Search Results (1,034)

The COVID-19 pandemic precipitated unprecedented social isolation measures, profoundly disrupting daily life, educational routines, and mental health worldwide. University students, already susceptible to psychological distress, encountered intensified challenges under remote learning and prolonged confinement. This longitudinal study examined fluctuations in anxiety and mood among 102 Brazilian university students during the pandemic, distinguishing between those solely engaged in academic pursuits and those simultaneously balancing work and study. Data collected via the Brunel Mood Scale and State-Trait Anxiety Inventory in April and July 2021 revealed that students exclusively focused on studies exhibited significant increases in depressive symptoms, anger, confusion, and anxiety, alongside diminished vigor. Conversely, participants who combined work and study reported reduced tension, fatigue, confusion, and overall mood disturbance, coupled with heightened vigor across the same period. Notably, women demonstrated greater vulnerability to anxiety and mood fluctuations, with socioeconomic disparities particularly pronounced among females managing dual roles, who reported lower family income. These findings suggest that occupational engagement may serve as a protective factor against psychological distress during crises, underscoring the urgent need for tailored mental health interventions and institutional support to mitigate the enduring impacts of pandemic-related adversities on the student population. Full article

Lower respiratory tract infections remain a leading cause of morbidity and mortality among Intensive Care Unit patients, with severe cases often progressing to acute respiratory distress syndrome (ARDS). This life-threatening syndrome results from alveolar–capillary membrane injury, causing refractory hypoxemia and respiratory failure. Early detection and management are critical to treat the underlying cause, provide protective lung ventilation, and, eventually, improve patient outcomes. The 2012 Berlin definition standardized ARDS diagnosis but excluded patients on non-invasive ventilation (NIV) or high-flow nasal cannula (HFNC) modalities, which are increasingly used, especially after the COVID-19 pandemic. By excluding these patients, diagnostic delays can occur, risking the progression of lung injury despite ongoing support. Indeed, sustained, vigorous respiratory efforts under non-invasive modalities carry significant potential for patient self-inflicted lung injury (P-SILI), underscoring the need to broaden diagnostic criteria to encompass these increasingly common therapies. Recent proposals expand ARDS criteria to include NIV and HFNCs, lung ultrasound, and the SpO₂/FiO₂ ratio adaptations designed to improve diagnosis in resource-limited settings lacking arterial blood gases or advanced imaging. However, broader criteria risk overdiagnosis and create challenges in distinguishing ARDS from other causes of acute hypoxemic failure. Furthermore, inter-observer variability in imaging interpretation and inconsistencies in oxygenation assessment, particularly when relying on non-invasive measurements, may compromise diagnostic reliability. To overcome these limitations, a more nuanced diagnostic framework is needed—one that incorporates individualized therapeutic strategies, emphasizes lung-protective ventilation, and integrates advanced physiological or biomarker-based indicators like IL-6, IL-8, and IFN-γ, which are associated with worse outcomes. Such an approach has the potential to improve patient stratification, enable more targeted interventions, and ultimately support the design and conduct of more effective interventional studies. Full article

People living with HIV (PLWH) faced diverse challenges during the COVID-19 pandemic, including disruptions to care, housing instability, emotional distress, and economic hardship. This study used graph-based clustering methods to analyze pandemic-era experiences of PLWH in a national sample from the NIH’s All of Us dataset (n = 242). Across three graph configurations we identified consistent subgroups shaped by social connectedness, housing stability, emotional well-being, and engagement with preventive behaviors. Comparison with an earlier local study of PLWH in Illinois confirmed recurring patterns of vulnerability and resilience while also revealing additional national-level subgroups not observed in the smaller sample. Subgroups with strong social or institutional ties were associated with greater emotional stability and proactive engagement with COVID-19 preventive behaviors, while those facing isolation and structural hardship exhibited elevated distress and limited engagement with COVID-19 preventive measures. These findings underscore the importance of precision public health strategies that reflect the heterogeneity of PLWH and suggest that strengthening social support networks, promoting housing stability, and leveraging institutional connections may enhance pandemic preparedness and HIV care in future public health crises. Full article

