[Changes in the provision and utilization of health care in German primary care practices during the COVID-19 pandemic - A survey of patients in three federal states]. / Veränderungen in der Bereitstellung und Inanspruchnahme der Gesundheitsversorgung in deutschen Hausarztpraxen während der COVID-19-Pandemie ­ eine Befragung von Patient*innen in drei Bundesländern.

INTRODUCTION: During the COVID-19 pandemic general practitioners (GP) practice teams were temporally confronted with major challenges which were accompanied by changes in practice organization and service provision. So far, little has been known about the views of patients who visited the GP practice for other than COVID-related reasons with regard to provision and use of GP services, the adjustments in the practice and the work of the practice team members. METHODS: The patient survey is a sub-study of the mixed-methods study VeCo-Praxis (GP healthcare for patients not suffering from COVID during the Corona pandemic) of the research practice network RESPoNsE (Research Practice Network East), which was conducted in the federal states of Berlin, Brandenburg and Thuringia. The questionnaire-based survey was carried out among patients who visited their GP practice in November 2022. The topics covered in the survey were developed by two focus groups consisting of 13 members of the RESPoNsE patient advisory board. The questionnaire was developed and piloted in a participatory approach with the RESPoNsE Patient Advisory Board. The results were analyzed descriptively using SPSS and discussed with the advisory board. RESULTS: 1,405 questionnaires from 37 practices were analyzed. 97% of respondents felt that the treatment they received at their GP practice during the COVID-19 pandemic was good. For the vast majority, appointments and acute consultations, prescriptions, laboratory tests, discussions of diagnostic results, routine follow-up check-ups and health checks were available to a sufficient extent. From the patients' perspective, the practices have successfully adapted to the challenges caused by COVID-19. Overall, the patients' trust in and their appreciation of the work of the practice staff have increased since the pandemic. Patients stated that GP practices should continue hygiene procedures, such as wearing a mask or keeping physical distance, in the future. DISCUSSION: Despite multiple reports of a significant decline in both provision and utilization of standard care in GP practices during the pandemic, our survey showed that the majority of patients felt that they received adequate GP care and were highly satisfied. The results should be interpreted against the background of possible selection bias. CONCLUSION: In this survey, GP patients were predominantly appreciative of GP care during the COVID-19 pandemic. The patients' assessment of the provision and use of GP services during the pandemic complements the corresponding perspective of GPs and medical practice assistants.

Framing Later Life Vulnerability during the COVID-19 Pandemic: A Content Analysis of Newspaper Coverage in Canada and the United States.

This study explores vulnerability narratives used in relation to older adults and others during the COVID-19 pandemic. A mixed-method content analysis was conducted of 391 articles published in two major newspapers in Canada and the USA during the first wave of the pandemic. The findings indicated that during the early months of the pandemic, limited attention was directed towards its impact on older adults or other 'vulnerable' subpopulations in both countries. Where evident, intrinsic (individual-level) risk factors were most consistently used to frame the vulnerability of older adults. In contrast, vulnerability was more likely to be framed as structural with regard to other subpopulations (e.g., ethno-racial minorities). These narratives also differed somewhat in Canadian and US newspapers. The framing of older adults as intrinsically vulnerable reflects ageist stereotypes and promotes downstream policy interventions. Greater attention is needed to the role of structural factors in influencing pandemic-related outcomes among older adults.

Covid-19 psychological distress: Analysis of antipsychotic drugs' use in an Italian population sample.

BACKGROUND: The current pandemic, in addition to putting a strain on healthcare systems and global economies, has exacerbated psychiatric problems and undermined the mental health of many individuals. In an Italian cohort, this phenomenon has been assessed through a retrospective study aimed at evaluating the consumption and costs of antipsychotic drugs between 2020 and 2022. METHODS: All dispensations made in local pharmacies accessible to the public have been extracted from a database called 'Sistema Tessera Sanitaria', which covers a population of approximately one million people residents in the ASL Napoli 3 Sud. Consumption data expressed in defined daily dose (DDD) and expenditure data expressed in Euro have been extrapolated. RESULTS: The results in the years 2020-2021 were relatively consistent, with consumption and expenditure decreasing slightly from 2020 to 2021. In 2022, the results showed a decrease in consumption and expenditure (2,706,951.07 DDD and €1,700,897.47) representing the reduced accessibility of patients to the healthcare facilities due to the pandemic. However, it should be noted that the antipsychotic drug aripiprazole showed an upward trend, registering an increase in consumption. CONCLUSION: Despite expectations of increased consumption of antipsychotic medications, real-world evidence indicated a different phenomenon, with the pandemic seemingly not affecting the consumption of these drugs. The difficulty in accessing care and medical appointments has probably influenced this data, masking the therapeutic needs of citizens. It will be necessary to assess in the coming years, as normal clinical activity resumes, whether there will be a growing consumption of these medications, which represent one of the main expenditure categories for the National Healthcare System.

