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The climate has an influence on the COVID-19 virus lethality. The aim of this study is to verify if the summer weather coincided with the decrease of the Case Fatality Ratio (CFR) in Europe and if, on the contrary, an inverse trend was observed in Australia and New Zealand. To verify our hypothesis, we considered the largest European countries (Germany, UK, France, Italy, and Spain), plus Belgium and the Netherlands. Furthermore, we compared these countries with Australia and New Zealand. For each country considered, we have calculated the CFR from the beginning of the pandemic to May 6th and from May 6th to September 21st (late summer in Europe, late winter in the southern hemisphere). The CFRs were calculated from the John Hopkins University database. According to the results, in all European countries, a progressive decrease in CFR is observed. A diametrically opposite result is found in Australia where, on the contrary, the CFR is much higher at the end of September (at the end of winter) than on May 6th (mid-autumn), and the risk of dying if we count the infection is higher in September. In New Zealand, there are no statistically significant differences between the two surveys. The present study was based on public access macro data.

PURPOSE: The present study seeks to examine gender differences in internalizing and externalizing problems either parent/teacher or self-reported and to investigate the influence of country-level gender gap on children's mental health problems across countries with high and low gender gap across Europe. METHODS: The School Children's Mental Health in Europe (SCMHE) survey collected data on primary school children living in six European countries, using self-reports (SR) from children (Dominic Interactive), as well as combination of parent- and teacherreports (P/T C) (Strengths and Difficulties Questionnaire) to assess internalizing and externalizing mental health problems. The World Economic Forum's (WEF's) Global Gender Gap report's Gender Gap Index (GGI) was used to categorize countries with high and low gender gap. RESULTS: Boys had greater odds of externalizing problems (OR = 2.6 P/T C, 1.95 SR), and lower odds of internalizing problems (OR = 0.85 P/T C, 0.63 SR). The gender gap's association with mental health problems was different depending on the informant used to identify these problems. A small gap was a risk factor based on reports from adults for externalizing (OR = 1.53) and internalizing problems (OR = 1.42) while it was a protective factor for SR internalizing problems (OR = 0.72). For these problems the gender gap impacted boys and girls differently: a small gender gap was protective for boys but not for girls, including when controlling for key confounding variables. CONCLUSIONS: The differential impact of country-level gender gap observed between self-reported and parent- or teacher-reported mental health is complex but nevertheless present trough mechanisms that are worthwhile to study in depth, with a special attention to the informants and the type of problems examined.

BackgroundBullying behavior is recognized internationally as a serious issue associated with mental health and functioning problems among children.ObjectiveThe present study sought to determine the associations between bullying involvement and self-reported mental health among elementary school children across seven European countries.Participants and settingThe School Children Mental Health in Europe study was conducted in Bulgaria, Germany, Italy, Lithuania, the Netherlands, Romania and Turkey in 2010 using similar methodology to collect cross-sectional data from children, parents, and teachers.MethodsThe study focused on children who had completed the Dominic Interactive and whose mother and/or teacher had completed the Strengths and Difficulties Questionnaire (n = 5,183).ResultsOverall 14.3 % of children were identified as bullies, 18.2 % as victims and, 19.0 % as both bullies and victims. Despite the low threshold for defining bullying status, children identified as being involved were highly likely to present with self-reported mental health problems: 31.6 % of bully-victims reported any disorder, while 25.4 % of bullies and 23.1 % of victims did. Adjusting for key factors, bullies and bully-victims were significantly more likely to present with any externalizing disorder, while victims were not. Additionally, bully-victim status was associated with significantly greater odds of presenting with each internalizing disorder: phobia (AOR = 1.48, 95 %CI = 1.01–2.19), GAD (AOR = 2.54, 95 %CI = 1.67–3.87), separation anxiety (AOR = 1.88, 95 %CI = 1.43–2.47) and depression (AOR = 2.52, 95 %CI = 1.61–3.93). However, victim status was only associated with GAD (AOR = 1.63, 95 %CI = 1.07–2.48) and bully status with separation anxiety (AOR = 1.44, 95 %CI = 1.07–1.93).ConclusionsThe results highlight the association of bullying involvement and child mental health in elementary school children across Europe.

