Conditions Of Social Isolation Research Articles

Особенности волевой регуляции поведения у осужденных женщин, имеющих наркотическую зависимость

The article presents a study of the features of volitional self-regulation of convicted women with drug addiction in conditions of social isolation. The purpose of the study was to study the characteristics of volitional regulation of convicted women with drug addiction. The subject of the study is the peculiarities of volitional regulation of convicted women with drug addiction. The hypothesis of the study is the assumption that the volitional regulation of convicted women with drug addiction differs from the volitional regulation of convicted women who do not have drug addiction. The study was carried out using the following diagnostic tools:
 – a methodology for studying stylistic self-regulation of behavior (SSP) aimed at the emotional-volitional sphere;
 – the methodology for studying volitional regulation (VVR) is aimed at studying the emotional-volitional and motivational-need spheres of the individual;
 – the “Volitional Personality Qualities Questionnaire” (VQL) technique designed to assess the volitional qualities of an individual.
 60 respondents took part in the study. The subjects were divided into two groups. 30 convicted women with drug addiction were selected for the experimental group. The control group consisted of 30 convicted women who did not have drug addiction.
 The results obtained during the study indicate that convicted women with drug addiction are extremely dependent on the opinions and assessments of others, are unable to independently develop plans and programs of action, and often and uncritically follow other people’s advice. In the absence of outside help, they inevitably experience regulatory failures. The stylistic features of self-regulation of activity reveal uncertainty in a rapidly changing environment; they have great difficulty getting used to changes in life and are extremely dependent on the opinions and assessments of others. They also have a reduced ability to consciously overcome obstacles on the path to their goals and conflict-free behavior; they are characterized by low initiative, independence, suggestibility, and dependence on the opinions of groups.

The role of gender differences in the outcome of juvenile social isolation: Emphasis on changes in behavioral, biochemical and expression of nitric oxide synthase genes alteration

Social isolation can cause serious problem in performance of individuals in community. As gender differences may cause variation results in the severity of depressive behavior and response of patients to therapy, the impact of gender and the interaction of the level of endocrine secretion in depression were investigated in this study. Wistar rats of both sexes were subjected to post-weaning social isolation (PWSI) conditions and, together with the control group, experienced several behavioral tests including open-field Test (OFT), elevated plus maze (EPM), force swimming test (FST), splash test and novel object recognition test (NOR). Hippocampal tissue was isolated to measure biochemical factors such as nitric oxide level, FRAP amount, MDA level. In addition, real-time-PCR test was used to quantify the genes expression level of inducible nitric oxide synthase (iNOS) and neuronal nitric oxide synthase (nNOS). On the other hand, sexual hormone levels in blood were measured. Both cognitive and behavioral f unctions were declined as the result of PWSI induction in male and diestrus female rats. The consequent surge of estradiol during estrous phase seems to suppress the accumulation of reactive oxygen species (ROS), and modulate iNOS and nNOS expression. In conclusion, while the pattern of PWSI in surge cellular antioxidants, raising cellular ROS level is gender-specific, this alleviation was in relation with the drop of estradiol and unrelated with testosterone level.

Forced Social Isolation leads to Smartphone Addiction and Depression

Background: Addiction to smartphone usage is a common problem among adults worldwide. Smartphones are popular devices capable of processing more information than other phones. During COVID-19, a situation of “forced social isolation” was created which increased the use of smartphones. We conducted this study with the hypothesis that the period of social isolation may enhance depression and it may be related to the excessive use of smartphones among the population.
 Objective: The purpose of this work is to investigate the impact of social isolation on smartphone addiction and depression.
 Materials and methods: The study was carried out on 191 individuals (44.50% male) with a mean age of (23.79 ±3.91) years. The participants completed the questionnaire via online Google forms to access their smartphone use, depression and chronotype.
 Result: Smartphone use and depression significantly increase during social isolation (p<0.001). Smartphone addiction was found positively correlated with depression (r = 0.324, p < 0.01) and was maintained during social isolation conditions as well (r = 0.434, p <0.01). There was no direct effect of gender on smartphone addiction during lockdown (β= -0.059, t= -0.887, p= <0.001).
 Conclusions: The Smartphone addiction is positively correlated with depression and the social isolation induced the smartphone dependency may lead to depression in the Indian population. This study expanded the literature to include smartphone overuse and depression in the Indian population.

