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  • Open access
  • 97 Reads
Quality of life and psychosocial impact of the lockdown due to the Covid-19 pandemic on patients with cancer: a cross-sectional study


Following the Covid-19 outbreak, the Italian Government adopted a progressive implementation of measures and limitations until a complete lockdown was reached. For cancer patients, the severity of the virus and the implemented restrictive measures have been a source of concern and anxiety both due to the fear of increased risk of complications if infected and the fear of no longer receiving the necessary cancer treatment.

Aim of the study

To assess the quality of life and the psychosocial impact of the lockdown due to Covid-19 pandemic on cancer patients in Italy


The cross sectional study collected data from a random sample of 186 patients with different type of cancer. Respondents were asked to complete online the Short Form-12 (SF-12) and a questionnaire aiming to detect the psychosocial impact of the lockdown.


The participants were mostly unemployed females with a high school diploma. The majority of them lived with other people in urban areas and used the Internet as the main source of information on the Coronavirus.

Among the basic needs, psychological and medical support appeared to be prevalent followed by the need of safe transportation to reach the treatment facilities.

Although 72.7% of patients did not give up hospital therapies, 33.3% complained of variations in the continuity of the treatments. The majority of the sample (73.2%) was worried of being infected but the 22.3% didn’t share their anxieties and worries with others. The mean score for the Physical component Summary (PCS) was 65.3 ± 7.3SD, while for the Mental component summary (MCS) it was 64.3 ± 9.7SD.

The multivariate regression analysis showed that a pessimistic perception of the quality of life was influenced by living in an extra-urban areas (OR = 1.29) and alone (OR 1.55); while a perception of a reduced physical function resulted affected by the state of anxiety and stress (OR = 1.81) and the difficulties in continuity of medical assistance (OR = 1.33).


A socio-medical cooperation is needed in order to enhance home care interventions, personalize and optimize care, ensure continuity of care and guarantee a high quality of life even in a health emergency situation.

  • Open access
  • 83 Reads
Preliminary Study on Associated Risk Factors of Mortality Due to COVID-19 Pandemic in Malaysia

The COVID-19 pandemic has claimed numerous lives worldwide. Malaysia documented about 118 mortalities during the second wave of the outbreak. This study aims to assess associated risk factors of the COVID-19 mortalities from 18th March until 22nd May 2020. The majority of patients were above 60 years old (69.0%), male (78.0%), and Malaysian citizens (98.0%). The mean age of the mortalities was 64.01 years old (± SD 14.91 years). The major risk factors consist hypertension (52.0%), diabetes mellitus (43.0%), cardiovascular diseases (21.0%), extra-pulmonary solid malignancies (5.0%), cerebrovascular diseases (3.0%), pulmonary diseases (1.0%) and pulmonary malignancies (1.0%). About 23.0% of mortalities were related to established clusters while 5.0% had a history of travelling overseas. The mean survival time was 11.87 days (± SD 9.32 days). Approximately 50.0% of the patient survive until day 10 post-admission. The probability of the patients surviving beyond 30 days post-admission was less than 10.0%. There is a significant difference between groups for having a shorter duration to death for risk factors including age group, history of travelling overseas, attending mass gatherings, and having pulmonary malignancies. The hazard ratio (HR) for pulmonary malignancy is 5.512 (95% CI 0.662, 45.899), mass gathering; 3.434 (95% CI 1.375, 8.579), pulmonary disease is 2.442 (95% CI 0.314, 18.983), travelling overseas; 2.251 (95% CI 0.657, 7.711), extra-pulmonary solid malignancy; 2.165 (95% CI 0.767, 6.112), , and despite the significant result only applied for mass gathering (p-value = 0.008). COVID-19 screening should be mandatory for those who attend mass gatherings as they are the main source of COVID-19 spread in the community during the second wave outbreak in Malaysia.

  • Open access
  • 109 Reads
The need for and the impact of a community-based intervention for parents of children with developmental disabilities: A model project in rural Ireland.

Parents of children with developmental disabilities are at greater risk of poor mental health and social isolation that is compounded by family circumstances and living in rural settings. Often little personal support is available to parents. Family-centred interventions have been endorsed internationally for promoting children’s development as well as enhancing parental wellbeing. Yet current service provision is predominately child-focussed and clinic-centred.

