COVID-19 Health Emergency Research Articles

Moral Distress among Frontline Physicians and Nurses in the Early Phase of COVID-19 Pandemic in Italy.

During the COVID-19 health emergency, healthcare professionals faced several ethical demanding job stressors, becoming at particular risk of moral distress. To date, only a few scales have been developed to evaluate moral distress among frontline professionals working in contact with COVID-19 patients. Moreover, although many healthcare professionals from various disciplines were converted to COVID-19 patient care, no study has yet analyzed whether the resulting change in duties might represent a risk factor for moral distress. Thus, this study aimed to investigate how and when the change in duties during the emergency would be related to healthcare professionals’ psycho-physical malaise. To this aim, a first Italian adaptation of the Stress of Conscience Questionnaire (SCQ) was provided. In total, 272 Italian healthcare professionals participated in this cross-sectional study. Healthcare professionals who had to perform tasks outside their usual clinical duties were more likely to experience moral distress and then psycho-physical malaise. This was particularly likely for those who were extremely concerned about becoming infected with the virus. The results also indicated that the Italian adaptation of the SCQ had a one-factor solution composed of six items. This study provides the first Italian adaptation of SCQ and practical suggestions on how supporting professionals’ well-being during emergencies.

Interstate Licensure: Has The Time Come?

In the midst of the unprecedented public health emergency of COVID-19, many states developed programs to recognize out-of-state practitioners' licenses for in-state practice. This rapid expansion had a profound impact on care during periods of surge and offers lessons for future disasters as well as usual operating periods. As technology improves and care delivery evolves, interstate licensure offers immense opportunities, but there are also risks that must be mitigated.

The Psychological Consequences of SARS-CoV 2 in Healthcare Professionals

During the Covid-19 health emergency, the self-assessment of psychological relapses in 24 health workers through a Covid-19 Emergency Triage Card sought to examine how doctors, health technicians, nurses and auxiliaries perceived their mental state immediately after the communication coronavirus positivity. A Covid-19 Emergency Triage Card consisting of two sections was submitted to the study sample. First section personal data: age, sex, educational qualification, seniority, marital status, offspring, job, workload in hours, presence of night shifts, lifestyle habits (use of alcohol, tobacco, coffee). Second section: self-assessment of the psychological repercussions of the pandemic event with five sub-dimensions: anxiety; psychosomatic disorder; depression; thought disorder. behavioral changes, rated on a three-level scale: mild - medium - severe. The analysis of our results shows that anxiety-depressive symptoms take on significant values in Covid-19 positive healthcare personnel, with greater predominance among nurses. This results in identifying workers most at risk of adverse mental health outcomes during times of health emergency is a public health task. Ensuring the physical and mental health of health care workers is crucial to maintaining a high level of health care in the population.

Investigating the Obsessive and Compulsive Features of Cyberchondria: A Holistic Review.

BackgroundCyberchondria has been brought into sharp focus during the COVID-19 health emergency; it refers to individuals who obsessively and compulsively search for health information online, resulting in excessive health concerns. Recent scholarship focuses on its obsessive and compulsive aspect, following a biopsychosocial approach as opposed to a pathology of health anxiety. It lacks interpretation of the socio-psychological dynamics between the dimensions.ObjectiveThis review aims to propose a holistic view toward understanding cyberchondria as an obsessive–compulsive syndrome and considers possible interventions. It specifically seeks to explain cyberchondria from diversified mediator variables and to pinpoint connections between each perspective.MethodologyComprehensive searches of databases such as PubMed and Springer were conducted to identify English articles relating to cyberchondria from 2001 to 2022. Based on a systematic filtering process, 27 articles were finally reviewed.FindingsThe authors compare and confirm three forecasts to predict cyberchondria, associating it with individual metacognition, uncertainty of unverified information, and algorithm-driven, biased information environments.ValueTheoretically, a holistic framework is proposed to explain the obsessive and compulsive features of cyberchondria. Clinically, the research calls for more professional psychoeducation and chain screening of cyberchondria and other psychological disorders. Socially, it promotes support for risk-sensitive, information-deficient groups during pandemics like COVID-19. It also stresses more careful use of algorithm-driven search engine technology for platforms delivering medical information. Future research may explore areas such as the association between cyberchondria and other social-related disorders, as well as correlations among cyberchondria, obsessive and compulsive disorders, medical trust, and algorithm-driven search results.