Background/Objectives: Healthcare workers (HCW) have increased the risk of occupational stress injuries and adverse mental health outcomes, which were exacerbated during the COVID-19 pandemic. Understanding HCW psychological distress patterns and help-seeking behaviors can inform responsive resource development that may mitigate negative outcomes in future crises. This paper provides insights on monthly trends in HCW distress and support utilization at a large Canadian hospital over a 14-month period. Methods: As part of a hospital-wide wellness initiative during COVID-19, the STEADY program emailed monthly confidential wellness assessments to hospital staff from April 2020 to May 2021. The assessments included screens for burnout, anxiety, depression and posttraumatic stress, types of support accessed, and demographic information. Repeated cross-sectional data were summarized as monthly proportions and examined alongside longitudinal COVID-19 data. Results: A total of 2498 wellness assessments were submitted (M = ~168 monthly, range: 17–945). Overall, 67% of assessments had at least one positive screen for distress. Average positive screens were 44% for anxiety, 29% for depression, 31% for posttraumatic stress, and 53% for burnout. Despite high distress, most respondents used informal supports (e.g., family/friends), highlighting limited formal support use. Conclusions: HCWs experienced sustained high levels of psychological distress during the COVID-19 pandemic, with burnout remaining a predominant and persistent concern. The limited use of formal support services may indicate barriers to accessing these types of supports. Our findings underscore the need for accessible and acceptable mental health supports for HCW during prolonged crises. Full article

Background/Objectives: Postoperative acute respiratory distress syndrome (ARDS) is a recognized complication with reported prevalence rates of up to 20% and highly variable mortality. However, there is limited published evidence comparing the outcomes of postoperative ARDS with those of medical ARDS. We aimed to evaluate the prevalence, hospital mortality, and healthcare costs of postoperative ARDS in Spain between 2000 and 2022 and to compare them with those of medical ARDS. Methods: We performed a nationwide, registry-based study of all hospitalizations for postoperative ARDS in Spain between 1 January 2000 and 31 December 2022 using the Minimum Basic Data Set (MBDS) Registry. Results: We identified a total of 93,192 ARDS patients, of which 40,601 had postoperative ARDS. The postoperative ARDS prevalence varied between 0.05 and 0.22%, accounting for 45–50% of total ARDS cases recorded during the study period. Hospital mortality was lower in postoperative ARDS compared with medical ARDS during the first phase (2000–2015) (47.0% vs. 49.9%, p < 0.001) and converged during the second phase (2017–2022) (42.7% vs. 43.2%, p = 0.413). Postoperative ARDS was associated with a longer hospital stay and 1.5 times higher healthcare costs compared with medical ARDS. During the COVID-19 pandemic, mortality rates declined but costs peaked in both groups. The incidence of digestive tract infection was higher in postoperative ARDS. Conclusions: The prevalence of postoperative ARDS remained stable, except during the COVID-19 pandemic, and its hospital mortality declined and equalized with that of medical ARDS. However, the costs associated with postoperative ARDS remained significantly higher. Full article

Background: Hospitalization during the COVID-19 pandemic has been linked with increased psychological distress, cognitive impairment, and reduced quality of life (QoL). Posttraumatic stress symptoms (PTSS) and rumination may significantly influence QoL outcomes, yet the mechanisms underlying these effects remain poorly understood. Based on the Cognitive Aging Model, this study examines the mediating effects of cognitive and emotional functioning, loneliness, and posttraumatic growth (PTG) on the connection between PTSS/rumination and QoL among patients hospitalized with COVID-19, including the moderator effect of sex, time since discharge, and admission to the intensive care unit (ICU). Methods: A cohort of 258 patients previously hospitalized with COVID-19 as the primary or secondary diagnosis was assessed 6 to 24 months post-discharge. Participants completed validated self-report and neuropsychological assessments of PTSS, rumination, cognitive function, psychological morbidity (depression and anxiety), loneliness, PTG, and QoL. Path analysis and multigroup analysis were employed to assess mediating and moderating effects. Results: PTSS and rumination were associated with reduced physical and mental QoL, primarily via increased psychological morbidity, impaired cognitive functioning, loneliness, and reduced PTG. Rumination showed strong direct and indirect effects on multiple mediators. Only sex and time since discharge significantly moderated pathways, with women showing a strong association between rumination and cognitive impairment/loneliness, while the association between loneliness and mental QoL was significant only in men and in recently discharged patients. Conclusions: PTSS and rumination contribute negatively to QoL in post-discharged patients with COVID-19 through emotional, cognitive, and social pathways, influenced by sex and duration since discharge. The findings underscore the significance of comprehensive long-term care methods focused on cognitive rehabilitation, psychosocial sT, and social reintegration for COVID-19 survivors. Full article

