The Impact of the COVID-19 Pandemic on the Management of Mental Health Services for Hospitalized Patients in Sibiu County—Central Region, Romania

Introduction: The COVID-19 pandemic brought a burden and represented a challenge for the Romanian medical system. This study explored the consequences that COVID epidemiological measures had on the quality of the mental health care provided to hospitalized patients in a regional psychiatric hospital in Romania. Materials and methods: Both patient-level and hospital-level indicators were considered for this comparative retrospective study. On the one hand, we extracted patient-level indicators, such as sociodemographics, diagnosis, admission, and discharge dates for 7026 hospitalized patients (3701 women, average age = 55.14) from hospital records. On the other hand, for the hospital-level indicators, we included indicators referring to the aggregated concept of mental health services, such as case mix index, length of stay, bed occupancy rate and patients’ degree of satisfaction. Data extracted covered a period of two years (1 March 2019–28 February 2021) before and during the first year of the COVID-19 pandemic. Results: We found that, compared to the pre-pandemic period, the pandemic period was marked by a drastic decrease in hospitalized patient admissions, coupled with an increase in emergency-based admissions. Other management indicators, such as the case mix index, the number of cases contracted/performed, and the degree of patient satisfaction, decreased. In contrast, the average length of stay and bed occupancy rate increased. Conclusions: The COVID-19 pandemic, especially in the first year, raised multiple difficult issues for the management of psychiatric hospitals. It imposed an application of strict measures designed to face these new and unprecedented challenges. Our findings offer a detailed snapshot of the first year of the COVID-19 pandemic in terms of its impact on mental health services and suggest some future directions. Implications for hospital management are discussed.Keywords: hospital management; COVID-19 pandemic; hospitalized patients; psychiatric hospital; mental health services

The “Sandwich” System: A Potential Solution for Protecting Overwintering Cornu aspersum Snails Reared in Semi-Intensive Heliciculture Farms in Colder Climates

(1) Background: Hibernation in pens covered with LFC was associated with high mortality of C. aspersum snails in Romanian snail farms. This three-year study aimed to develop a simple, but effective system for protecting breeders in colder climates. (2) Methods: The first phase investigated the (pre)hibernal burrowing behavior and the overwintering habitat choice. Protective structures based on straw, LFC, and/or HDPE were tested at pilot level (no snails). The most suitable system was applied under farm conditions. (3) Results: Wood and ridge-tile micro shelters were significantly preferred to corrugated iron micro shelters. Burrowing specimens acted as shallow-burrowers, and this behaviorwas significantly more common for looser soils. All pilot systems displayed significantly higher thermal protection efficiency compared to the sole use of LFC. The balance between straw moistening and thermal protection favored using structure soil/LFC/straw/10-cm air cushion/HDPE. Its use yielded significantly higher survival compared to the sole use of LFC. Most hibernating snails clustered together in large groups, attached on the lower surface of micro shelters. Predator occurrence appeared to marginally affect overwintering survival. (4) Conclusions: The “sandwich” system could be an effective solution for overwintering mature C. aspersum snails in colder climates