Factores del riesgo crediticio en una cooperativa de ahorro y credito, en la emergencia sanitaria de la COVID-19

The Financial system is a fundamental component of the national economy which is made up of public and private financial institutions, and its purpose is focused on financial intermediation. During the COVID-19 health emergency, the exposure of the financial system to the materialization of the credit risk was practically inevitable. In consequence, this work was developed to identify the credit risk factors of a credit union from segment 1 in the context of the pandemic. Being a qualitative, non-experimental, descriptive and transversal research, for the data collection, not only a structured survey was applied to the members but also an interview to the executives of the institution. In addition, through fieldwork, documentation was analyzed, the one which provided valuable information and was complemented with an exhaustive bibliographic review. The results reveal that internal and external credit risk factors have increased significantly. The internal ones are evidenced in: low operability of the banking core, deficiency in credit origination, portfolio concentration, limited recovery management and lack of knowledge about credit card policies. The external ones are determined by: the loss of employment of the members, suspension of school activities, mobility restrictions at national level, and an impending reduction of the family income. In this sense it is concluded that, the credit union under study did not take the necessary measures to mitigate in a timely manner the internal credit risk factors and reacted somewhat slowly to the external credit risk factors during the COVID-19 pandemic.

The social and professional image of the nurse: results of a survey during the Covid-19 pandemic.

Although nursing today is an intellectual profession to all intents and purposes, thesocial and professional image gap has not yet been bridged. Also, in the rest of the world, the social image of the nurse suffers from some stereotypes, not only perpetuated by a wrong knowledge on the part of the population but also fostered by the mass media (commentary, cinema, television series). To investigate the perception of students at the University of Piemonte Orientale about the nursing profession. A survey was conducted using an online questionnaire sent during the period of the health emergency linked to COVID-19 (from 18 August to 15 September 2020). 662 questionnaires were analysed. It was investigated how students describe nurses and whether that description would have been the same even before the COVID-19 health emergency. Furthermore, it was assessed which gender they consider most suited for the profession and whether the mass media has influenced their view of nurses. The students described the nurse with adjectives such as "expert / capable", "courteous / polite" and "welcoming / listening oriented" and stated that they would use the same terms even before the health emergency. The majority of the sample then believed that there is no more suitable gender to fill the role of nurse and that TV series or news reports have positively influenced their perception. However, only a small percentage of the sample would have considered the idea of becoming a nurse. A positive view of nurses emerged to overcome gender stereotype and a greater confidence in their technical-professional abilities. The data also highlight that the positive view of the nursing profession is not a consequence of the "publicity" provided by the media during COVID-19 emergency, which represented nurses as "heroes" of the National Health System.

Impact of COVID-19 emergency on the psychological well-being of susceptible individuals

The current pandemic has exerted an unprecedented psychological impact on the world population, and its effects on mental health are a growing concern. The present study aims to evaluate psychological well-being (PWB) during the COVID-19 crisis in university workers with one or more diseases likely to increase the risk of severe outcomes in the event of SARS-CoV-2 infection, defined as susceptible. 210 susceptible employees of an Italian University (aged 25–71 years) were recruited during the COVID-19 second wave (October–December 2020). A group comprising 90 healthy university employees (aged 26–69 years) was also recruited. The self-report Psychological General Well Being Index (PGWBI) was used to assess global PWB and the influence on six sub-domains: anxiety, depressed mood, positive well-being, self-control, general health, and vitality. We applied non-linear dimension-reduction techniques and regression methods to 45 variables in order to assess the main demographic, occupational, and general-health-related factors predicting PWB during the COVID-19 crisis. PGWBI score was higher in susceptible than in healthy workers, both as total score (mean 77.8 vs 71.3) and across almost all subscales. Age and jobs involving high social interaction before the pandemic were inversely associated with the PWB total score, general health, and self-control subscores. The current data suggest no decline in PWB during the second wave of COVID-19 health emergency in susceptible individuals of working age. Critically, higher risk for mental-health issues appears to be inversely related to age, particularly among individuals deprived of their previous level of social interaction at work.