From Compliance to Care: Qualitative Findings from a Survey of Essential Caregivers in Ontario Long-Term Care Homes.

BACKGROUND: The COVID-19 pandemic highlighted the importance of the care provided by family members and close friends to older people living in long-term care (LTC) homes. Our implementation science team helped three Ontario LTC homes to implement an intervention to allow family members to enter the homes during pandemic lockdowns. OBJECTIVE: We used a variety of methods to support the implementation, and this paper reports results from an Ontario-wide survey intended to help us understand the nature of the care provided by family caregivers. METHODS: We administered a survey of essential caregivers in Ontario, and a single open-ended question yielded a substantial qualitative data set that we analysed with a coding and theming procedure that yielded 13 themes. FINDINGS: The 13 themes reveal deficiencies in Ontario's LTC sector, attempts to cope with the deficiencies, and efforts to influence change and improvement. DISCUSSION: Our findings indicate that essential caregivers find it necessary to take on vital roles in order to shore up two significant gaps in the current system: they provide psychosocial and emotional (and sometimes even basic) care to residents, and they play a monitoring and advocacy role to compensate for the failings of the current regulatory compliance regime.

[Barriers to entry into Ehpad since the Covid-19 crisis: a qualitative study of people over 65 in Marseille]. / Freins à l'entrée en Ehpad depuis la crise Covid-19 : étude qualitative auprès de personnes âgées de plus de 65 ans à Marseille.

From the outset of the Covid-19 health crisis, residential care facilities for the dependent elderly (Ehpad) were faced with health and safety challenges. Strict infection prevention measures, such as visiting restrictions and the implementation of sanitary protocols, have been essential to protect residents. While Ehpad occupancy rates were stable before the health crisis, they fell sharply in the aftermath of Covid-19.

[Chronology of the ISO 9001:2015 certification and satisfaction survey in the multidisciplinary Clinical Investigation Center (CIC) of the historic Saint-Louis Hospital during the COVID-19 pandemic]. / Chronologie de la certification ISO 9001:2015 et enquête de satisfaction au sein du centre d'investigations cliniques plurithématique (CIC-P) de l'historique hôpital Saint-Louis en période de pandémie du COVID-19.

The main objectives of multidisciplinary clinical investigation center (CIC-P) are to facilitate the availability of new drugs for patients, to enhance the visibility and attractiveness of French clinical research, to improve the quality of early phase trials, and to enhance the value of academic research by evaluating molecules in rare diseases. Since 2017, the CIC-P has been committed to a quality approach process, launching in 2018 its first satisfaction survey on patient care and clinical trial management of all its employees. A second satisfaction survey targeted by profession type was to be launched in 2020, in view of the requirements of the ISO 9001:2015 standard, but the process was interrupted following the coronavirus diseases 2019 (COVID-19) pandemic. The successful reorganization of the CIC-P activity during the first containment of the COVID-19 pandemic was driven by the implementation of a quality management system that promotes continuous improvement through the organization and involvement of all the staff. This voluntary and participative approach motivated the CIC-P to apply for the organizational sesame. The ISO 9001:2015 certification of CIC-P aims at increasing its performance, to satisfying its customers and to fully integrate its activities in a continuous improvement process, according to the requirements of this international standard, through the deployment of quality tools such as The Deming wheel (PDCA), an indispensable tool for transformation and reorganization; the analysis of the environment by the strengths, weakness, opportunities, threats (SWOT) analysis tool; the analysis and management of risks by the FMEA method, and all with performance indicators (SMART) and precise objectives at each stage of a project/process. The implementation of satisfaction questionnaires remains the essential tool for evaluating the expectations and needs of interested parties, but also for improving the quality of CIC-P activities and services. All these tools put in place have allowed us to continuously improve the means of production and to constantly improve our organization.

Validation of the French COVID-Related Thoughts and Behavioral Symptoms Questionnaire (Cov-Tabs): A self-report assessment.

OBJECTIVES: The COVID-Related Thoughts and Behavioral Symptoms (Cov-Tabs) is a self-reported questionnaire developed to identify the presence of psychological distress and anxiety-related behavior associated with COVID-19. This scale has been used since the first episodes of mass contamination of COVID-19 disease in the USA without psychometric validation analysis. The objective of this paper is to validate the French version of the Cov-TaBS. METHOD: In this study, we assessed a French translation of Cov-Tabs in 300 subjects from the general population. Moreover, we assessed convergent and discriminant validities using an anxiety and depression scale and a paranoid ideation scale. Statistical analyses consisted of evaluating internal consistency, test-retest reliability, and construct validity as well. RESULTS: The French translation of the Cov-Tabs demonstrated high internal consistency and reliability, as well as good temporal stability over a period of less than 2 weeks. It also showed strong convergent validity with anxiety and depression traits and divergent validity with paranoid ideation. CONCLUSION: Our study indicates that the French version of the Cov-Tabs has robust psychometric properties and is a valid tool for evaluating behavioral symptomatology and thoughts related to COVID-19 disease. Therefore, the French version of the Cov-Tabs is a valid tool that can be used in French-speaking individuals.