The COVID-19 pandemic has illuminated and intensified pre-existing structural vulnerabilities among older adults living with HIV/AIDS in sub-Saharan Africa, particularly Nigeria. Within already overstretched healthcare infrastructures, these individuals faced heightened economic precarity, disrupted HIV care, and pronounced psychosocial distress. Exploring their lived experiences critically advances an understanding of resilience and informs contextually responsive interventions that can mitigate future health crises. This study employed a narrative qualitative approach to explore the lived experiences of older adults (aged 50 and above) attending the Infectious Diseases Institute (IDI) clinic in Ibadan, Nigeria, during the pandemic lockdown. Purposive sampling guided by maximum variation principles enabled the selection of 26 participants who provided detailed accounts through in-depth interviews. Reflective thematic analysis identified complex narratives illustrating intensified financial hardships, disrupted access to antiretroviral therapy (ART), and heightened psychological distress, including anxiety, depression, and profound isolation. Conversely, participants also articulated experiences of resilience, manifesting in improved medication adherence, strengthened family bonds, and introspective growth fostered by enforced isolation. These nuanced findings highlights the necessity of developing an adaptive, integrated healthcare interventions that addresses economic vulnerabilities, psychosocial wellbeing, and ART continuity, thereby better preparing resource-constrained health systems to support older adults with HIV/AIDS in future public health crises. Full article

Debt financing is important for financing major investments in the biopharmaceutical industry. Debt financing allows companies to raise funds without giving up ownership or control through indenture and covenants of the company. In this study, I analyze the effects of debt financing decisions on profitability in the biopharmaceutical industry. I find that short-term debt, long-term debt, and total debt negatively impact the return on assets (ROA) as a firm’s profitability measure. A comparison is made between American and European biopharmaceutical firms, and the result shows the negative effects of short-term and long-term debt on profitability persist more for US biopharmaceutical firms than European firms. Short-term and long-term debt both impact profitability negatively with 10-year lagged R&D intensity and financial distress. Short-term debt’s negative impact is stronger post-COVID-19, indicating increased financial strain. Long-term debt consistently affects profitability negatively, with relatively stable effects during the pre- and post-COVID-19 pandemic. Full article

The COVID-19 pandemic significantly disrupted higher education worldwide, imposing strict isolation measures, transitioning learning online, and exacerbating existing social and economic inequalities. This literature review examines the pandemic’s impact on the mental health of college students, with a focus on those belonging to minority groups, including racial, ethnic, migrant, gender, sexuality-based, and low-income populations. While elevated levels of anxiety, depression, and loneliness were observed across all students, findings indicate that LGBTQ+ and low-income students faced the highest levels of psychological distress, due to compounded stressors such as family rejection, unsafe home environments, and financial insecurity. Racial and ethnic minority students reported increased experiences of discrimination and reduced access to culturally competent mental healthcare. International and migrant students were disproportionately affected by travel restrictions, legal uncertainties, and social disconnection. These disparities underscore the need for higher education institutions to implement targeted, inclusive mental health policies that account for the unique needs of at-risk student populations during health crises. Full article

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the 2019 coronavirus disease pandemic. The virus primarily spreads through person-to-person contact via aerosols and droplets, contributing to high case numbers and related morbidities. SARS-CoV-2 targets the respiratory tract, causing acute respiratory distress syndrome, particularly in immunocompromised individuals such as those with cystic fibrosis (CF). CF is a life-threatening genetic disorder caused by mutations in the CF transmembrane conductance regulator (CFTR) gene, leading to impaired respiratory function and recurrent severe respiratory symptoms. Despite their potential vulnerability, CF patients have shown a lower incidence of severe COVID-19, suggesting protective factors against SARS-CoV-2. Differential expression of the ACE2 receptor, crucial for viral entry, and other host factors, such as TMPRSS2, may play a role in this resistance to SARS-CoV-2. Analyzing the genomics and transcriptomics profiles of CF patients could provide insights into potential resistance mechanisms. The potential resistance mechanisms include blood and extracellular ATP levels, a deleted/dysfunctional CFTR gene, ACE and ACE2 regulation and expression, ACE and ACE2 polymorphism effects, host proteins and SARS-CoV-2 interactions, and SMN1 and ACE/ACE2 interactions. This review discusses the underlying factors and potential resistance mechanisms contributing to CF patients’ responses to SARS-CoV-2 infection. The review provides an opportunity to further investigate future therapy and research through understanding the underlying potential resistance mechanisms exhibited by CF patients against SARS-CoV-2, including ACE and ACE2 polymorphisms. Full article

