The Association Between Exposure to COVID-19 and Mental Health Outcomes Among Healthcare Workers

Due to the unprecedented impact of the COVID-19 pandemic on health care systems, there has been great interest in the mental wellbeing of healthcare workers. While most studies investigated mental health outcomes among frontline vs. non-frontline healthcare workers, little is known about the impact of various work-related variables. The present study aimed to examine the association between work-related [i.e., having contact with COVID-19 patients, being redeployed due to the pandemic and availability of sufficient personal protective equipment (PPE)] and subjective (i.e., worries about getting infected or infecting others) exposures and self-reported mental health outcomes (i.e., psychological distress, depressive symptoms, and posttraumatic stress symptoms). Between February and May 2021, 994 healthcare workers employed at a variety of healthcare settings in the Netherlands filled out an online survey as part of the COVID-19 HEalth caRe wOrkErS (HEROES) study. Mental health outcomes were measured using the General Health Questionnaire-12, the Patient Health Questionnaire-9, and the Primary Care PTSD Screen for DSM-5. Approximately 13% reported depressive symptoms, 37% experienced psychological distress, and 20% reported posttraumatic stress symptoms. Multilevel linear models consisted of three levels: individual (work-related and subjective exposures), healthcare center (aggregated redeployment and availability of sufficient PPE), and regional (cumulative COVID-19 infection and death rates). Worries about infection were associated with all three mental health outcomes, whereas insufficient PPE was associated with psychological distress and depressive symptoms. There were no differences in outcomes between healthcare centers or provinces with different COVID-19 infection and death rates. Our findings highlight the importance of adequate PPE provision and the subjective experience of the COVID-19 pandemic. These factors should be part of interventions aimed at mitigating adverse mental health outcomes among healthcare workers during the COVID-19 pandemic

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Διερεύνηση των σχέσεων της γονικότητας με την εκδήλωση τελειοθηρίας σε φοιτητικό πληθυσμό

Previous research suggests that the origins of perfectionism lie in parental factors. The present study examined how parenting style and family perfectionism is associated with the manifestation of perfectionism in a sample of 855 Greek university students, using the Almost Perfect Scale-Revised (APS-R), the Family Almost Perfect Scale (FAPS) and the Parental Authority Questionnaire (PAQ). The subscales of APS-R and FAPS are combined to provide three types of personal and family perfectionism respectively (adaptive, maladaptive, absence of perfectionism), whereas PAQ distinguishes three parenting styles (authoritarian, permissive, authoritative). The authoritative parenting style was positively associated with adaptive perfectionism in both genders and negatively associated with maladaptive perfectionism among women, the authoritarian parenting style was positively associated with maladaptive perfectionism among men, whereas the permissive parenting style was positively associated with maladaptive perfectionism among women and the absence of perfectionism among men. Moreover, the type of personal perfectionism was associated to the respective type of family perfectionism

Heart non-specific effector CD4+ T cells protect from postinflammatory fibrosis and cardiac dysfunction in experimental autoimmune myocarditis

Heart-specific CD4$^{+}$ T cells have been implicated in development and progression of myocarditis in mice and in humans. Here, using mouse models of experimental autoimmune myocarditis (EAM) we investigated the role of heart non-specific CD4$^{+}$ T cells in the progression of the disease. Heart non-specific CD4$^{+}$ T cells were obtained from DO11.10 mice expressing transgenic T cell receptor recognizing chicken ovalbumin. We found that heart infiltrating CD4$^{+}$ T cells expressed exclusively effector (T$_{eff}$) phenotype in the EAM model and in hearts of patients with lymphocytic myocarditis. Adoptive transfer experiments showed that while heart-specific T$_{eff}$ infiltrated the heart shortly after injection, heart non-specific T$_{eff}$ effectively accumulated during myocarditis and became the major heart-infiltrating CD4$^{+}$ T cell subset at later stage. Restimulation of co-cultured heart-specific and heart non-specific CD4$^{+}$ T cells with alpha-myosin heavy chain antigen showed mainly Th1/Th17 response for heart-specific T$_{eff}$ and up-regulation of a distinct set of extracellular signalling molecules in heart non-specific T$_{eff}$. Adoptive transfer of heart non-specific T$_{eff}$ in mice with myocarditis did not affect inflammation severity at the peak of disease, but protected the heart from adverse post-inflammatory fibrotic remodelling and cardiac dysfunction at later stages of disease. Furthermore, mouse and human T$_{eff}$ stimulated in vitro with common gamma cytokines suppressed expression of profibrotic genes, reduced amount of α-smooth muscle actin filaments and decreased contraction of cardiac fibroblasts. In this study, we provided a proof-of-concept that heart non-specific T$_{eff}$ cells could effectively contribute to myocarditis and protect the heart from the dilated cardiomyopathy outcome

The Association Between Exposure to COVID-19 and Mental Health Outcomes Among Healthcare Workers

Due to the unprecedented impact of the COVID-19 pandemic on health care systems, there has been great interest in the mental wellbeing of healthcare workers. While most studies investigated mental health outcomes among frontline vs. non-frontline healthcare workers, little is known about the impact of various work-related variables. The present study aimed to examine the association between work-related [i.e., having contact with COVID-19 patients, being redeployed due to the pandemic and availability of sufficient personal protective equipment (PPE)] and subjective (i.e., worries about getting infected or infecting others) exposures and self-reported mental health outcomes (i.e., psychological distress, depressive symptoms, and posttraumatic stress symptoms). Between February and May 2021, 994 healthcare workers employed at a variety of healthcare settings in the Netherlands filled out an online survey as part of the COVID-19 HEalth caRe wOrkErS (HEROES) study. Mental health outcomes were measured using the General Health Questionnaire-12, the Patient Health Questionnaire-9, and the Primary Care PTSD Screen for DSM-5. Approximately 13% reported depressive symptoms, 37% experienced psychological distress, and 20% reported posttraumatic stress symptoms. Multilevel linear models consisted of three levels: individual (work-related and subjective exposures), healthcare center (aggregated redeployment and availability of sufficient PPE), and regional (cumulative COVID-19 infection and death rates). Worries about infection were associated with all three mental health outcomes, whereas insufficient PPE was associated with psychological distress and depressive symptoms. There were no differences in outcomes between healthcare centers or provinces with different COVID-19 infection and death rates. Our findings highlight the importance of adequate PPE provision and the subjective experience of the COVID-19 pandemic. These factors should be part of interventions aimed at mitigating adverse mental health outcomes among healthcare workers during the COVID-19 pandemic

Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic

Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women’s well-being and ensure healthcare system preparedness during future public health crises.PRIMUS Research Programme (PRIMUS/22/MED/012)Ministry of Health of the Czech Republic (NU22J-09-00064)Fundacion Martin EscuderoEuropean Union’s Horizon 2020 Research and Innovation Programme Societal Challenges (Grant Agreement No. 101016127)Ministerio de Ciencia Tecnología e Innovación (Minciencias; CT 860-2020)The UK Research and Innovation (UKRI; ES/V013157/1)Ministry of Education, Universities and Research (Bando FISR 2020IP_05308)Fondazione di Sardegna (Bando 2020)3.9 Q2 JCR 2022No data SJR 2022No data IDR 2022UE