An innovative family-centred support service was designed and evaluated in a rural county of Ireland. Support staff visit the family home every two weeks for around one year. Developmental goals for the child are agreed with parents alongside actions to address the needs of parents and siblings. Community activities are identified or created to promote the social inclusion of the child and family in local communities as well as social activities for mothers.

Thus far 85 families have been involved with this ongoing project. Baseline information on parents’ mental health and social isolation was gathered. A majority of parents had below average scores on a standardised measure of parental well-being as well low participation in social and community activities.

These measures have been repeated with 42 parents who have completed their involvement with the project to date along with qualitative information of parents' experiences. Most parents achieved their chosen targets, particularly greater involvement in community activities, increased knowledge and skills along with more confidence and resilience. Significant increases in their well-being scores were reported but with limited impact on their social participation. Covid 'lock-downs' in recent months may have contributed to the latter.

This evidence-based model of provision is an example of how current social care provision for families who have a child with developmental disabilities could be transformed even in rural areas at a relatively low cost.

  • Open access
  • 60 Reads
Managing Uncertainty in the Face of Certain Dangers

In this work, we examine the effects of the COVID-19 pandemic on a community-based research project. This clinical trial investigates whether increased neighborhood greenness lowers the risk of cardiovascular disease through reduction of air pollution. Facilitating the project involves considerable community engagement (e.g., an active community advisory board, participation in neighborhood association meetings, collaborations with schools and other organizations, presentations, health education sessions, to name but a few activities), and the project relies on successful collaboration across a large, multidisciplinary research team. As concerns surrounding SARS-CoV-2 increased, adjustments to our research timeline and activities were needed. When cases of COVID-19 escalated, many U.S. clinical trials were halted. While some facets of the project have resumed, most areas involving community work have not returned to face-to-face interaction.

Across the months of halted progress and altered interaction, our research team has simultaneously experienced both frustration and relief. In this analysis, we employ a dialectical approach to examine the competing tensions evidenced in community research work during the pandemic. From the vantage point of dialectical theory, competing feelings can occur simultaneously and influence our views and actions. In particular, we examine concurrent experiences of dissatisfaction-satisfaction, need for progress-need for safety, desires to engage-needs to separate, and wishes to share updates-uncertainty on future specifics. This analysis considers the months our community engagement efforts have been affected by the pandemic (March 2020-December 2020), the associated dialectical tensions, and the means of reconciling some tensions and wrestling with others.

  • Open access
  • 211 Reads
What is the untreated remission or natural recovery rate of people with depression? A systematic review and meta-analysis

Background: Depression is the leading cause of disease burden globally and most of the people with this illness left untreated. Remission without treatment may occur in some cases of depression. The aim of this study was to estimate the spontaneous remission (natural recovery) of people from this untreated depression.

Methods: Systematic review, conducted in accordance with PRISMA guidelines and registered on PROSPERO, CRD42020198773. We have used two-steps approach searching EMBASE, PsycINFO, and PubMed supplemented with additional relevant sources to identify studies reporting natural recovery from untreated depression. First, we systematically searched for existing reviews and then we conducted a search for original studies. Study selection and screening were carried out by three independent reviewers. Methodological quality assessment of the included studies was conducted. The data were synthesized using narrative summary and random-effects meta-analysis.

Results: From 2,574 identified unique records, 16 studies were included in the systematic review and meta-analysis fulfilling the eligibility criteria. Most of the included studies were randomized waitlist control trials. The overall pooled remission from untreated depression (natural recovery) was 22.6% within widely varied follow-up duration ranged from one month to six years. The remission was 11.4% within three months of follow-up period and 49.2% within six months or more duration.

Conclusions: Remission within a short untreated period is not common where 1 in 10 people may be remitted within 3 months duration of untreated depression. Interpretation of the result should be considered with caution as the data from waitlist controls may represent mild or moderate depression.

  • Open access
  • 108 Reads
Parent-Child Connectedness and its Association with alcohol, tobacco, and cannabis use among Argentinian Adolescents

Background: In research predominantly from Western countries, studies have been identifying links of parental and peer influences towards adolescent substance use. Evidence from countries that may differ in parental-child relationships across different cultures is limited, e.g. in Argentina, where the prevalence of adolescent substance use is high. Therefore, the objective of this study was to assess the association between parent-child connectedness and substance use among Argentinian adolescents using the Global School-based student Health Survey (GSHS).