Oblicza samotności w epistolografii rosyjskich emigrantów pierwszej fali

A strong sense of loneliness and alienation was a common feature among Russian emigrants of the first wave, who were suddenly forced to leave the country due to the revolutionary events of 1917 and the civil war. They were unexpectedly deprived of contact with their loved ones and familiar places, losing their common denominator: their homeland. Thrown into a foreign world, they desperately missed their relatives and friends, the sounds of their native language, and the familiar materiality of life. The resulting feeling of loneliness led to various types of problems: lack of adaptation to new socio-cultural realities, social isolation, identity crisis, deteriorating mental and (or) physical condition, and creative impotence. Coping strategies for the traumatic experience of emigration included voluntary ghettoization, linguistic purism, and an extremely active exchange of letters with relatives and friends, which somewhat compensated for the lack of physical contact and direct conversation. Through correspondence, some sought information about loved ones left behind, while others sought deeper understanding, sympathy, and the chance to share their problems and fears. The analyzed epistolary material reveals similarities in the fates of the first wave of Russian emigrants, who, regardless of their origin and financial status, experienced similar problems and emotions. This is evident in the correspondence of both well-known emigrants (Mikhail Arcybashev, Ivan Bunin, Vera Muromtseva-Bunina, Aleksandr Kuprin, Nadezhda Teffi, Boris Zaitsev) and less well-known representatives of the post-October diaspora (Klaudia Fłorovskaya, Alexei Gvozdiński).

Суб’єктивна оцінка стану здоров’я педагогічними працівників з різними рівнями професійного вигорання в умовах соціальної ізоляції та воєнного стану

The aim of the study is to analyze data on the state of health of teachers with different levels of occupational burnout who were in different social conditions of life (social isolation and martial law). Materials and methods. To achieve the goal, the method of V. V. Boiko «Diagnostics of the level of emotional burnout» (1998) and a specially developed questionnaire «Subjective assessment of the state of health, life activities and working conditions of teachers» were used, with the help of which an anonymous survey was conducted general secondary education institutions in the city of Sumy during the period of social isolation due to the COVID-19 pandemic caused by the SARS-CoV-2 coronavirus in 2021 (85 people) and during martial law in April 2023 (106 people). Results. The proportion of the group of teachers with a low level of occupational burnout increased and was 2.22 times higher than the similar group of teachers during the period of social isolation (30.97±3.35)%, t=8.04, p≤0.001), which may indicate a possible decrease in the influence of professional stressors and an actualization of the feeling of uncertainty, constant anxiety, fear for one’s own life and the lives of loved ones, which is due to the military situation in the country. In conditions of social isolation caused by the COVID-19 pandemic, average (48.24±3.36)% t=9.54, p≤0.001) and low (41.18±3.31)% t=7.83, p≤0.001) levels of occupational burnout prevailed. Under the conditions of martial law, the manifestations of occupational burnout changed: the proportion of the group of teachers with a low level of occupational burnout increased and was 2.22 times higher than the similar group of teachers during the period of social isolation (30.97±3.35)%, t=8.04, p≤0.001), which may indicate a possible decrease in the influence of professional stressors and an actualization of the feeling of uncertainty, constant anxiety, fear for one’s own life and the lives of loved ones, which is due to the military situation in the country. If during the period of isolation caused by the COVID-19 pandemic, a high level of occupational burnout significantly prevailed among teachers under the age of 40 (55.56±5.38)%), then during the period of martial law, a high level of occupational burnout was mainly registered among teachers of the older age group (up to 50 – (42.86±4.81)%). In general, (76.02±3.09)% of the surveyed teachers defined their health status as satisfactory, (16.29±2.67)% as unsatisfactory, and only (7.69±1.93)% of respondents as excellent. Among the interviewees in the group with unsatisfactory self-assessment of health, teachers of the age groups «under 50» and «over 50» predominated (36.11±3.47)% and (30.56±3.33)%, respectively) compared to the groups «up to 30» – (8.33±1.99)% and «up to 40» – (25.00±3.13)%, which can be explained by the natural accumulation over the years of functional abnormalities and chronic pathology. The leading complaints, regardless of social conditions and levels of occupational burnout, were complaints of headaches, palpitations, sleep disturbances, and increased blood pressure. Conclusions. The established results of the study require further improvement of the assessment of the components of mental health among teaching staff in conditions of martial law and the development of hygienic recommendations for the prevention of occupational burnout in various social conditions of the labor process.