Impact of the COVID-19 pandemic and lockdowns on emergency data related to mental health disorders in Nouvelle-Aquitaine, France.

This study estimates the association between emergency department (ED) visits for mental health disorders (MHDs) and the health context of the COVID-19 pandemic in the French region of Nouvelle-Aquitaine. This retrospective study took place between 2018 and 2021 using ED data. We defined the main exposure according to five periods: "Pre-pandemic (reference)", "First lockdown", "Second lockdown", "Third lockdown", and "Pandemic out-of-lockdown." We constructed the daily indicators for each MHD-related ED visit based on medical diagnoses. We described and then modeled the daily time series using generalized additive models with a quasi-Poisson regression. The analysis included 5,693,341 ED visits of which MHDs accounted for 4%. We observed a decline in ED use for most indicators, particularly during the first lockdown. Models revealed a statistically significant relative increase in ED visits for almost all MHDs during the first lockdown; for anxiety and child psychiatric disorders during the second lockdown; and only for child psychiatric disorders during the pandemic out-of-lockdown period. The public health crisis and lockdowns associated with the COVID-19 pandemic have been important sources of stress that could partially explain the deterioration of MHD indicators, thus leading to new public health concerns (notably among the youngest age group). Mental health is a major determinant of overall health and should therefore be considered in the management of crises that may require similar responses in the future.

Recommendations Related to Visitor and Movement Restrictions in Long-Term Care and Retirement Homes in Ontario during the COVID-19 Pandemic: Perspectives of Residents, Families, and Staff.

In Canada, long-term care and retirement home residents have experienced high rates of COVID-19 infection and death. Early efforts to protect residents included restricting all visitors as well as movement inside homes. These restrictions, however, had significant implications for residents' health and well-being. Engaging with those most affected by such restrictions can help us to better understand their experiences and address their needs. In this qualitative study, 43 residents of long-term care or retirement homes, family members and staff were interviewed and offered recommendations related to infection control, communication, social contact and connection, care needs, and policy and planning. The recommendations were examined using an ethical framework, providing potential relevance in policy development for public health crises. Our results highlight the harms of movement and visiting restrictions and call for effective, equitable, and transparent measures. The design of long-term care and retirement policies requires ongoing, meaningful engagement with those most affected.

Changing Roles and Responsibilities of Dietitians from Diverse Settings During the First Three Waves of the COVID-19 Pandemic in Nova Scotia.

Purpose: To explore the impact of the COVID-19 pandemic on Nova Scotian dietitian's roles, responsibilities, and professional development needs.Methods: We conducted a province-wide, online, exploratory survey with registered dietitians during the initial waves of the COVID-19 pandemic. Differences were explored with descriptive statistics by work sector (hospital/acute care; primary health/community or public health (PH); long-term care [LTC]; other [e.g., private practice, retail]).Results: Dietitians (n = 122) reported being most frequently challenged by stress and anxiety, changing work expectations, and rapidly evolving safety protocols during the pandemic. Those working in PH, primary health, and LTC reported experiencing more work responsibilities, more change, and perceived less employer support than dietitians in other sectors. Despite the identified challenges, most participants (70.7%) felt their education and training were sufficient to take on these new work roles. Primary and PH dietitians, however, more frequently perceived their skill sets to be under-utilized than other sectors. Key learnings from practice identified as being important for dietetic education included qualities such as resilience, problem-solving, flexibility, and self-care.Conclusion: These findings will be of interest to health administrators, professional bodies, and academic institutions to inform strategies for strengthening dietetic practice, building resilience, and preparing for future emergencies.

Experience report of two living systematic Cochrane reviews on COVID-19.

