half of patients regardless of disease severity, and clinicodemographic characteristics.

Poisoning is a frequent cause of emergency department visits, with attempted suicide accounting for up to two-thirds of all fatalities from pesticide poisoning. Despite extensive pyrethroid use worldwide, relatively few cases of human poisoning have been reported in the literature. Although most pesticide use occurs in the developed world, 99% of all acute pesticide poisoning occurs in developing countries. Deltamethrin poisoning is uncommon, with fewer than 10 deaths reported following ingestion or occupational exposure. The present case report describes deltamethrin intoxication due to intentional oral ingestion in a suicide attempt, resulting in a life-threatening combination of seizures and coma due to non-convulsive status epilepticus.

A 64-year-old male presented with a 6-month history of symmetric polyarthritis involving proximal interphalangeal joints and metacarpophalangeal joints of the hands, wrists, and ankles. Associated symptoms included vomiting, progressive fatigue, and weight loss. Laboratory results showed microcytic anemia, leukocytosis, thrombocytosis, elevated C-reactive protein and erythrocyte sedimentation rate, and rheumatoid factor (RF) and anti-cyclic citrullinated protein (ACPA) antibody positivity. Joints radiographs were normal, without erosions. Upper endoscopy and gastric endoscopic ultrasonography showed a gastric adenocarcinoma with lymphatic involvement. Intraoperatively, peritoneal carcinomatosis was documented, and the patient started palliative chemotherapy. A paraneoplastic seropositive arthritis was assumed, and treatment with low-dose prednisolone and hydroxychloroquine was started. Arthritis remission was achieved and sustained up to 18 months of follow-up, although gastric cancer progression was documented. We describe a unique phenotype of paraneoplastic arthritis (PA) presenting as a seropositive (RF and ACPA positivity) rheumatoid arthritis (RA) with a good response to both low dose corticosteroids and hydroxychloroquine therapy. We also review the literature of PA, mostly the RA-like pattern, and the association between PA and ACPA positivity. This case highlights the importance of considering underlying cancer in elderly male patients, presenting with polyarthritis and systemic symptoms, even in those with ACPA-positive RA-like arthritis.

In a Clinical Health Psychology perspective, which focuses on the promotion and maintenance of mental and physical health of the individuals, mentalization (operationalized as reflective functioning; RF) may be conceived as a psycho-social competence associated with psychological well-being and good outcome treatment. In the university contexts, some studies demonstrated that the students' academic achievements may be related, on one hand, to RF improvements, on the other, to psychological well-being. Nevertheless, there is a lack of studies exploring RF in relationship with both academic achievement and psychological well-being regarding university students. This study aims at assessing the effectiveness, in terms of RF, psychological well-being and academic performance, of ten counselling groups addressed to 63 underachieving university students lagging behind in their studies. The counselling adopted an innovative narrative methodology, the Narrative Mediation Path (NMP), which aims to improve mentalization and psychological well-being in order to produce an impact on the students' academic performance. The Reflective Functioning Questionnaire (RFQ), the Psychological General Well-Being Index (PGWBI), and the Academic Performance Inventory (API) were administered at the beginning and at the end of the counselling. Results showed an overall improvement of students in genuine mentalization, especially of the hypomentalizing dimension of RF, an increase of the psychological well-being index and its sub-dimensions (except for the General Health dimension) and an improvement of the academic performance. This study highlighted the effectiveness of the NMP methodology for students' success and suggests the utility of planning clinical psychology interventions aimed at enhancing mentalization in the university contexts.