НЕКОТОРЫЕ ВОПРОСЫ ПСИХОЛОГИЧЕСКОЙ РАБОТЫ С ЭМОЦИОНАЛЬНОЙ СФЕРОЙ ОСУЖДЕННЫХ, СКЛОННЫХ К СУИЦИДУ

The article discusses the possible causes of the formation of suicidal manifestations in persons in conditions of social isolation. The statistical data of the Federal Penitentiary Service of Russia are presented, indicating the importance and timeliness of solving penitentiary tasks related to the identification of suicidal intentions in convicts, as well as actual factors of suicidal risk. It is proposed to discuss the problem of the influence of the emotional sphere of the individual on the commission of suicidal acts, taking into account the specific circumstances of serving a criminal sentence. The results of an empirical study of the emotional sphere of convicts with autoaggressive behavior using valid psychodiagnostic tools are presented. The conclusion is formulated that the instability of the emotional properties of the individual affects the increase in the level of suicidal risk. The importance of conducting comprehensive psychological work with suicidal convicts in institutions executing criminal penalties is emphasized. The question is raised about the need to improve the professional competencies of the staff of the penitentiary system to reduce the risk of suicide and improve the mental state of convicts

Involuntary social isolation and alcohol consumption: an ecological momentary assessment in Germany amid the COVID-19 pandemic.

Alcohol consumption often occurs in a social setting, which was affected by social distancing measures amid the coronavirus disease-2019 (COVID-19) pandemic. In this study, we examine how involuntary social isolation (i.e. comparing a no-lockdown stage with a lockdown stage) affects the association between loneliness, social activities, and drinking behavior. We performed an ecological momentary assessment eight times per day for 7days amid the COVID-19 pandemic in Germany. We recruited 280 participants and assessed their trait loneliness, daily state loneliness, social activities, and drinking behaviors. We found that a lockdown condition moderates the association between trait and daily state loneliness and alcohol consumption. During a lockdown stage, trait loneliness was positively associated, whereas state loneliness was negatively associated with alcohol consumption. During a no-lockdown stage, trait and state loneliness were both negatively associated with alcohol consumption. For both no-lockdown and lockdown stages, duration of social interaction, male gender, and weekends was positively associated with alcohol consumption. Our study suggests that an involuntary social isolation condition (i.e. a lockdown stage) changes how trait loneliness is associated with alcohol consumption.

Rise of Mental Sub-Health Consumers: Examining the Compulsive Buying Behavior in the Post-COVID-19 Era

The aftermath of the pandemic may have changes in consumer behaviors and motivations for buying. This study aims to find and prove the underlying psychological factors of compulsive buying behavior under the conditions of social isolation. The structural equation modeling via partial least squares (PLS-SEM) was used to test hypotheses and conduct a multigroup analysis on a sample of 394 consumers ( n = 206 for Utilitarian products, n = 188 for Hedonic products). The empirical findings reveal the significant relationships among perceived scarcity, perceived control, uncertainty, perceived severity through loneliness, anxiety, fear appeal and finally compulsive buying. Besides, the proved moderating effects show a significantly higher impact of anxiety on compulsive buying for those who buy utilitarian products and a significantly stronger impact of fear appeal on compulsive buying for those who buy hedonic products. This study integrates perceptions of the epidemic (perceived scarcity, perceived control, uncertainty, perceived severity) and mental-health factors (loneliness, anxiety, and fear appeal) in consumers’ compulsive buying behavior during the public health emergency period and examines its actual impact, and extends the conceptual framework of compulsive buying by comprehending the theory of fear appeal, including product type as the moderating effect.