INTRODUCTION: Up-to-date systematic reviews (SRs) are essential for making evidence-based decisions. During the 2019 coronavirus (COVID-19) pandemic, there was a particular need for up-to-date evidence, making the living systematic review (LSR) approach an appropriate review type. However, this approach poses certain challenges. OBJECTIVE AND OUTLINE: We aim to provide practice insights and report challenges that we faced while conducting two Cochrane LSRs on COVID-19 treatments with (i) convalescent plasma and (ii) systemic corticosteroids. We address our objective with an experience report and share challenges of the following components based on Iannizzi et al. (2022): study design, publication types, intervention/comparator, outcomes, search strategy, review updates and transparent reporting of differences between review updates. RESULTS: Regarding the study design, the plasma LSR included different study designs because RCT data were not available at the beginning of the pandemic, whereas for the corticosteroids LSR, which started several months later, RCT data were already available. The challenges in both LSRs included the publication types (preprints were included with caution) and the intervention/comparator, for instance the unavailability of standard of care for either LSR, or SARS-CoV-2 variants occurrence. Further challenges in both LSRs occurred in the components "outcome sets" (which had to be adjusted) and "literature search". The decision criteria for updating were based on important studies and available resources in both LSRs and policy relevance in the plasma LSR. Transparent reporting of the differences between the various update versions were discussed for both LSRs. DISCUSSION AND CONCLUSION: In summary, there are similarities and differences regarding challenges of review components for both LSRs. It is important to keep in mind that the two LSR examples presented here were conducted in the wake of the COVID-19 pandemic. Therefore, many of the challenges are attributable to the pandemic and are not specific to LSRs, such as constant adjustments of the outcome sets or changes in the database search. Nevertheless, we believe that some of these aspects are helpful for LSR authors and are applicable to other LSRs outside the pandemic context, particularly in areas where new evidence is rapidly emerging.

Psicoterapia online durante a fase inicial da pandemia de COVID-19: desafios e benefícios percebidos / Online psychotherapy during the early phase of the COVID-19 pandemic: perceived challenges and benefits / Psychothérapie en ligne pendant la phase initiale de la pandémie de COVID-19: défis et avantages perçus / Psicoterapia en línea durante la fase inicial de la pandemia de COVID-19: retos y beneficios percibidos

Resumo: Este estudo tem como objetivo identificar os desafios e benefícios percebidos da psicoterapia online durante a fase inicial da pandemia de COVID-19. Trata-se de pesquisa exploratória e descritiva, com abordagem quanti-qualitativa. A amostra foi composta por 385 psicólogas(os) que preencheram um formulário online. Os dados quantitativos foram submetidos à análise estatística descritiva e as questões abertas à análise temática reflexiva. As categorias elencadas foram: (1) Aprendendo a lidar com a crise, que abarca os desafios identificados no ambiente online, com destaque para a insegurança dos profissionais devido à falta de domínio de aspectos técnicos, preocupações com questões éticas e resistência dos pacientes ao atendimento remoto; e (2) Expandindo as fronteiras da atuação, que concerne aos benefícios percebidos com o uso das plataformas digitais, como ampliação da oferta de atendimento psicológico e vantagens financeiras. A passagem da modalidade presencial para a psicoterapia online nos primeiros meses da pandemia de COVID-19 evidenciou tanto limites como possibilidades, além da necessidade de desenvolver competências específicas para a oferta de cuidado psicoterapêutico mediado por tecnologia digital.

Abstract: This study aims to identify the perceived challenges and benefits of online psychotherapy during the early phase of the COVID-19 pandemic. This is an exploratory and descriptive research with a quali-quantitative approach. The sample consisted of 385 psychologists who completed an online form. The data were subjected to descriptive statistical analysis and the open questions to reflective thematic analysis. The categories listed were: (1) Learning to deal with the crisis , which encompasses the challenges identified in the online setting, with emphasis on professionals' insecurity due to lack of mastery of technical aspects, concerns about ethical issues, and patients' resistance to remote care; and (2) Expanding the frontiers of practice , which refers to the benefits perceived with the use of digital platforms, such as expanding the offer of psychological care and financial advantages. The shift from face-to-face to online psychotherapy in the first months of the COVID-19 pandemic has highlighted both limits and possibilities, as well as the need to develop specific skills to offer technology-mediated psychotherapeutic care.

Résumé : Cette étude vise à identifier les défis et les avantages perçus de la psychothérapie en ligne pendant la phase initiale de la pandémie de COVID-19. Il s'agit d'une recherche exploratoire et descriptive, avec une approche quanti-qualitative. L'échantillon était composé de 385 psychologues qui ont répondu à un formulaire en ligne. Les données numériques ont été soumises à une analyse statistique descriptive et les questions ouvertes à une analyse réflexive thématique. Les catégories énumérées étaient les suivantes: (1) Apprendre à faire face à la crise , qui englobe les défis identifiés dans la thérapie en ligne, notamment l'insécurité des professionnels due au manque de maîtrise des aspects techniques, les préoccupations liées aux questions éthiques et la résistance des patients aux soins à distance; et (2) Élargir les frontières de l'action, qui renvoie aux avantages perçus de la psychothérapie en ligne, tels que l'élargissement de l'offre de services de soins psychologiques et les avantages financiers. La transition de la psychothérapie présentielle vers la psychothérapie en ligne au cours des premiers mois de la pandémie de COVID-19 a mis en évidence les limites et les possibilités, ainsi que la nécessité de développer des compétences spécifiques pour l'offre de psychothérapie médiatisée par les technologies de la communication.

