Teachers' emotional well-being during the SARS-CoV-2 pandemic with long school closures: a large-scale cross-sectional survey in Northern Italy.

OBJECTIVES: This study aimed to evaluate the magnitude of emotional burden on teaching staff during the SARS-CoV-2 pandemic in a significantly impacted region. In addition, the correlates of emotional burden were analysed to enable the design of targeted interventions. STUDY DESIGN: This study was a cross-sectional survey. METHODS: An electronic survey was administered to the teaching staff at public schools and kindergartens in a specific geographical area. Cross-sectional assessments of pandemic-specific variables were performed using the Pandemic Fatigue Scale, the Depression Anxiety Stress Scale (DASS)-21, the Satisfaction with Life Scale, and the Resilient Coping Scale. DASS-21 results were compared with results from a parallel survey that was representative of the local general population. RESULTS: In total, 3251 teaching staff members participated in the survey. Teachers showed a higher emotional burden for depression, anxiety and stress than the general population during the pandemic. According to a linear regression model, this burden is correlated with the language in which the questionnaires were answered, mistrust towards institutions, specific SARS-CoV-2 anxiety, past infection with SARS-CoV-2, avoidance of information about the pandemic and pandemic fatigue; emotional burden was negatively correlated with measures for life satisfaction, resilience and team atmosphere. Some independent variables were shown to contribute differentially to the variance of depression, anxiety or stress. CONCLUSIONS: Emotional distress during the pandemic among teachers is higher than in the general population and correlates with variables that could, at least in principle, be targeted for specific interventions.

Estimating linkages between forest structural variables and rainfall interception parameters in semi-arid deciduous oak forest stands.

An understanding of the relationship between canopy structure and the water balance is needed for predicting how forest structure changes affect rainfall partitioning and, consequently, water resources. The objective of this study was to predict rainfall interception (I) and canopy storage capacity (S) using canopy structure variables and to investigate how seasonal changes influence their relationship. The study was conducted in twelve 50m×50m plots in the Zagros forest in the western Iranian state of Ilam, protected forests of Dalab region. Average cumulative I was 84.2mm, accounting for 10.2% of cumulative gross precipitation (GP) over a 1-year period. Using a regression based method, S averaged ~1mm and 0.1mm in the leafed and leafless periods, respectively. There were no relationships between tree density and I:GP or S, but I:GP and S increased with leaf area index, canopy cover fraction, basal area, tree height, and diameter at breast height in the leafed period. In addition, wood area index and canopy cover fraction were related to I:GP or S in the leafless period.

Clinical comparisons of posturography and electronystagmography.

A retrospective study was conducted of 103 balance-disturbed patients of mixed etiologies tested with electronystagmography (ENG) and computerized dynamic posturography (CDP). CDP was abnormal for 83% of the group as compared to 42% abnormal ENG results. In cases of otolithic dysfunction, ENG was more sensitive and gave specific information. Results of this preliminary study indicate that CDP has merit when used in the evaluation of patients with undifferentiated balance complaints. ENG testing is still needed in cases of vestibular dysfunction to establish anatomic level and laterality as well as for lesions involving the otolith. Additional study will be needed to verify these findings and to develop a means of detecting otolith dysfunction with CDP.

Meningitis: the influence of routine otolaryngologic consultation on morbidity and mortality in 290 cases.

A prospective study was designed to obtain data on all meningitis patients admitted to a large county Communicable Disease Unit. The epidemiologic and clinical features of 290 cases were analyzed to ascertain the effect of routine O.R.L. consultation on the morbidity and mortality of this disease. The results of physical examination provided current statistics as to the existence of ear, nose, and throat diseases associated with meningitis.

The pitfalls of limiting ENG testing to patients with vertigo.

A high incidence of patients who do not experience vertigo with unilateral vestibular disease has been observed. Recognizing that many clinicians perform electronystagmographic vestibular testing on only patients who describe vertigo, a retrospective study of 229 patients was designed to study the potential pitfalls of this practice. The results confirm a preliminary study and show that 66% of the patients described no vertigo. Included were 13 intracranial lesions of which only one had the classic symptom. Differences in cortical perception and adaptation are postulated as factors responsible for these and other observations relative to caloric stimulation, torsion swing testing, and the presence of spontaneous nystagmus.

Remote monitoring of evoked potentials.

The clinical value of evoked potential testing is now well established. The general availability of this form of testing is currently limited by cost of the equipment and availability of personnel not only to operate it but also to interpret the results. These limiting factors can be reduced by remote monitoring, a technique that utilizes a data program designed to transmit processed responses via standard telephone lines to a central location. The practicality of this method of testing and the considerations that should be given with regard to development of such a program are discussed.