Transformation of internet addiction on the background of social isolation and security crisis

Aim — based on the analysis of the characteristics of Internet addiction, identify its peculiarities on the background of social isolation and security crisis. Materials and methods. The study was conducted on a contingent of 120 respondents (students of higher education) aged 18 to 23, who have experience of permanent stay in conditions of social isolation in Ukraine (2020—2023), with established Internet-addiction according to Internet Addiction Test (K. Young, 1998) and Internet Use Disorders Identification Test (Linskiy I. V., Minko A. I., Artemchuk A. P. et al., 2009). The distribution of the contingent by gender was symmetrical. The research method is a structured psychological interview. Study results. In our analysis, it becomes evident that the excessive utilization of the Internet does not merely align with a series of non-chemical addictions; rather, it operates as a facilitative mechanism for a broad range of behavioral and psychological transgressions, which arise as an interconnected functional entity. Within this multifaceted spectrum, we discern two discrete categories: the formation of compulsive behavior patterns and the justification of pre-existing behavior abnormalities. Compulsive behavior patterns include compulsive gaming and gambling behavior, compulsive social media use, compulsive pornography consumption, news-related compulsive behavior. Formation of compulsive behavior patterns associated with problematic excessive use of Internet have such mechanisms: openness and accessibility of hyper-stimulating content, reinforcement and rewards with feedback loops, social comparison, escapism and avoidance, information overload. Justification of pre-existing behavior abnormalities associated with problematic excessive use of Internet include reinforcement of attention-seeking and provocative behaviors; reinforcement of rude and violent behaviors, reinforcement of self-harm and destructive behaviors, progressive reinforcement of deviant sexuality, reinforcement of cult-like behavior. Noticed underlying mechanisms: echo chambers, disinhibition due to anonymity, group polarization and competitive dynamics. Conclusions. Behavioral and psychological disorders linked to problematic excessive Internet use do not fit neatly into a singular pathological disorder classification within current assessment frameworks that may trivialize Internet addiction as a mere form of non-chemical addiction. Instead, in the contemporary context, it is imperative to examine and thoroughly evaluate the intricate array of behavioral and psychological disorders that manifest through Internet usage. Key words: Internet, addiction, Internet addiction, compulsions, behavior violations

Resilience, Vulnerability, and Social Isolation: Barriers to Poverty Reduction in War

Abstract The majority of the world’s ultra-poor live in conflict-affected environments. Poverty reduction efforts are increasingly attempting to target the most vulnerable inhabitants of these settings. Few studies have so far examined their impacts. Against the backdrop of one of the largest humanitarian crises in recent years, survey data from the Central African Republic demonstrates that a year after the conclusion of a large social safety net program, the poorest female participants did not benefit proportionately to other women and men. We draw on 257 in-depth qualitative interviews in extremely difficult-to-access conflict-affected sites across the country to explore the puzzle of why the most vulnerable inhabitants of conflict-affected settings may fail to benefit equally from poverty reduction programs. We demonstrate that conditions of social isolation—rather than poverty itself—create two specific barriers to long-term benefits. First, social isolation means that the poorest women recipients lack the social support networks that permit others to respond to conflict-related shocks without draining all their new income on emergency spending. Second, small social networks create a shortage of labor and higher start-up costs for new revenue-generating activities, thereby preventing spending on investment opportunities. These factors highlight the social barriers to poverty reduction, which are often intensified by shocks born from war, that material aid alone fails to redress.