Resumen: Este estudio tiene como objetivo identificar los retos y beneficios percibidos de la psicoterapia en línea durante la fase inicial ola de la pandemia de COVID-19. Se trata de una investigación exploratoria y descriptiva, con enfoque cuanticualitativo. La muestra estaba compuesta por 385 psicólogos(as) que respondieron a un formulario en línea. Los datos numéricos se sometieron a un análisis estadístico descriptivo, y las preguntas abiertas, a un análisis temático reflexivo. Las categorías enumeradas fueron las siguientes: (1) Aprender a hacer frente a la crisis , que abarca los retos detectados en la terapia en línea, especialmente la inseguridad de los profesionales debido a la falta de dominio de los aspectos técnicos, las preocupaciones por las cuestiones éticas y la resistencia de los pacientes a la atención a distancia; y (2) Ampliar las fronteras de actuación , que se refiere a los beneficios percibidos con el uso de las plataformas digitales, como la ampliación de la oferta de atención psicológica y las ventajas financieras. La transición a la psicoterapia en línea en los primeros meses de la pandemia de la COVID-19 puso de relieve tanto los límites como las posibilidades, así como la necesidad de desarrollar habilidades específicas para la prestación de atención psicoterapéutica mediada por las tecnologías de la información y comunicación.

... "Mas agora é outro sentido": uma leitura do trauma nas tecituras do trabalho psíquico adolescente / ... "But now it has different meaning": a reading of trauma in the textures of adolescent psychic work / ... "Pero ahora es otro sentido": una lectura del trauma en las tramas del trabajo psíquico adolescente / ... "Mais maintenant est un autre sens": une lecture du trauma dans les tessitures du travail psychique adolescent

Resumo Este estudo objetiva discutir possíveis incidências e vicissitudes do traumático, considerando a pandemia covid-19, a partir das narrativas de adolescentes participantes do Projeto Jovem Aprendiz, em uma pesquisa-intervenção de caráter psicanalítico, com 26 adolescentes separados em dois grupos, entrevistados em quatro encontros. As narrativas evidenciaram um encurtamento de experiências, achatamento do tempo psíquico e dificuldade de elaboração, culminando em sentimentos de paralisia e inibição, dificuldade de projetar futuro e perfazer a experiência adolescente. Os encontros foram tomados, pelos adolescentes, enquanto medida potencializadora de fala, pois engendraram uma oferta de escuta, com possibilidades de produção de saídas simbólicas da experiência imobilizante do trauma. Tomamos a escrita do Diário de Anne Frank como inspiração para pensarmos sobre a fala que se forma pela função de escuta e desejo relacionado ao ato analítico. Consideramos fundamental, no trabalho com adolescentes, produzir janelas de abertura e espaços de fala engendrados pelo desejo e oferta de escuta.

Abstract This study aims to discuss possible incidences and vicissitudes of trauma, considering the COVID-19 pandemic, from the narratives of adolescents participating in the Young Apprentice Project, in a psychoanalytical research-intervention, with 26 adolescents separated into two groups, interviewed in four meetings. The narratives highlighted a shortening of experiences, a flattening of psychic time, and difficulties in elaboration, culminating in feelings of paralysis and inhibition, difficulty in projecting the future and making up the adolescent experience. The meetings were taken, by the adolescents, as a speech potentiating measure, since it engendered an offer of listening, with possibilities of producing symbolic outlets from the immobilizing experience of trauma. We took the writing of Anne Frank's Diary as inspiration to think about the speech engendered by the listening function and the desire regarding the analytical act. We consider it essential, while working with adolescents, to produce opening windows and spaces of discussion engendered by the desire and the offer of listening.

Resumen Este estudio tiene como objetivo discutir las posibles incidencias y vicisitudes de lo traumático durante la pandemia de la covid-19 a partir de las narrativas de adolescentes participantes del Proyecto Joven Aprendiz; para ello, se realizó una investigación-intervención psicoanalítica, con la aplicación de entrevistas a 26 adolescentes separados en dos grupos durante cuatro encuentros. Los relatos evidenciaron un acortamiento de las vivencias, aplanamiento del tiempo psíquico y dificultad en la elaboración, culminando en sentimientos de parálisis e inhibición, dificultad para proyectar el futuro y completar la experiencia adolescente. Los encuentros fueron considerados por los adolescentes como una medida potenciadora del habla, puesto que permiten la escucha, con posibilidades de producir salidas simbólicas de la experiencia inmovilizadora del trauma. Se tomó como inspiración el Diario de Anne Frank para pensar el discurso que se crea desde la función de escucha y el deseo relacionado con el acto analítico. Es fundamental, en el trabajo con adolescentes, generar espacios de apertura y de discurso basados en el deseo y la oferta de escucha.

