Views of Mental Health Professionals on Positive Changes in Service Practices and Staff-User Relationships After One Year of Covid-19 Pandemic in Italy

Abstract This study explored views of mental health services (MHS) professionals regarding positive changes in service practices and organizations, and staff-user relationships after one year of COVID19 in Italy. Professionals from a community-oriented MHS completed online the Questionnaire on MHS Transformations during the COVID-19 pandemic, a 30-item tool developed by a participatory approach and validated. Of the 184 participants, 91.8% felt it was ‘‘true/definitely true’’ that during the pandemic they had informed users on procedures to reduce contagion risks, and 82.1% stated that they had increased telephone contact with users. Sixty-nine percent of professionals reported that staff revised treatment plans according to new needs of care and 78.6% stated that they had been able to mediate between user needs and safe working procedures. Moreover, 79.4% of respondents stated that they had rediscovered the importance of gestures and habits, and 65% that they had gained strength among colleagues to face fear. Fifty-four percent of participants admitted that they had discovered unexpected personal resources in users. Overall, 59.6% of participants stated that they found some positives in the COVID-19 experience. Perceived positive changes was greater among professionals from community facilities vs. those from hospital and residential facilities. In community-oriented MHS, the pandemic offered an opportunity to change practices and rethink the meaning of relationships between people. This data may be useful in generating a more balanced understanding of COVID-19’s impact on MHS and for MHS planning in the pandemic era

Involvement of Level I Neck Lymph Nodes and Submandibular Gland in Laryngeal and/or Hypopharyngeal Squamous Cell Carcinoma

Abstract Objective: To investigate the prevalence of level I neck lymph node metastases or submandibular nodal metastases in laryngeal and/or hypopharyngeal squamous cell carcinoma (SCC). Patients and Methods: One hundred fifty consecutive neck dissection specimens from 100 patients with laryngeal and hypopharyngeal SCC, who were treated at our institution between 1992 and 2002, were retrospectively reviewed. Results: The tumour stage was T1-T4, and the neck stage was N0-N3. Metastases were never found in level I (Ia + Ib) or in the submandibular gland. Metastases were concentrated within the jugular chain (levels II-IV in 92.2% of the N-positive necks). Conclusion: Metastases of level I of the neck and the submandibular gland are extremely rare in cases of laryngeal and/or hypopharyngeal carcinoma. The risk of facial or hypoglossal nerve injury does not justify the dissection of level I and of the submandibular gland in this type of tumou