Emotion recognition in the times of COVID19: Coping with face masks

Emotion recognition through machine learning techniques is a widely investigated research field, however the recent obligation to wear a face mask, following the COVID19 health emergency, precludes the application of systems developed so far. Humans naturally communicate their emotions through the mouth; therefore, the intelligent systems developed to date for identifying emotions of a subject primarily rely on this area in addition to other anatomical features (eyes, forehead, etc..). However, if the subject is wearing a face mask this region is no longer visible. For this reason, the goal of this work is to develop a tool able to compensate for this shortfall. The proposed tool uses the AffectNet dataset which is composed of eight class of emotions. The iterative training strategy relies on well-known convolutional neural network architectures to identify five sub-classes of emotions: following a pre-processing phase the architecture is trained to perform the task on the eight-class dataset, which is then recategorized into five classes allowing to obtain 96.92% of accuracy on the testing set. This strategy is compared to the most frequently used learning strategies and finally integrated within a real time application that allows to detect faces within a frame, determine if the subjects are wearing a face mask and recognize for each one the current emotion.

Exposed and unprotected: Sex worker vulnerabilities during the COVID-19 health emergency in Mozambique

ABSTRACT Measures to contain the spread of COVID-19 have been shown to disproportionately affect the marginalised groups in our societies. We studied the impacts of national restrictions on young adult sex workers in Mozambique, and actions at individual, governmental and civil society level to mitigate against these impacts. The country case study was part of a multi-country qualitative research, including fifty-four semi-structured interviews with female sex workers (N = 38), outreach workers (N = 10) in Maputo and Quelimane, and informants with key positions in national COVID coordination bodies, the Ministry of Health and civil society organisations (N = 7). While restrictions impacted all sex worker participants, the COVID crisis was found to deepen existing class differences and further incite violence against the most visible and economically vulnerable category of street-based sex workers. Parallel enforcement of morals against this group of ‘urban undesirables’ resulted in bodily harm and further degradation of the female sex worker under the guise of COVID emergency decrees, while restrictions weakened protection from peers and outreach workers against abuse by the police and other perpetrators. The State needs to act against unlawful police action and include impact mitigation strategies in its public health response to COVID in order to protect the most vulnerable.

Attempting to Mitigate COVID-19: Does the Public Readiness and Emergency Preparedness Act Provide Patent Infringement Immunity?

Abstract This article analyzes various legal defenses and immunities against patent infringement liability during COVID-19 under the Public Readiness and Emergency Preparedness Act (“PREPA” or “Act”). Although initially enacted in response to the 2001 Anthrax attacks, PREPA was once again invoked in response to COVID-19 under the authority of the Secretary of Health and Human Services (the “Secretary”). Through declarations issued by the Secretary, the scope of the original Act inferably expanded in a pursuit to mitigate the public health emergency of COVID-19. The nature of this review primarily focuses on the uncertainties surrounding the extent and practical legal applications of this expansion.

From COVID-19 Pandemic to Patient Safety: A New "Spring" for Telemedicine or a Boomerang Effect?

During the Covid-19 health emergency, telemedicine was an essential asset through which health systems strengthened their response during the critical phase of the pandemic. According to the post-pandemic economic reform plans of many countries, telemedicine will not be limited to a tool for responding to an emergency condition but it will become a structural resource that will contribute to the reorganization of Healthcare Systems and enable the transfer of part of health care from the hospital to the home-based care. However, scientific evidences have shown that health care delivered through telemedicine can be burdened by numerous ethical and legal issues. Although there is an emerging discussion on patient safety issues related to the use of telemedicine, there is a lack of reseraches specifically designed to investigate patient safety. On the contrary, it would be necessary to determine standards and specific application rules in order to ensure safety. This paper examines the telemedicine-risk profiles and proposes a position statement for clinical risk management to support continuous improvement in the safety of health care delivered through telemedicine.