Résumé Cette étude a pour objectif de discuter de possibles incidences et vicissitudes du traumatique, en considérant la pandémie de covid-19, à partir des narrations d'adolescents participants au Projet Jeune Apprenti, dans une recherche-intervention de caractère psychanalytique, avec 26 adolescents répartis en deux groupes, interviewées dans quatre rencontres. Les narrations ont mis en évidence un raccourcissement d'expériences, un aplatissement du temps psychique et une difficulté d'élaboration, culminant en sentiments de paralysie et d'inhibition, en une difficulté de projeter l'avenir et de parfaire l'expérience adolescente. Les rencontres ont été prises, par les adolescents, en tant que mesure potentialisatrice de parole, car elles ont engendré une offre d'écoute, avec des possibilités de production d'issues symboliques de l'expérience immobilisante du trauma. Nous avons pris l'écriture du Journal d'Anne Frank comme inspiration pour penser sur la parole engendrée par la fonction d'écoute et de désir relationné à l'acte analytique. Nous considérons comme fondamental, dans le travail avec des adolescents, de produire des fenêtres d'ouvertures et des espaces de parole engendrés par le désir et l'offre d'écoute.

WER HILFT DEN HELFERINNEN: GESUNDHEITS - UND PFLEGEPERSONAL IN DER PANDEMIEWHO HELPS THE HELPERS: HEALTH AND CARE PERSONNEL IN THE PANDEMIC.

In diesem Beitrag wird aufgezeigt, dass das Gesundheitspersonal während der COVID-19-Pandemie nicht nur physisch, sondern auch psychisch stark belastet war. Unterschiedliche Risikofaktoren wie ein junges Alter, das weibliche Geschlecht, ein niedriger sozioökonomischer Status und bereits bestehende psychische Erkrankungen spielten eine Rolle. Das Gesundheitspersonal zeigte erhöhten Stress, Symptome von Posttraumatischen Belastungsstörungen, Depressionen, Ängsten und Schlafstörungen. Eigene Studien zeigen auch, dass moralische Konflikte und eine unzureichende Unterstützung durch die Organisation und die Gesellschaft zu weiteren Belastungen führten. Die Bedeutung von Resilienz, die auf individueller, team- und organisationsbezogener Ebene gefördert werden sollte, spielt eine entscheidende Rolle. Hierfür sind Maßnahmen wie Stressmanagement-Trainings, Unterstützungssysteme, Kommunikation, Weiterbildung, emotionale Unterstützung und Partizipationsmöglichkeiten erforderlich. Auch politische Maßnahmen sind erforderlich, um das Wohlergehen des Gesundheitspersonals zu fördern, das sie die Gesetzgebung sowie die Verfügbarkeit von Akutunterstützung und die Förderung von Forschung und Innovationen beeinflussen.

[Does Provision of Care in Child and Adolescent Psychiatry End when Viruses Come? Hometreatment in Times of Covid-19]. / Hört KJP Versorgung auf, wenn Viren kommen? Hometreatment in Zeiten von Covid-19.

During the Covid-19 pandemic, provision of care in child and adolescent psychiatry was a challenge: Emergency presentations as well as psychiatric problems in children and adolescents increased, while at the same time capacity of inpatient treatment was reduced due to closed inpatient departments and staff shortage. Altogether quarantine, social distancing, testing and hygenic measures complicated daily life as well as inpatient treatment. This article describes the change in numbers of inpatient emergency admissions and prevalent mental health diagnoseses, as well as the role of hometreatment during Covid-19 pandemic. It can be demonstrated that the hometreatment team was able to operate without reduction of treatment capacities throughout the Covid-19 pandemic as long as they took care that basic hygienic measures were in place, Not one single case of Covid-19 infection was transmitted. Hometreatment proved to be an effective treatment alternative for children and adolescents with mental health problems and their families during Covid-19.

[Implications on the Diagnosis and Treatment of Narcissistic Personality Pathology in Adolescents Based on the Sequelae of the Covid-19 Pandemic]. / Implikationen für die Diagnostik und Behandlung der narzisstischen Persönlichkeitspathologie bei Jugendlichen in Folge der COVID-19-Pandemie.