ВЛИЯНИЕ ПЕРЕНЕСЕННОЙ ИНФЕКЦИИ SARS-COV-2 НА МЕНСТРУАЛЬНУЮ ФУНКЦИЮ У ЖЕНЩИН РАННЕГО РЕПРОДУКТИВНОГО ВОЗРАСТА

The pandemic has had a significant impact on the lives of people around the world. Both those who have directly had a coronavirus infection, and those who have been exposed to stress in conditions of social isolation, deteriorating financial well-being and other changes associated with long-term quarantine. Human existence is subject to biological rhythms, adapting the body to changing environmental conditions. One of the most important regulatory roles is played by circadian (daily) rhythms, namely the cycle of sleep and wakefulness. Pineal hormone - melatonin, is involved in the regulation of pigment metabolism, but its main effect is inhibition of the secretion of gonadotropins. In women, the highest level of melatonin is observed during menstruation, the lowest - during ovulation. This hormone plays an important role in the female reproductive system. In turn, SARS-CoV-2 can cause mental disorders by affecting the central nervous system. The most common symptoms and conditions: headaches and dizziness, taste and smell disorders (hyposmia and anosmia), weakness, anxiety, obsessive-compulsive disorders, insomnia, impaired attention and concentration. With prolonged illness, serious disorders of the central nervous system are observed. This study aims to correlate changes in sleep quality and changes in menstrual function in patients who have had SARS-CoV-2 infection.

Impact of Lighting Condition and Social Isolation on Rats' Playfighting Behaviour

Playfighting in rats is a well-documented phenomenon, however, studies frequently differ in terms of the conditions under which play behaviour is assessed. This study examined the impact of lighting condition and social isolation on play, two conditions which vary in literature. The goal was to quantify and advance the understanding of optimal conditions for promoting playfighting behaviour in rats. Twenty-four male Long-Evans rats were randomly assigned a lighting condition (complete darkness vs. low mixed red-white light) and social isolation condition (0 hours vs. 5 hours vs. 24 hours). Rats were habituated in cagemate pairs to a plexiglass test chamber (60 x 60 x 40 cm) under their respective lighting conditions for three days prior to testing. Prior to the test day, cagemate pairs were randomly selected to be isolated from their play partners for different durations. After their respective isolation periods, cage-mate pairs of adolescent rats (PD30-37) were video-taped freely interacting in the test chamber for 10-minutes and their play behaviour was scored in NOLDUS by a trained coder. Data were analyzed in SPSS using a 2x3 ANOVA. Rats tested in complete darkness displayed higher rates of nape attacks (p = 0.008) and pinning (p = 0.002), two measures used to quantify playfighting. Post-hoc testing revealed that rats isolated for 24-hours prior to testing displayed higher rates of nape attacks (p = 0.028) and pins (p = 0.005) compared to non-isolated rats, but there were no other differences between other isolation conditions. These findings suggest that the conditions under which rats are tested can impact their play behaviour, driving differences in rates of commonly scored play behaviours. The data suggest it is ideal to assess rats’ play behaviour in complete darkness after at least 24-hours of social isolation to optimize baseline levels of playfighting.

Studying the Involvement of Ghrelin in the Mechanism of Gambling Addiction in Rats after Exposure to Psychogenic Stressors in Early Ontogenesis

We investigated the role of ghrelin and its receptors in the manifestation of gambling a-ddiction elements in rats exposed to early psychogenic stress. Rearing in conditions of social isolation or maternal deprivation in early ontogeny increased risk behavior and impulsivity in the Iowa Gambling Task test: animals sought more food reinforcement, but with a low probability. Maternal deprivation or rearing in social isolation increased expression of Ghsr in the amygdala and hypothalamus respectively. The level of expression of the gene under study in the prefrontal cortex did not change. It is concluded that early psychogenic stress causes an imbalance in the brain ghrelin regulatory system, which manifests itself in increased of Ghsr level as well as elements of gambling addiction. The scheme of the effect of chronic stress on the hypothalamic ghrelin system and on the extrahypothalamic regulation of ghrelin is presented.

