Morbidity and mortality in a prospective cohort of people who were homeless during the COVID-19 pandemic

IntroductionCertain living conditions, such as homelessness, increase health risks in epidemic situations. We conducted a prospective observational cohort study to investigate the impact of the COVID-19 pandemic on morbidity and mortality in adult people who were homeless.MethodsThe study population comprised around 40% of the entire population experiencing homelessness in Marseille. They were enrolled at 48 different locations during the first pandemic wave (June to August 2020) and were followed up 3 and 6 months later. Rapid serological screening for SARS-CoV-2 was performed by community outreach teams at each follow-up, who also conducted interviews. Death registers and hospital administrative databases were consulted.ResultsA total of 1,332 participants [mean age 40.1 years [SD 14.2], women 339 (29.9%)] were enrolled in the cohort. Of these, 192 (14.4%) participants were found positive for COVID-19 and were propensity score matched (1:3) and compared with 553 non-COVID-19 cases. Living in emergency shelters was associated with COVID-19 infection. While 56.3% of the COVID-19-infected cohort reported no symptoms, 25.0% were hospitalized due to the severity of the disease. Presence of three or more pre-existing comorbidities was associated with all-cause hospitalization. Among COVID-19 cases, only older age was associated with COVID-19 hospitalization. Three deaths occurred in the cohort, two of which were among the COVID-19 cases.ConclusionThe study provides new evidence that the population experiencing homelessness faces higher risks of infection and hospitalization due to COVID-19 than the general population. Despite the efforts of public authorities, the health inequities experienced by people who are homeless remained major. More intensive and appropriate integrated care and earlier re-housing are needed

La santé mentale à l'épreuve du confinement : étude des déterminants du bien-être psychologique et du stress pendant la première vague de COVID-19 en Italie

Contexte : l’Italie a été le premier État européen à prendre des mesures radicales de lutte contre l’épidémie de COVID-19, en mettant d’abord en quarantaine les principaux foyers épidémiques, et en instaurant ensuite un confinement généralisé (avec suspension des activités non essentielles) à toute la péninsule à partir du 9 mars 2020. Nous évaluons ici les facteurs associés au bien-être mental et au stress de la population italienne pendant le confinement national.Méthodes : les citoyens italiens âgés de ≥18 ans étaient invités à participer à une enquête de 15 minutes disponible en ligne du 6 avril au 4 mai 2020. Hormis les échelles d'évaluation du bien-être mental et du stress, l'enquête explorait un panel de caractéristiques des participants et de facteurs liés à la situation. Des régressions logistiques multivariées ont été utilisées pour identifier les déterminants du bien-être mental et du stress pendant le confinement national.Résultats : l'étude a reçu un total de 967 réponses valides. Au total, respectivement 248 (28.38%) et 542 (62.8%) personnes présentaient un bien-être mental altéré et un état de stress. Souffrir d'un trouble mental et être à risque de pauvreté avaient un impact négatif sur le bien-être mental (respectivement, OR 2.6 95% 1.4-4.8 et OR 1.59 95% 1.04-2.3) et le stress (OR 2.04 95% 1.03-4.3 et OR 1.9 95% 1.3-2.9), tandis qu’être un homme (OR 0.67 95% 0.44-0.99 et 0.64 95% 0.45-0.91) et percevoir du soutien social (OR 0.3 95% 0.21-0.45 et OR 0.53 95% 0.36-0.78) étaient des facteurs de protection pour les deux outcomes. Les catégories le plus à risque de détresse psychologique étaient les jeunes adultes (bien-être mental altéré : OR 2.24 95% 1.11-4.5), les personnes vivant en zone urbaine (stress : OR 1.89 95% 1.29-2.77), et les personnes travaillant pendant le confinement (stress : OR 2.15 95% 1.49-3.11). A noter, l'accord avec les mesures de confinement et la satisfaction à l'égard des informations fournies par les autorités étaient des facteurs clé de protection de détresse psychologique (stress : OR 0.26 95% 0.07-0.72 ; bien-être altéré OR 0.55 95% 0.36-0.88).Interprétation : des initiatives de promotion de la santé mentale s'appuyant sur ces données peuvent être suggérées. Outre la vulnérabilité de certaines sous-populations, cette étude a mis en évidence (i) le rôle essentiel de l'information et de l'adhésion des personnes aux politiques de santé publique, et (ii) la nécessité d'assurer un soutien social et matériel à la population confinée. D'autres études sont nécessaires pour déceler les conséquences psychologiques à long terme du confinement pour COVID-19

Model-Observer Similarity, Error Modeling and Social Learning in Rhesus Macaques

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Social Facilitation of Cognition in Rhesus Monkeys: Audience Vs. Coaction

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Social Learning as a Way to Overcome Choice-Induced Preferences? Insights from Humans and Rhesus Macaques

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Schematic representation of a learning session.

<p>One of the three models first showed six pairs, the so-called ‘social pairs’, modeling the correct response (success) for three of them, and the incorrect response (error) for the other three. Then, the observer monkey was tested. Three additional pairs were inserted in the list (the ‘individual pairs’) and the now complete 9-pair list was presented 10 times to the monkey. The observer’s performance was thus evaluated over 10 hands-on trials for all pairs, whether ‘individual’ or ‘social’.</p

Learning Δs per subject and per model calculated separately for observed successes vs. errors.

<p>Each learning Δ represents the gain or loss observed in the number of errors committed over 10 hands-on trials for pairs preceded by observation of a model vs. pairs learned purely individually (individual score – social score/individual score *100). Positive Δs indicate that individual learning after observation of a model was better (i.e. accompanied by less errors) than purely individual learning, whereas negative Δs correspond to a loss of performance after observation, i.e. more errors.</p

Effectiveness of the monkey model and of the two human models (‘stimulus-enhancing’ vs. ‘monkey-like’).

<p>A positive learning Δ denotes fewer errors for ‘social’ pairs than for the ‘individual’ pairs tested during the very same sessions, i.e. a beneficial model. A negative learning Δ denotes more errors for ‘social’ than for ‘individual’ pairs, i.e. a detrimental model. Results are illustrated for each monkey and for the group. Monkeys are grouped per trio of housemates according to their rank in the group hierarchy. For the detrimental ‘stimulus-enhancing’ model, two bars were truncated to keep the figure balanced. The actual scores were −103 for the top-ranking male (♂ 1) and −63 for the bottom-ranking female (♀ 3). Note that although 5/6 monkeys benefited slightly more from the monkey than from the ‘monkey-like’ human, the reverse pattern did occur too (♂ 2), hence, the indistinguishable group means yielded by the two beneficial models.</p

Learning from the three models’ successes vs. errors.

<p>Learning Δs were calculated separately for the ‘social’ pairs for which the model’s demonstrated the correct response and for the ‘social’ pairs for which the model’s demonstrated the incorrect response relative in both cases to scores for the ‘individual’ pairs tested during the same sessions. Group scores (mean + or – sem) are shown for each model. Note that errors widened the gap between the two effective and the ineffective models.</p

Boosting Norepinephrine Transmission Triggers Flexible Reconfiguration of Brain Networks at Rest

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