The COVID-19 pandemic caused more adolescents with a pathological narcissistic personality to seek clinical as well as psychotherapeutic treatment due to suicidal crises, breakdown of social functioning and inability to continue school attendance. Recent study results show that youth with personality disorders (pd) had more trouble returning to school and to everyday life following pandemic related closures of schools. In a sample of adolescent patients with pd who were treated with transference focused psychotherapy (TFP-A) in a day-clinic programsignificantlymore juveniles remained absent fromschool during the pandemic then pre-pandemic. Only 42 % of the adolescents from the pandemic-group returned to school as a result of the treatment in comparison to 53%of the juvenile patients who returned to school after being treated before the pandemic. This might be explained by the specific effect the pandemic had on adolescents with narcissistic pd and their problem with being treated. Unfortunately, there is still hesitance in diagnosing and investigating narcissistic personality pathology in adolescence despite the knowledge that the early diagnosis and specified treatment could prevent unfavorable pathways and chronification of their severe problems. Changes in the conceptualization of pd in ICD-11 and DSM-5 enable a differentiated diagnosis beginning in late childhood. Furthermore, there are specialized manualized treatment approaches for adolescents with pd. This paper aims at illustrating the specific characteristics of narcissistic pd in youth as well as describing the symptom aggravation following the pandemic. It also points out the possibilities of a modified specialized treatment approach based on transference focused psychotherapy. Further research is needed to improve diagnostic and therapeutic modifications for juveniles with pd.

Substance use disorder in the context of the economic crisis, covid-19 pandemic and social unrest: a cross-sectional study across Beirut (2020-2021).

BACKGROUND: Substance use disorder (SUD) is related to the interplay of various factors. The primary objective of this study was to assess the variation in substance use (SU) among a set of Lebanese people undergoing treatment for SUD during the Lebanese economic crisis, COVID-19 pandemic, and Beirut Blast. METHODS: A cross-sectional study including Lebanese adults previously diagnosed with and being treated for SUD at the Skoun center was conducted. Data collection was done using a paper-based Arabic questionnaire tackling the economic crisis, the Covid-19 pandemic, and the Beirut Blast, as well as the following scores: APGAR, PHQ-9, GAD-7 and PCL-6. Data were analyzed using SPSS version 25.0 with P value<0.05 considered significant. A bivariate analysis was conducted to study the association between the use of substances and study variables and scores. RESULTS: The sample included 126 men and 10 women. Most participants had a stable consumption of illicit drugs (58.8%), alcohol (76.5%), prescription drugs (70.6%) and non-prescription drugs (89%). Additionally, most participants had concomitant mild or moderate depression (55.1%), mild or moderate anxiety (50.7%), and PTSD (61.8%). Factors found to significantly increase SU were economic distress, change in employment status, and decrease in working hours. PTSD was also identified as a risk factor for increased illicit drug and alcohol use. Furthermore, severe anxiety was found to be a risk factor for increased alcohol consumption. CONCLUSION: Most participants were able to maintain a stable pattern of SU despite the quadruple crisis in Lebanon highlighting the important role played by Lebanese Non-Governmental Organizations (NGOs) and efforts employed to control SUD.

Encrucijadas de la virtualidad. Niñeces y adolescencias en tiempos de incertidumbre y violencias / Crossroads of virtuality. children and adolescences in times of uncertainties and violence / Carrefour de la virtualité. les enfants et les adolescents en temps d'incertitudes et de violence / Encruzilhadas da virtualidade. infância e adolescência em tempos de incertezas e violências

Entre otros efectos, la pandemia produjo en niños y adolescentes un uso casi abusivo de las pantallas, como modo de conectarse con el mundo. Y mientras algunos las utilizaron para sostener redes afectivas, otros se encerraron en ellas y se aislaron del mundo, resultándoles después muy difícil el regreso. Estamos viendo ahora los efectos de esos tiempos de apego a la virtualidad y de ausencia de contacto con pares, tanto en la primera infancia, como en la edad escolar y en la adolescencia. Así, nos encontramos con un recrudecimiento de un modo de ubicarse por parte de los adultos frente a niñas, niños y adolescentes en el que no se toma en cuenta la lógica infantil, no se los escucha y no se toma en cuenta su sufrimiento. Esto lleva a que se supongan pandemias de TEA (Trastorno de Espectro Autista) y de TDAH (Trastorno por déficit de atención con hiperactividad).Los profesionales psi tenemos una enorme responsabilidad en esta época. Somos artífices de futuro. Es decir, podemos cambiar destinos de niñas, niños y adolescentes si entendemos que trabajar con ellos, en el ámbito que fuera, supone un posicionamiento que implica una representación del otro como ser humano, como sujeto merecedor de intercambios simbólicos AU