College students are particularly vulnerable to psychological distress, including anxiety, depression, and chronic stress, often triggered by academic pressure, developmental challenges, and events such as the COVID-19 pandemic. This study examined the effectiveness and feasibility of a structured mindfulness-based program—Mindfulness Laboratory (MLAB)—delivered over three academic years to psychology students in Italy through online, hybrid, and in-person formats. A total of 194 students participated, with 176 completing pre- and post-intervention assessments. Standardized self-report measures evaluated mindfulness (FFMQ, MAAS), perceived stress (PSS), resilience (RS-14), sleep quality (PSQI), depressive symptoms (BDI-II), anxiety (STAI-Y1, STAI-Y2), and self-compassion (SCS). A non-randomized control group of 51 students who did not undergo the intervention was also included. The results showed significant improvements in mindfulness, perceived stress, anxiety, and depression, with a smaller but significant increase in resilience. Sleep quality remained stable, while self-compassion levels slightly declined. Surprisingly, no significant differences were found across the three delivery formats, suggesting comparable effectiveness regardless of modality. These results support the feasibility and benefits of mindfulness-based interventions for university students. Further controlled studies with long-term follow-up are needed to confirm upon these findings. Full article

The rapid shift to online education during the COVID-19 pandemic exacerbated mental health risks for students, particularly those experiencing multidimensional poverty—a potential contributor to psychological distress in digital learning environments. This study examines how poverty-driven techno-distress (technology-related stress) impacts university students’ mental health, focusing on 202 Chilean learners engaged in remote classes. Using partial least squares structural equation modeling (PLS-SEM), we analyzed multidimensional poverty and its association with techno-distress, measured through validated scales. The results suggest that poverty conditions are associated with 32.5% of technostress variance (R² = 0.325), while techno-distress may indirectly relate to 18.7% of students’ dissatisfaction with academic life—a proxy for emerging mental health risks. Importance–performance map analysis (IPMA) identified housing habitability (e.g., overcrowding, inadequate study spaces) and healthcare access as priority intervention targets, surpassing purely digital factors. These findings indicate that techno-distress in online education may function as a systemic stressor, potentially amplifying pre-existing inequities linked to poverty. For educators and policymakers, this highlights the urgency of early interventions addressing students’ physical environments alongside pedagogical strategies. By framing techno-distress as a public health challenge rooted in socioeconomic disparities, this work advances preventive approaches to safeguard student well-being in increasingly hybrid educational landscapes. Full article

Background The COVID-19 epidemic had a deleterious impact on mental health and substance abuse and led to an increase in several forms of violence, including self-harm and interpersonal violence among youth from low- and middle-income countries. Nevertheless, the relationship between the variables and their directionality has not been recognized. This study describes the relationship directionality between these variables among 18- to 20-year-old Mexican youths during the COVID-19 pandemic. Methods The longitudinal cohort study comprises an evolving group of young Mexican adults: 1390 participants aged 18 in 2021, 654 aged 19 in 2022, and 442 aged 20 in 2023. Proportions by sex—50% were matched in every cohort, and the evolution–age sample accomplishment accounted for 47% in 2022 and 32% in 2023. Results According to a structural equation model, which fit the data from 195 iterations with 246 parameters (X²[2722] = 8327.33, p < 0.001), yielding a CFI of 0.946, a TLI of 0.943, and an RMSEA of 0.029 [0.028–0.029]), perpetrating intimate violence, preceded by suffering intimate violence, combined with suffering anxiety symptoms, was associated with self-harm–suicide thoughts and behaviors (ShSTB), marked distress, dysfunction, and somatization symptoms. The relationship was stronger in women and 20-year-old Mexicans. In men, this pathway was exclusively associated with ShSTB. Suffering from intimate violence has been associated with depression, anxiety, and PTSD symptoms, as well as harmful alcohol use. Conclusions During an epidemic, prevention programs should be designed to warn about self-harm–suicide thoughts and behaviors, not only to ensure the safety of the victims of intimate personal-violence but also to prevent the suicidal behavior of perpetrators. Full article