Methods: We analyzed the 2012 Global School-based student Health Survey of 28,368 Argentinian adolescents aged 11 – 17 years. The GSHS is a self-administered survey asking students about the use of substances (alcohol, cigarette smoking, and cannabis), demographic variables, and social and psychological factors. Latent class analyses were conducted to identify patterns of polysubstance use. Associations between parent-child connectedness and polysubstance latent classes were assessed using multinomial logistic regression after adjusting for other factors.

Results: Latent class analysis identified three classes. The first class (67% of the sample) comprised of mainly nonsubstance users and mild alcohol users. The second class (13%) included mainly moderate alcohol/tobacco/cannabis users. The third class (20%) was made up of mainly moderate alcohol/tobacco users and non-cannabis users. Lower parental connectedness was associated with a higher likelihood of polysubstance use (classified as either class 2 or 3) (aOR = 2.49; 95% CI: 2.24, 2.76).

Conclusion: Parental connectedness is an important factor when concerning Argentinian adolescent alcohol, tobacco, and cannabis use and should be the focus of interventions to prevent substance-related burden among adolescents.

  • Open access
  • 255 Reads
Smartphone addiction through age and gender during Italian lockdown for COVID-19


Nomophobia (no-mobile-phobia or Disconnection Syndrome) is the fear of not being able to consult your mobile phone, not being connected or traceable. This is an addiction to excessive smartphone usage related to the constant need to consult it to view notifications and updates. Like other forms of addiction, nomophobia is associated with excessive behaviors that lead to an increasing use of the phone to the point where it cannot do without it and the need to take it with it to any place or circumstance. The fear of not being connected consequently evokes reactions of excessive anxiety with specific physiological related (e.g., breathlessness, sweating, tremor, heart acceleration, sweating etc.).

Nomophobia, however, is not included in anxiety disorders but is part of the pathological addictions to which it responds adequately. In fact, there are many behavioral and emotional analogies with other forms of addiction (including gambling) so the hypothesis that the abuse of the smartphone should be categorized as a real addiction can be accepted.

The dependencies associated with the Internet and technologies that can be defined Dependencies 2.0, include the smartphone. During the Italian lockdown caused by COVID-19, the use of technologies has been the fundamental basis of adaptation for smart working, school and professional training, which has led to a change in the population lifestyle.

Objective: The purpose of this work is to document the level of smartphone dependence that has occurred during the COVID-19 lockdown period.

Material and Methods: The NoMobilePhobia-Questionnaire (NMP-Q) was presented online to 1264 participants between the ages of 15 and 60.

With regard to the selection of participants, approximately between the ages of 15 and 60, we used the method of random numbers: in fact, one participant for every hundred inhabitants was chosen in a randomized way. Finally, it was necessary for all participants to have access to the Internet. These dynamics have been acquitted in order to give us a valid representative sample.

Results: The results show no significant main effects for the two factors taken into account (Gender and Age of participants). However the significant interaction shows that female participants reported on average higher scores on NoMobilePhobia-Questionnaire (NMP-Q) than males , for the younger age group (15 to 44), while for those over the age of 44, the average highest scores were for male participants.

The main effects of the "Sex" factor [F(1,1256)= 3.179 and p=0.75] and "Age_class" [F(4,1253)=1.82 and p=0.12] are not significant; the interaction between the Sex-Age_class factors is significant with F(4,1253) =7.06 and p<.001 and an observed power close to 1 (0.99).

The correlation between the Variable "Score" and the measure of the "Age" was found to be significant (negative) linear relationship (r of Pearson =-.093 and p<.001) considering the whole sample.

Conclusions: One of the "positive" aspects of the COVID-19 pandemic is the use of the Internet and smartphones, and our analysis aimed to document the frequency of use in the Italian context with the NoMobilePhobia-Questionnaire. The results reveal the risk in some parts of the Italian population to develop forms of smartphone dependence, especially in circumstances that prohibit direct social interactions.

  • Open access
  • 233 Reads
Depression, Anxiety, Stress and Physical Activity in Health-Related University Students during COVID-19

The coronavirus disease 2019 (COVID-19) pandemic led to the increased negative affective condition among university students. High levels of depression, anxiety, and stress are commonly reported among health-related university students. Likewise, current partial lockdown in Croatia could result in negative consequences on students’ mental health. It is well-established that physical activity has positive effects on mental health and well-being, but due to gym closure as a restriction measure, levels of students’ physical activity may decrease.