CAOS in Italian hospitals during COVID: an analysis of healthcare intangible resources

PurposeThis paper aims to analyse the roles of relational capital (RC) and knowledge management (KM) during the COVID-19 in Italian public and private hospitals, considering that intangible elements are essential during periods of uncertainty.Design/methodology/approachAuthors used a qualitative design in a case study on two Italian hospitals that have different ownership structures, which are located in the epicentre of the pandemic in Lombardy. The study was carried out using the CAOS (“caratteristiche personali”, “ambiente”, “organizzazione” and “start-up”) model (Paoloni, 2021), which allows for comprehending and commenting on RC because of the connections between typical factors that influence an organisation. The model also allows for discussion of the use of a network and how it supports organisations.FindingsFindings of the analysis showed that during the management of the COVID-19 health emergency, ownership structure was not a discriminating factor, the created relationships were similar and they were considered in the same way. The relationships were mainly formal (except for contributions by associations or individuals) and temporary. The RC's reactive role in overcoming crises was confirmed, and the findings indicated that this result was possible also, thanks to the KM's role played within the organisation.Originality/valueTheoretical implications of the work are that it contributes to the sparse healthcare literature on intellectual capital (IC) and on RC and its relationships with KM. The practical implications are related to the creation of new relationships during the healthcare emergency between hospitals and the central government, which can be considered a useful lesson for the future. The theoretical implications derived from the analysis are generalisable to all organisations regardless of their type and location, as well as the practical implications are applicable to the entire national territory.

Is a Good Boss Always a Plus? LMX, Family–Work Conflict, and Remote Working Satisfaction during the COVID-19 Pandemic

This study investigated the relationships between leader–member exchange (LMX) and workers’ perceptions of family–work conflict (FWC) and between LMX and satisfaction with remote working (SRW). It also assessed the moderating effect of employees’ ability to cope (AC) with the work in the interaction between LMX and FWC. Using a cross-sectional design, this study tested a moderated mediation model using Model 7 of Macro “PROCESS” for SPSS. The study sample consisted of 455 employees engaged in remote working activities during the COVID-19 health emergency. Surprisingly, the results showed that LMX was positively associated with FWC, while the latter was negatively associated with SWR. There were neither direct nor indirect effects of LMX on SRW, but the moderation of the AC with work on the relationship between LMX and FWC was significant and negative. In particular, the results showed that, in workers who reported lower values of AC, the increase in the quality of LMX also corresponded to an increase in FWC. Conversely, in employees with very high AC, as LMX increased, FWC decreased. Good relationships with the boss in a new and challenging situation such as remote working during COVID-19 threatens employees’ well-being when accompanied by poor coping skills. This study sheds light on these mechanisms and opens new questions in the literature about family–work conflict and remote working.

Development and validation of the Remote Working Benefits & Disadvantages scale

The changes that are constantly occurring in the labour sector have led organisations and companies to move towards digital transformation. This process was accelerated by the COVID-19 pandemic and conducted to a massive recourse to the practice of remote working, which in this study is understood as the term for the way of performing work outside the usual workplace and with the support of ICT. Currently, there are no flexible scales in the literature that allow measuring the benefits and disadvantages of remote working with a single instrument. Thus, the distinction between the positive and negative consequences of working remotely, substantiated by a solid literature, provides a framework for a systematical understanding of the issue. The aim of the present study is to develop and validate a scale on remote working benefits and disadvantages (RW-B&D scale). For this end, a preliminary Exploratory Factor Analysis (EFA) with 304 participants, a tailored EFA with a sample of 301 workers and a Confirmatory Factor Analysis (CFA) with 677 workers were conducted. Participants were all Italian employees who worked remotely during the period of the COVID-19 health emergency. Data were collected between October 2020 and April 2021. The psychometric robustness of the model was assessed through bootstrap validation (5000 resamples), fit indices testing and measurement of factorial invariance. The statistical analyses demonstrated the bifactorial nature of the scale, supporting the research hypothesis. The model showed good fit indices, bootstrap validation reported statistically significant saturations, good reliability indices, and convergent and discriminant validity. Measurement invariance was tested for gender and organisational sector. The results suggested that the novel scale facilitates the quantitative measurement of the benefits and disadvantages associated with remote working in empirical terms. For this reason, it could be a streamlined and psychometrically valid instrument to identify the potential difficulties arising from remote working and, at the same time, the positive aspects that can be implemented to improve organisational well-being.

Workplace Violence among Healthcare Providers during the COVID-19 Health Emergency: A Cross-Sectional Study.