To explore the prevalence of Aberrant Salience (AS, an alleged experiential feature of psychosis-proneness) in Italian young people and corroborate the transcultural validity of the Aberrant Salience Inventory (ASI).Young adults attending an Italian university (n = 649) underwent serial evaluations with the ASI together with psychometric proxies for help seeking General Health Questionnaire and attenuated positive and negative symptoms Schizotypal Personality Questionnaire (SPQ). The distribution of ASI scores was explored with latent class analysis (LCA).Reliability of the Italian version of the ASI (I-ASI) was acceptable for all subscales (ordinal alpha.70). Concurrent validity was in the expected direction, with higher correlations with measures of attenuated positive symptoms vs negative symptoms of psychosis (Steigers' z test, P.005 in all comparisons). LCA identified three classes, with 217 (33.4%) participants in the "high aberrant salience" class. Gender and age were not related to class membership. Compared to the baseline class, SPQ scores in the schizotypy range were more likely in the "high aberrant salience" class (OR = 39.1; 95%confidence interval: 5.30-288.1).AS is a relatively common experience among Italian young people. The study also confirmed the validity of field-testing ASI as a tool for the real-world characterization of people with vulnerability to psychosis, such as symptomatic help seekers with clinical high-risk states.

Background: Physical activity in the elderly is recommended by international guidelines to protect against cognitive decline and functional impairment. Objective: This Randomized Controlled Trial (RCT) was set up to verify whether medium-intensity physical activity in elderly people living in the community is effective in improving cognitive performance. Design: RCT with parallel and balanced large groups. Setting: Academic university hospital and Olympic gyms. Subjects: People aged 65 years old and older of both genders living at home holding a medical certificate for suitability in non-competitive physical activity. Methods: Participants were randomized to a 12-week, 3 sessions per week moderate physical activity program or to a control condition focused on cultural and recreational activities in groups of the same size and timing as the active intervention group. The active phase integrated a mixture of aerobic and anaerobic exercises, including drills of “life movements”, strength and balance. The primary outcome was: any change in Addenbrooke's Cognitive Examination Revised (ACE-R) and its subscales. Results: At the end of the trial, 52 people completed the active intervention, and 53 people completed the control condition. People in the active intervention improved on the ACE-R (ANOVA: F(1;102)=4.32, p=0.040), and also showed better performances on the memory (F(1;102)=5.40 p=0.022) and visual-space skills subscales of the ACE-R (F(1;102)=4.09 p=0.046). Conclusion: A moderate-intensity exercise administered for a relatively short period of 12 weeks is capable of improving cognitive performance in a sample of elderly people who live independently in their homes. Clinical Trials Registration No: NCT03858114

Background Aging is marked by a progressive rise in chronic diseases with an impact on social and healthcare costs. Physical activity (PA) may soothe the inconveniences related to chronic diseases, has positive effects on the quality of life and biological rhythms, and can prevent the decline in motor functions and the consequent falls, which are associated with early death and disability in older adults. Methods We randomized 120 over-65 males and females into groups of similar size and timing and will give each either moderate physical activity or cultural and recreational activities. Being younger than 65 years, inability to participate in physical activity for any medical reason, and involvement in a massive program of physical exercise are the exclusion criteria. The primary outcome measures are: quality of life, walking speed, and postural sway. Participants are tested at baseline, post-treatment, and 6-month (24 weeks) and 12-month (48 weeks) follow-ups. Discussion This study aims at improving the quality of life, wellness, and cognitive functioning in the elderly through a low-cost affordable program of moderate physical activity. Given the growing aging of the world population and the social and economic burden of disability in the elderly, our results might have a major impact on future practices. Trial registration ClinicalTrials.gov NCT03858114. Registered on 28 February 2019.

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Background For ICD-11, the WHO emphasized the clinical utility of communication and the need to involve service users and carers in the revision process. Aims The objective was to assess whether medical vocabulary was accessible, which kinds of feelings it activated, whether and how users and carers would like to rephrase terms, and whether they used diagnosis to talk about mental health experiences. Method An innovative protocol focused on two diagnoses (depressive episode and schizophrenia) was implemented in 15 different countries. The same issues were discussed with users and carers: understanding, feelings, rephrasing, and communication. Results Most participants reported understanding the diagnoses, but associated them with negative feelings. While the negativity of “depressive episode” mostly came from the concept itself, that of “schizophrenia” was largely based on its social impact and stigmatization associated with “mental illness”. When rephrasing “depressive episode”, a majority kept the root “depress*”, and suppressed the temporal dimension or renamed it. Almost no one suggested a reformulation based on “schizophrenia”. Finally, when communicating, no one used the phrase “depressive episode”. Some participants used words based on “depress”, but no one mentioned “episode”. Very few used “schizophrenia”. Conclusion Data revealed a gap between concepts and emotional and cognitive experiences. Both professional and experiential language and knowledge have to be considered as complementary. Consequently, the ICD should be co-constructed by professionals, service users, and carers. It should take the emotional component of language, and the diversity of linguistic and cultural contexts, into account.