Increased mRNA grelin receptor expression in rat cubs brain structures in models of separation from mother and social isolation

BACKGROUND: Stress exposure at an early age can have serious long-term consequences for the development of the human body, leading to adaptive disorders, increased anxiety, depression and other mental disorders in people. The effect of stressors in the first weeks after birth affects the proliferation, differentiation and migration of neurons, in particular, the neurogenesis of hippocampal cells. Repetitive stress can lead to changes in the structure and function of the brain, including deterioration of memory and skill acquisition, reduced resistance to stress in the future, decreased immune system function and increased risk of depression and other mental illnesses.
 AIM: The aim was to study the effect of social isolation weaning on the level of ghrelin receptor mRNA expression in the brain structures of Wistar rats.
 MATERIALS AND METHODS: 60 male rats (8 litters) with a body weight of 230250 g were used in the work and three experimental groups were formed: control (n = 20); maternal deprivation (n = 20); social isolation (n = 20). On the 90th day of life, the animals were decapitated, the brain was quickly extracted, placed in the cold and brain structures (hypothalamus, amygdala, prefrontal cortex) were isolated, immediately frozen in liquid nitrogen and stored at a temperature of 80C until PCR analysis was performed. The data obtained were normalized to the expression level of the glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene and calculated in relative units with respect to the expression value of the GRLN-R gene for each structure separately by method 2 (-DeltaDelta C(T)).
 RESULTS: In rats raised in conditions of social isolation, compared with the indicators of the control group and the group of animals with maternal deprivation (p 0.05), an increase in the expression of the GHSR1A gene was noted in the hypothalamus. Whereas in rats after the stress of maternal deprivation in the amygdala there was an increase in the expression of the GHSR1A gene compared with the indicators in the control group of rats.
 CONCLUSIONS: 1. In rats that survived weaning from the mother from the 2nd to the 12th postnatal day, a significant statistically significant increase in the expression of the GHSR1A gene was revealed in the hypothalamus in comparison with the control group and the social isolation group. 2. In rats raised in conditions of social isolation from their relatives, a significant statistically significant increase in the expression of the GHSR1A gene in the amygdala was revealed in comparison with the control group and the weaning group.

The health professional-sub-Saharan migrant relationship in the network of primary healthcare facilities in Morocco: “Case prefecture of Meknes”

Given its geographical position, Morocco has become a crossroad of migratory flows for sub-Saharan migrants. This recent phenomenon has taken several forms over the last decade. Among others, certain migrants take the risk in difficult conditions and find themselves at the end of their African trajectory, stopped in the north of the continent due to restrictive measures taken by the European Union. Most of them are forced to stay in Morocco, where these sub-Saharan migrants face all sorts of health precariousness and difficulties in accessing healthcare, as well as subhuman conditions of social and family isolation, and economic and administrative vulnerability. The study aims to take a sociological look at the specific context of the health of sub-Saharan migrants, which aims, through a quantitative and qualitative study, to analyse the relationship between health professionals and sub-Saharan migrants. The survey took place in primary healthcare facilities in the prefecture of Meknes. The results obtained reveal that despite the efforts made by the Moroccan Ministry of Health to facilitate migrants’ access to health services, the “cultural diversity” dimension in the field of health has remained a hindrance. This is evident in the misunderstanding between the health professional and the Sub-Saharan migrants, which has influenced the quality of healthcare delivery in that it has sometimes put the health professional in “cultural shocks” on the one hand, and the Sub-Saharan migrants in difficulties to easily benefit from culturally congruent healthcare on the other hand. This said, health professionals need training on the cultural diversity of Sub-Saharan communities to ensure culturally sensitive and competent transcultural healthcare.

Association between social vulnerability profiles, prenatal care use and pregnancy outcomes