The COVID-19 pandemic has had a profound impact on society, including on physical and mental health. This study investigated changes in mental health parameters among a Swedish sample during and after the pandemic. Using a longitudinal study, we investigated the relationships among life dissatisfaction, psychological distress, and worries, with factors such as age, sex, education, severe illness, and job loss due to the pandemic among 588 men (mean age 54.9 years), and 653 women (mean age 52.9 years). The results reveal sex differences in life dissatisfaction and psychological distress; in addition, younger individuals reported more life dissatisfaction, and psychological distress compared with older groups. Women were 4.5 times more likely than men to report worries in 2021 and 2.3 times more likely in 2022, even after adjusting for age, education, severe illness, and job loss. This study shows how societal expectations and sex roles may exacerbate these differences in mental well-being during a time of crisis. The conclusions emphasize the importance of considering factors such as sex, age, education, and employment status when developing interventions and support systems during a global crisis. The COVID-19 pandemic will continue to affect society for a long time, indicating a need for ongoing research into population-level consequences. Full article

Severe Acute Respiratory Syndrome (SARS) represents a significant cause of morbidity and mortality in children under one year of age, a particularly vulnerable population due to immunological and respiratory immaturity. The diverse etiology includes multiple respiratory viruses such as Respiratory Syncytial Virus (RSV), influenza, rhinovirus, and SARS-CoV-2, each with distinct potential to cause severe illness and death. Understanding the specific incidence and lethality by etiological agents in the recent Brazilian context (2024), after the COVID-19 pandemic, is essential to guide surveillance and public health strategies. This study aimed to analyze the risk of incidence and lethality by specific etiology of SARS in children under one year of age hospitalized in Brazil during the year 2024. A descriptive cross-sectional study was performed using secondary data from the 2024 Influenza Epidemiological Surveillance Information System (SIVEP-Gripe), obtained via OpenDataSUS. Reported cases of SARS hospitalized in children <1 year of age in Brazil were included. Distribution by final classification and epidemiological week (EW) was analyzed; the incidence rate by Federative Unit (FU) (cases/100,000 < 1 year) with risk classification (Low/Moderate/High) was assessed; and, for cases with positive viral RT-PCR, the etiological frequency and virus-specific lethality rate (deaths/total cases of etiology ×100), also with risk classification, were extracted. A multivariate logistic regression model was performed for the risk factors of death. A total of 66,170 cases of SARS were reported in children under 1 year old (national incidence: 2663/100,000), with a seasonal peak between April and May. The majority of cases were classified as “SARS due to another respiratory virus” (49.06%) or “unspecified” (37.46%). Among 36,009 cases with positive RT-PCR, RSV (50.06%) and rhinovirus (26.97%) were the most frequent. The overall lethality in RT-PCR-positive cases was 1.28%. Viruses such as parainfluenza 4 (8.57%), influenza B (2.86%), parainfluenza 3 (2.49%), and SARS-CoV-2 (2.47%) had higher lethality. The multivariate model identified parainfluenza 4 (OR = 6.806), chronic kidney disease (OR = 3.820), immunodeficiency (OR = 3.680), Down Syndrome (OR = 3.590), heart disease (OR = 3.129), neurological disease (OR = 2.250), low O₂ saturation (OR = 1.758), SARS-CoV-2 (OR = 1.569) and respiratory distress (OR = 1.390) as risk factors for death. Cough (OR = 0.477) and RSV (OR = 0.736) were associated with a lower chance of death. The model had good calibration (Hosmer–Lemeshow p = 0.693) and overall significance (p < 0.001). SARS represented a substantial burden of hospitalizations, with marked seasonal and geographic patterns. RSV and rhinovirus were the main agents responsible for the volume of confirmed cases but had a relatively low to moderate risk of lethality. In contrast, less frequent viruses such as parainfluenza 4, influenza B, parainfluenza 3, and SARS-CoV-2 were associated with a significantly higher risk of death. These findings highlight the importance of dissociating frequency from lethality and reinforce the need to strengthen etiological surveillance, improve diagnosis, and direct preventive strategies (such as immunizations) considering the specific risk of each pathogen for this vulnerable population. Full article