This cross-sectional study aimed to define the levels of depressive, anxiety, and stress symptoms along with physical activity among health-related university students during the second partial COVID-19 lockdown. The survey included 212 students from the Faculty of Dental Medicine and Health of the University of Osijek in Croatia. To estimate the levels of depression, anxiety, and stress, the DASS-21 (The Depression Anxiety Stress Scale-21) and GSLTPAQ (The Godin-Shephard Leisure-Time Physical Activity Questionnaire) questionnaires were used.

The majority of students (57.1%) reported increased stress levels during the second COVID-19 lockdown, and 58% reported decreased physical activity. A high prevalence of depressive (52.8%), anxiety (51.9%), and stress (54.7%) symptoms were found among health-related university students, with 33% of students were insufficiently active. Depression was strongly correlated with anxiety and stress; moreover, anxiety also correlated with stress. Female students scored higher on depression, anxiety, and stress, but on lower physical activity than their male counterparts.

The results of this study suggested a high prevalence of negative affective conditions (depression, anxiety, and stress) and decreased physical activity among health-related university students during the second partial lockdown. The resulting symptoms were mostly of mild intensity; however, we consider this a significant mental health issue during the COVID-19 pandemic. It is crucial to monitor and promote students' mental health, especially in more affected females, to reduce the negative impact of this pandemic.

  • Open access
  • 154 Reads
The influence of manual therapy on biometric parameters in patients with improper body weight.

Objective: In recent years, there have been only a few studies showing an improvement of the lymphatic system function in patients with abnormal body weight after the use of manual lymphatic drainage (MLD). The aim of the study was to assess the effectiveness of using MLD of the abdominal cavity as one of the forms of therapy for lymphatic system dysfunction in people with abnormal body weight.

Material and methods: The study presents the therapy of two women aged 30 to 59. They underwent 10 treatments of manual lymphatic drainage of the abdominal cavity (30 minutes x 3 times a week). Biochemical tests were performed before and after the MLD treatment. The degree of obesity was determined on the basis of the BMI (body mass index) and WHR (waist-to-hip ratio). The 7-point Likert scale was used to evaluate the patients’ quality of life.

Results: The overweight patient showed an improvement in biochemical parameters, including a decrease in the level of C-peptide and C-reactive protein, and a better quality of life compared to the state before the therapy. This subject scored 3 points before vs. 5 points after the MLD treatment. The patient with class 2 obesity and comorbidities showed no improvement in biochemical parameters, however, there was a change for better in the quality of life after the therapy. The patient scored 3 points before vs. 4 points after the MLD treatment.

Conclusions: Preliminary studies indicate potential benefits of using MLD for improving biochemical parameters, including a reduction of inflammation in an overweight patient.

  • Open access
  • 65 Reads
Psychological variables and sport practice during the lockdown caused by Covid-19: comparative analysis.

The pandemic caused by the coronavirus disease, caused changes in the population in relation to the habits of physical activity and sports practice. If to this we add the work situation and the care or not of children during the lockdown, the routines of sport practice can be reduced, with the risk that this entails to health. This study analyzed motivation, commitment and self-efficacy in relation to sport practice as well as the differences depending on the employment situation and the care or not of children, during the lockdown. The study sample was conformed of 179 subjects (90 men and 89 women) between 18 and 65 years of age (M = 28.64; SD = 10.28). The Behavioral Regulation in Sport Questionnaire (BRSQ), the Psychological Need Satisfaction in Exercise Scale (PNSE), the Physical Activity Self-Efficacy scale and the Sport Commitment scale, were applied. The most relevant results have showed significant differences in favor of the population that studies and works in terms of levels of autonomous motivation and amotivation, as well as higher levels of self-efficacy, basic psychological need of competence and commitment to sport practice. However, no significant differences were found depending on the care or not of children. It is interesting that the people who study and work were the most involved with the sport practice during the lockdown. Therefore, the results will be discussed in relation to how, the basic psychological need of competence, should be fostered in order to increase the levels of self-determined motivation, self-efficacy and commitment to sports practice of the entire population.