BackgroundEvaluating social vulnerability is a challenging task. Indeed, former studies demonstrated an association between geographical social deprivation indicators, administrative indicators, and poor pregnancy outcomes.ObjectiveTo evaluate the association between social vulnerability profiles, prenatal care use (PCU) and poor pregnancy outcomes (Preterm birth (PTB: <37 gestational weeks (GW)), small for gestational age (SGA), stillbirth, medical abortion, and late miscarriage).MethodsRetrospective single center study between January 2020 and December 2021. A total of 7643 women who delivered a singleton after 14 GW in a tertiary care maternity unit were included. Multiple component analysis (MCA) was used to assess the associations between the following social vulnerabilities: social isolation, poor or insecure housing conditions, not work-related household income, absence of standard health insurance, recent immigration, linguistic barrier, history of violence, severe dependency, psychologic vulnerability, addictions, and psychiatric disease. Hierarchical clustering on principal component (HCPC) from the MCA was used to classify patients into similar social vulnerability profiles. Associations between social vulnerability profiles and poor pregnancy outcomes were tested using multiple logistic regression or Poisson regression when appropriate.ResultsThe HCPC analysis revealed 5 different social vulnerability profiles. Profile 1 included the lowest rates of vulnerability and was used as a reference. After adjustment for maternal characteristics and medical factors, profiles 2 to 5 were independently associated with inadequate PCU (highest risk for profile 5, aOR = 3.14, 95%CI[2.33–4.18]), PTB (highest risk for profile 2, aOR = 4.64, 95%CI[3.80–5.66]) and SGA status (highest risk for profile 5, aOR = 1.60, 95%CI[1.20–2.10]). Profile 2 was the only profile associated with late miscarriage (adjusted incidence rate ratio (aIRR) = 7.39, 95%CI[4.17–13.19]). Profiles 2 and 4 were independently associated with stillbirth (highest association for profile 2 (aIRR = 10.9, 95%CI[6.11–19.99]) and medical abortion (highest association for profile 2 (aIRR = 12.65, 95%CI[5.96–28.49]).ConclusionsThis study unveiled 5 clinically relevant social vulnerability profiles with different risk levels of inadequate PCU and poor pregnancy outcomes. A personalized patient management according to their profile could offer better pregnancy management and reduce adverse outcomes.

Testing the Impact of Social Isolation on Students' Acceptance of Learning Management Systems After the COVID-19 Crisis Using a Modified UTAUT Model

After more than two years of the beginning of Covid-19 crisis, this research work investigates the students' acceptance towards utilizing learning management systems (LMSs) as a useful supporting learning medium while most of higher education institutions over the world have adopted these systems to become an indispensable, promising teaching tool and considering the distance learning as compliance to the conditions of social isolation is case of any crisis. This article analyzes the most significant factors effecting the adoption and led to the acceptance of LMSs through the higher education across 423 undergraduate and postgraduate students from several universities in Jordan. By applying the structural equation modelling, the results reveal that all proposed determinants have an impact on the adoption of distance learning, with noted significant impact for social isolation. The infection anxiety and students' level have moderated these effects on the behavioral intentions and actual use of learning management systems and show significant impact on them.

Use of pregnancy personalised follow-up in case of maternal social vulnerability to reduce prematurity and neonatal morbidity

BackgroundSocial deprivation is a major risk factor of adverse pregnancy outcomes. Yet, there is few studies evaluating interventions aiming at reducing the impact of social vulnerability on pregnancy outcomes.ObjectiveTo compare pregnancy outcomes between patients that received personalized pregnancy follow-up (PPFU) to address social vulnerability versus standard care.MethodsRetrospective comparative cohort in a single institution between 2020 and 2021. A total of 3958 women with social vulnerability that delivered a singleton after 14 gestational weeks were included, within which 686 patients had a PPFU. Social vulnerability was defined by the presence of at least one of the following characteristics: social isolation, poor or insecure housing conditions, no work-related household income, and absence of standard health insurance (these four variables were combined as a social deprivation index (SDI)), recent immigration (< 12 month), interpersonal violence during pregnancy, being handicaped or minor, addiction during pregnancy. Maternal characteristics and pregnancy outcomes were compared between patients that received PPFU versus standard care. The associations between poor pregnancy outcomes (premature birth before 37 gestational weeks (GW), premature birth before 34 GW, small for gestational age (SGA) and PPFU were tested using multivariate logistic regression and propensity score matching.ResultsAfter adjustment on SDI, maternal age, parity, body mass index, maternal origin and both high medical and obstetrical risk level before pregnancy, PPFU was an independent protective factor of premature birth before 37 gestational weeks (GW) (aOR = 0.63, 95%CI[0.46–0.86]). The result was similar for premature birth before 34 GW (aOR = 0.53, 95%CI [0.34–0.79]). There was no association between PPFU and SGA (aOR = 1.06, 95%CI [0.86 – 1.30]). Propensity score adjusted (PSa) OR for PPFU using the same variables unveiled similar results, PSaOR = 0.63, 95%CI[0.46–0.86] for premature birth before 37 GW, PSaOR = 0.52, 95%CI [0.34–0.78] for premature birth before 34 GW and PSaOR = 1.07, 95%CI [0.86 – 1.33] for SGA.ConclusionsThis work suggests that PPFU improves pregnancy outcomes and emphasizes that the detection of social vulnerability during pregnancy is a major health issue.