(1) Background: Workplace violence among healthcare providers (HCPs) is a tangible barrier to patient care. The purpose of this study was to gain insight into physicians’ and nurses’ perceptions of workplace violence and their perceptions of communication skills during the COVID-19 health emergency. We also sought to assess and compare the association between types of workplace violence, communication skills, and several sociodemographic factors of physicians and nurses including gender, marital status, site of work, age, and educational level during this era. (2) Methods: We performed a cross-sectional study of a selected hospital in Jordan using the Arabic version of the workplace violence and communication skills scales for September to November 2020. We included a total of 102 physicians and 190 nurses via a self-reported questionnaire. (3) Results: During the COVID-19 health emergency, physicians (48%) experienced workplace violence more than nurses (31.6%). More than two-thirds of the participants did not formally report any type of violence. Multinomial logistic regression analysis showed that marital status, gender, age, site of work, educational levels, and communication skills were associated with different types of violence among the two samples. (4) Conclusions: A high prevalence of workplace violence is noted among HCPs in Jordan compared with before the pandemic, which highlights the importance of promoting public awareness during crises.

The COVID-19 pandemic and regional integration in Africa: Implications of the responses from ECOWAS and SADC

ABSTRACT The outbreak of the COVID-19 pandemic presented unprecedented challenges to regional bodies across the world. It resulted in a synchronised disruption of the world economy and regional integration agendas, and the re-emergence of nationalism and protectionism. The response to this health emergency differed across regions as regional and local impact of the disease varied. There were coordinated responses to the health crisis by some regional bodies while others saw more local and nationalistic reactions. The argument of this article is that the unilateral closure of borders and the imposition of travel restrictions showed protectionist inclinations and an unwillingness to cede authority to regional bodies. Inspired by the projected implications of the COVID-19 pandemic on the future of regional integration, this article examined the response of both ECOWAS and SADC to the COVID-19 health emergency and considers the implications for the quest for regional integration.

Walking on the Sea Traces: Developing a platform to bring Ocean Literacy and Citizen Science at Home

We describe the process of the development of a citizen science platform on Ocean Literacy designed and implemented during the lockdown period of 2020. As restrictions due to the COVID-19 health emergency did not allow researchers to organise public events and field data collection activities related to Ocean Literacy, we decided to take advantage of this situation by building an online platform to bring Ocean Literacy issues directly into citizens' homes. The massive use of digital tools by all civic communities during this time has allowed us to implement this idea and make it effective. The pandemic control measures then provided a unique opportunity to focus citizen attention on the collection of household data and information and to highlight the more or less direct connections between citizens' lifestyles and the eco-marine system. Short questionnaires were used to ascertain and highlight citizens' household behaviours and daily attitudes during the lockdown towards water use, seafood consumption and plastic material use and disposal. Data and information were also proposed, collected and analyzed in terms of: general environmental awareness of the respondents, perception regarding their purchasing choices during this particular period, as well as any changes in lifestyles and habits during the lockdown with respect to previous periods. The collected data allow us to improve our knowledge on some aspects of people domestic habits as well as their perception vs. real knowledge about the proposed environmental issues. We also realized that it is increasingly crucial for scientists to directly and extensively involve people and schools in educational and outreach activities and events as a good practice of science-society interaction. But to achieve good results we also need to develop appropriate communication tools and effective involvement strategies to promote their widespread participation in citizen science projects.

COVID-19 and United Kingdom’s legal regulation

There has been an unprecedented impact on the all spheres of society from the novel coronavirus (COVID-19). As it has rapidly become a global pandemic, states around the world had to implement appropriate measures for responding to it containment and control. The different countries have used various approaches to responding to the pandemic. This article explores the UK's approach to the COVID-19 health emergency. More precisely, it will be analysed two main aspects: on the one hand, the acts that were adopted in the context of the health crisis and its assessment; on the other hand, it will be analysed attention is focus to the issue related to the limitation of fundamental human rights and freedoms. In the early stages of epidemic, UK implemented herd immunity strategies and its danger was initially underestimated by the authorities. Nevertheless, watching how things unfolded, from March 2020 onwards UK took drastic measures to prevent the spread of the virus. including country-wide lockdown and the powers of public administration entities are expanded. The sagnificant of these measures have been implemented using acts of soft law or non-binding guidelines and recommendations, the legal status of which is not entirely clear. In addition, preference was given to the adoption of new legislation to combat the pandemic, regardless of the existing legal basis for emergency situations. At the same time, the authority to take measures to contain and spread СOVID-19 was transferred to the executive authority with minimal parliamentary control.