Among other effects, the pandemic led children and adolescents to an almost abusive use of screens as a way to connect with the world. While some used them to maintain affective relationships, others closed themselves off and isolated from the world, making it very difficult for them to return to in-person relationships afterward. We are now witnessing the effects of those times of attachment to virtuality and lack of contact with peers, both in early childhood, school-age and adolescence. Thus, we find an upsurge of a way for adults to position themselves in relation to children and adolescents, where the child's logic is not considered, they are not heard, and their psychological suffering is not taken into account. This leads to the assumption of pandemics of ASD (Autism Spectrum Disorder) and ADHD (Attention Deficit Hyperactivity Disorder). Psychologists have a huge responsibility in this era. We are architects of the future. That is, we can change the destinies of children and adolescents if we understand that working with them in any context involves a positioning that implies a representation of the other as a human being, as a subject deserving of symbolic exchanges AU

Entre autres effets, la pandémie a produit une utilisation presque abusive des écrans chez les enfants et les adolescents, comme moyen de se connecter avec le monde. Et tandis que certains les utilisaient pour entretenir des réseaux émotionnels, d'autres s'enfermaient et s'isolaient du monde, ce qui rendait très difficile leur retour ultérieur. Nous constatons aujourd'hui les effets de ces périodes d'attachement à la virtualité et d'absence de contact avec les pairs, tant dans la petite enfance qu'à l'âge scolaire et à l'adolescence.Ainsi, on constate une aggravation d'une manière de positionner les adultes envers les filles, les garçons et les adolescents dans laquelle la logique des enfants n'est pas prise en compte, ils ne sont pas écoutés et leurs souffrances ne sont pas prises encompte. Cela conduit à de supposées pandémies de TSA (trouble du spectre autistique) et de TDAH (trouble du déficit de l'attention avec hyperactivité). Nous, les professionnels du psi, avons une énorme responsabilité en cette période. Nous sommes les architectes du futur. Autrement dit, nous pouvons changer le destin des filles, des garçons et des adolescents si nous comprenons que travailler avec eux, quel que soit le domaine, implique un positionnement qui implique une représentation de l'autre comme être humain, comme sujet digne d'échanges symboliques AU

Entre outros efeitos, a pandemia levou crianças e adolescentes a um uso quase abusivo das telas como forma de se conectar com o mundo. Enquanto alguns as utilizavam para manter redes afetivas, outros se fecharam nelas e se isolaram do mundo, tornando difícil o retorno a relações presenciais. Estamos agora testemunhando os efeitos desses tempos de apego à virtualidade e falta de contato com os pares, tanto na primeira infância quanto na idade escolar e na adolescência. Assim, nos deparamos com o recrudescimento de uma forma de posicionamento por parte dos adultos em relação a crianças e adolescentes, em que a lógica infantil não é considerada, eles não são ouvidos, e seu sofrimento psicológico não é levado em conta. Issoleva à suposição de pandemias de Transtorno do Espectro Autista (TEA) e Transtorno do Déficit de Atenção/Hiperatividade (TDAH).Os profissionais da psicologia têm uma enorme responsabilidade nesta época. Somos arquitetos do futuro. Ou seja, podemos mudar os destinos das crianças e adolescentes se compreendermos que trabalhar com e qualquer contexto envolve um posicionamento que implica uma representação do outro como ser humano, como sujeito merecedor de trocas simbólicas AU

[Study of the links between type 2 diabetes and geriatric criteria]. / Étude des liens entre diabète de type 2 et critères gériatriques.

Type 2 diabetes in the elderly remains a major concern for all healthcare professionals and is itself considered a "global pandemic". Its prevalence is high and will continue to increase in years to come, becoming more and more prevalent in the elderly and very elderly. We offer a general summary of the work focusing on the links between type 2 diabetes and geriatric criteria.

Iranian Pharmacist's Experiences of COVID-19 Pandemic: A qualitative study.

BACKGROUND: Since the 2019 COVID-19 pandemic is not the first and will not be the last, pharmacists' experiences during this period can be used to establish a more efficient healthcare system to face future pandemics. OBJECTIVE: This study aims to explore Iranian pharmacists' experiences in pharmacies using the content analysis method. METHODS: In this qualitative study, a conventional content analysis approach was applied. Ten male and female pharmacists working in community pharmacies in Birjand, Iran participated using a purposeful sampling method. Semi-structured interviews were carried out for data collection. The data were analyzed using Graneheim and Lundman's method. RESULTS: Four categories and ten subcategories were extracted as follows: Multifaceted concerns of pharmacists (familial, economical, professional, and personal concerns), Non-compliance with protocols from occurrence to cause (facing non-compliance with protocols by clients, obstacles to complying with protocols in the pharmacy), Prevention from COVID-19 (protective equipment usage, designing protection rules), and Double reactions to COVID-19 (emotional and; practical reactions). CONCLUSIONS: Pharmacists dealt with different concerns and challenges during the COVID-19 pandemic. They are one of the main primary care providers and need to be supported by the authorities to maintain their standard level of services.