The SARS-CoV-2 pandemic as a source of unprecedented bioethical and biolaw issues: lessons for intensivists

The following article presents the relevant and unprecedented bioethical and biolaw issues posed by the SARS-COV-2 pandemic and summarizes the initiatives adopted by the Italian Society of Anesthesia and Resuscitation (SIAARTI) as well as by the Veneto Region ICU Network. Since the initial phase of the pandemic, in March 2020, there has been a strong appeal from both SIAARTI and the Veneto Region ICU Network to consider “the appropriate intensive treatment.” During the pandemic, the principle of proportionality must be applied, in compliance with the main principle in bioethics. This encompasses the concept of clinical appropriateness, based on the efficacy of the treatment in specific case and context, as well as the concept of ethical appropriateness, which refers to ethical and juridical principles of acceptance of health care. The “appropriate treatment” must never interfere with the withdrawal of patients, who are not eligible for intensive treatments since they would not benefit from them and who are eligible for ordinary treatments that must be maintained, and, where necessary, palliative treatments were initiated. On the other hand, it must not encroach on unreasonable obstinacy. At the end of 2020, the SIAARTI-SIMLA (Italian Society of Insurance and Legal Medicine) document provides healthcare professionals with a tool for responding appropriately to the emergency of the pandemic, in the event of an imbalance between healthcare demand and available resources. The document states that the ICU triage should be based on global evaluation of each patient, taking into account well-defined parameters and stresses that each person potentially eligible for intensive care should have a shared care planning (SCP) stipulated, and, when necessary, a proxy should be nominated. This has illustrated how the biolaw issues encountered by intensivists during the pandemic, such as those relating to consent and refusal to medical treatment, even when it is lifesaving, as well as requests for treatment of unproven clinical efficacy, were subject to appropriate guidelines and solutions through the application of Law 219/2017 (provisions for informed consent and advance directives treatment). Communication with family members and the management of sensitive personal data; the evaluation of “legal capacity” of comprehension and informed decision-making regarding the proposed treatment plan; and the need for emergency medical intervention in the absence of consent are all addressed in light of the relevant regulations and the particular conditions of social isolation induced by the pandemic. The collaborative ICUs network sustained by the Veneto Region has given great prominence to clinical bioethics issues, and as a result, multidisciplinary integration with the help of legal and juridical experts was developed. This has led to an increase in skills in the bioethical field, as well as providing a valuable lesson for the improvement of therapeutic relationships with critically ill patients and their families.

“Wanna Be Provoked”: Inner Peripheries Generators of Social Innovation in the Italian Apennine

The article examines the territorial conditions, actors, and processes that facilitate or hinder the emergence of social innovation in the inner peripheries. It investigates three social innovation initiatives taking place in the Italian Apennine through a discourse analysis of policy documents and a number of semi-structured interviews of project promoters and local actors. The research findings show that social innovation emerges as an act of territorial provocation practiced by a coalition of actors that weave strong ties with the local community. Provocation takes the form of an adaptive response of the local community to the dynamics of territorial marginalization, a reaction to tackle what we called the “wanna be” feeling, namely, a sense of constriction and frustration found in local inhabitants and linked to conditions of physical and social isolation, inertia, and a lack of future perspectives. This reaction has allowed them to shape new socio-institutional networks and structures that have catalyzed local communities’ capacity to mobilize particular resources or specific assets existing in places, improving their living conditions.