Comparison of symptoms and laboratory findings in unilateral vestibular dysfunction.

Although vertigo is the expected symptom of unilateral vestibular disease, exceptions have been observed. To determine the relative frequency of this observation, a retrospective study of patients seen over a 1-year period was done. Of the 126 patients found to have unilateral labyrinthine impairment with bithermal caloric testing, only 58 (46%) characterized their symptoms as vertigo. The ramifications of these findings are discussed, and a question is raised as to the propriety of reserving vestibular testing for only those patients describing vertigo.

Positional nystagmus in association with macroglobulinemia.

Summary--Waldenstrom's macroglobulinemia is a malignant lymphoproliferative disease associated with a monoclonal macroglobulinemia. Most explanations of the cochlear and vestibular symptoms in this disease have dealt with vascular thrombotic or hemorrhagic phenomena. Five patients currently being treated for macroglobulinemia have been reviewed. Three patients gave a history of periodic dizziness and underwent extensive neuro-otologic examination. The results suggestsed an alternate mechanism for the pathophysiology of the vestibular disturbance in macroglobulinemia. Vestibular examination by use of electronystagmography provided information which suggest that the cupulae may be altered by the macroglobulins to act as gravity receptors.

Thermal hazard during mastoid surgery.

Torque speed characteristics of two mastoid drills were measured. Potential temperature elevations in temporal bones were calculated from these measurements. Measured temperature elevations in temporal bones drilled without irrigation agreed well with predictions. Irrigation was demonstrated to be of critical importance in minimizing thermal hazard from mastoid drills.

Cordless telephones: a threat to hearing.

Several patients with documented permanent sensorineural hearing losses secondary to the use of cordless telephones have been evaluated. In the interests of saving space and weight, these units have the ear receiver double as the ringing or bell device. The output of the bell on all of the units we have tested to date has been in the 140-dB range on the A scale. In each instance, the patient held the telephone against the ear when ringing occurred, and in three instances a loud extraneous crack was transmitted. Unlike regular cord-type telephones, these devices have no automatic gain control in the receiver circuit.

How aging affects the ear.

With aging, a different variety of ear diseases becomes more common. External ear disease is often a local reflection of generalized skin problems aggravated by retained water or local manipulation. Hearing loss may be the result of long-standing middle ear disease rather than aging. In this situation, the inconveniences and possible dangers of a chronically infected ear may be resolved with surgical intervention. Nasopharyngeal or lymphomatous disease must be suspected in any geriatric patient manifesting middle ear disease for the first time. Like presbyopia, presbycusis is a normal consequence of aging. It may be severe, but it does not lead to total deafness and equally involves both ears. Early discovery of the condition and institution of hearing rehabilitation methods will minimize the individual's communicative handicap and tendency to withdraw from society. Unilateral or asymmetric sensorineural hearing loss should be thoroughly evaluated for the purpose of identifying a curable and potentially life-threatening disease.

Common ear diseases: recognition and management.

External otitis is directly related to patient habit patterns. It is easily treated, but the habits must be changed to effect permanent cure. Serous otitis media is the most common cause of conductive hearing loss, and its presence my predispose to development of purulent otitis media. Removal of middle ear fluid may be advisable in persistent serous otitis and is recommended in acute purulent otitis.

Genetic influence on dental arch form in orthodontic patients.

Human arch form varies considerably. This study analyzed the size and shape of the maxillary and mandibular dental arches of 320 adolescents from 155 sibships. A broad battery of measurements (k = 48) was computer-generated from Cartesian coordinates of cusp tips and line angles of the permanent teeth, and heritability estimates were generated from intraclass correlations, controlling for sex and age where indicated. Arch size has a modest genetic component, on the order of 50%, although this estimate may contain shared environmental influences. Tooth rotations have low h2 estimates, most of them indistinguishable from zero. Arch shape, assessed as length-width ratios, also has a modest transmissible component, suggesting that arch length and width growth factors are largely independent. Highest heritability estimates, as a group, were for transverse arch widths, which averaged about 60%. Several measures of left-right asymmetry also were analyzed (k = 31), and, while the arches are systematically asymmetric (generally with left > right), there is only weak evidence of a transmissible component for directional asymmetry and essentially none for fluctuating asymmetry. In all, arch size and shape are seen to be more subject to environmental influences than to heredity. These findings direct attention toward the need to better understand what extrinsic factors modulate arch size and shape during development.