Significant variations of dangerous exposures during COVID-19 pandemic in Italy: a possible association with the containment measures implemented to reduce the virus transmission

BackgroundIn response to the COVID-19 health emergency, mass media widely spread guidelines to stop the virus transmission, leading to an excessive and unaware use of detergents and disinfectants. In Italy and in other countries this tendency caused a significant increase of exposures to these products in 2020. Evaluating data collected by the Italian Pavia Poison Centre (PPC), this study intends to examine the relationship between the COVID-19 lockdown and the variations of exposures to specific product categories possibly associated to the containment measures implemented.Simultaneously, this work shows the effectiveness of the European Product Categorisation System (EuPCS) in surveillance activities of dangerous chemicals.MethodsExposure cases managed by the PPC during March–May 2020 (lockdown) and during the same months of 2017–2018-2019 were compared. Differences in categorical variables were tested with the Chi-square test. The level of significance was set at Alpha = .05. The study included all EuPCS groups but specifically focused on cleaners, detergents, biocides and cosmetics.ResultsDuring the lockdown, calls from private citizens showed a highly significant increase (+ 11.5%, p < .001) and occupational exposures decreased (− 11.7%, p = .011). Among Cleaners, exposures to Bleaches slightly increased while Drain cleaning products went through a significant reduction (− 13.9%, p = .035). A highly significant increase of exposures to Disinfectants was observed (+ 7.7%, p = .007), particularly to those for surfaces (+ 6.8%, p = .039). Regarding Cosmetics, both handwashing soaps and gel products significantly increased (respectively: + 25.0, p = .016 and + 9.7%, p = .028).Among children 1–5 years, the statistical significance is reached with exposures to Dishwashing detergents (+ 13.1%, p = .032), handwashing soaps (+ 28.6%, p = .014) and handwashing gel products (+ 16.8%, p = .010). Contrarily, Liquid Laundry Detergent Capsules decreased in a highly significant manner (− 25%; p = .001). The general severity of exposures showed a highly significant decrease (Moderate: − 10.1%, p = .0002).ConclusionsThis study investigated the relationship between the COVID-19 lockdown and the variations of exposures to some product categories related to the containment measures. The results obtained support any action to be taken by Competent Authorities to implement measures for a safer use of cleaners/disinfectants. This paper shows the benefit in applying the EuPCS to categorize products according to their intended use, though an extension of this system to products not covered by CLP Regulation may be a further advantage.

The Fear of Contagion and the Attitude Toward the Restrictive Measures Imposed to Face COVID-19 in Italy: The Psychological Consequences Caused by the Pandemic One Year After It Began.

The pandemic nature of COVID-19 has caused major changes in health, economy, and society globally. Albeit to a lesser extent, contingent access to shops and places to socialize the imposition of social distancing and the use of indoor masks is measures still in force today (more than a year after the start of the pandemic), with repercussions on economic, social, and psychological levels. The fear of contagion, in fact, has led us to be increasingly suspicious and to isolate ourselves from the remainder of the community. This has had repercussions on the perception of loneliness, with significant psychological consequences, such as the development of stress, anxiety, and, in extreme cases, depressive symptoms. Starting from these assumptions, this research was developed with the aim of deepening the perceptions that the participants have of their own mental health, loneliness, fear linked to contagion, and attitudes toward imposed social distancing. In particular, we wanted to analyze whether there is a relationship between perceived fear and the perceived level of mental health, loneliness, and attitude toward social distancing. Finally, we wanted to analyze whether there are differences related to gender, age, marital status, current working mode, and educational qualifications. The research, performed after the diffusion of the vaccination in Italy, lasted 14 days. The participants were 500 Italians who voluntarily joined the study and were recruited with random cascade sampling. The research followed a quantitative approach. The analyzed data, from participants residing throughout the national territory, allow us to return the picture of the perceptions that Italians have of the fear of contagion, of their level of mental health, of loneliness and of their attitude toward social distancing. In particular, the data show that fear of COVID-19 is an emotional state experienced by the entire population and that young people have suffered more from loneliness and have been less inclined to accept the imposed social distancing. The data that emerged should make policymakers reflect on the need to find functional strategies to combat COVID-19 or other health emergency crises whose effects do not affect the psychological wellbeing of the population.