Objective: To explore whether the climate has played a role in the COVID-19 outbreak, we compared virus lethality in countries closer to the Equator with others. Lethality in European territories and in territories of some nations with a non-temperate climate was also compared. Materials and Methods: Lethality was calculated as the rate of deaths in a determinate moment from the outbreak of the pandemic out of the total of identified positives for COVID-19 in a given area/nation, based on the COVIDJohn Hopkins University website. Lethality of countries located within the 5th parallels North/ South on 6 April and 6 May 2020, was compared with that of all the other countries. Lethality in the European areas of The Netherlands, France and the United Kingdom was also compared to the territories of the same nations in areas with a non-temperate climate. Results: A lower lethality rate of COVID-19 was found in Equatorial countries both on April 6 (OR=0.72 CI 95% 0.66-0.80) and on May 6 (OR=0.48, CI 95% 0.47-0.51), with a strengthening over time of the protective effect. A trend of higher risk in European vs. non-temperate areas was found on April 6, but a clear difference was evident one month later: France (OR=0.13, CI 95% 0.10-0.18), The Netherlands (OR=0.5, CI 95% 0.3-0.9) and the UK (OR=0.2, CI 95% 0.01- 0.51). This result does not seem to be totally related to the differences in age distribution of different sites. Conclusions: The study does not seem to exclude that the lethality of COVID-19 may be climate sensitive. Future studies will have to confirm these clues, due to potential confounding factors, such as pollution, population age, and exposure to malaria.

Populations fleeing war have often suffered or have witnessed violence, persecution, and imprisonment; they are at high risk of exposure to traumas and consequently to manifesting psychopathologies, stress-related disorders, and post-traumatic stress disorder (PTSD). Regarding the condition of refugees, factors inherent in the conditions of escaping, traveling, and reception in the host country can also aggravate the psychopathology linked to previous traumas, or even add new ones. The prevalence of PTSD in refugee camps in Africa varies from 15.8% in Ethiopia to 37.4% in Algeria. The presence of any severe mental disorder ranged from 17.5% in Ethiopian to 60.5% in Algerian refugees. In people of three Sub-Saharan refugee camps in postwar scenarios in Darfur Hamid and Musa, 54% of people were found positive at a screening test for PTSD and 70% positive in a screening test for general distress. The literature contains several studies on small cohorts in refugee camps suffering from disorders who had been subjected to specific treatments. However, studies on population samples or entire refugee populations repeated over time are infrequent. One of the studies, considered as a milestone in this field, shows in Bosnian refugees in Croatia that 45% of those who met the DSM-IV criteria for depression or PTSD presented these disorders 3 years later, and 16% of asymptomatic persons developed the disorders. A decrease in psychiatric symptoms at follow-up was shown 10 years later, but people suffering from PTSD showed an upward trend and the presence of PTSD was found associated with the unsuccessful extinction of traumatic memories. The few studies found in the literature do not clarify what social mechanisms may occur in the processes of recovery of hope, also because the different circumstances studied probably present specific variables that characterize each situation. However, the results of some studies, even on minors, appear to suggest that restoring a condition of safety and responding to primary needs is not always associated with an improvement in general and stress-related psychopathology. We had previously evaluated a sample of refugees of Tuareg ethnicity who were living in the Subgandé refugee camp in Burkina Faso. At that time (immediately after the crisis in Mali), refugees in the camp were faced with strong tensions and fear. There were no international organizations guaranteeing security and survival. These refugees had fled from Mali with very little information on those who had remained behind. Meanwhile, interventions by Islamic extremists meant that the political and military situation was not going well for the Tuaregs, who were fighting for independence. The majority of the Tuareg rebels were in fact engaged in the MLNA (Mouvement de Liberation de l’Azawar), the lay and losing party of the Malian rebels (1). At that time, around 60% of our sample had screened positive for the contemporary presence of both psychopathological stress-related symptoms (as positivity to Short Screening Scale for PTSD) and for the presence of general psychopathological symptoms and impairment linked to psychopathology [as positivity to the K6 screening scale], thus indicating severe mental distress and probable PTSD. Women aged 40 and older were found to be at higher risk of PTSD symptoms. Younger women (39 or younger) had higher frequencies of K6 positivity, but the distribution of people with both PTSD and K6 scales positivity was homogeneous by gender and age. During the 2-year period, many people had left the Subgandé camp and had been relocated to other camps where they appeared to be better supported. In this follow-up study 2 years later, we retraced a substantial portion of the first sample, but many were about to return to Mali. The aim of the follow-up is to ascertain the health status of those previously interviewed and those we were able to trace. We wanted to see whether the amended general conditions (e.g., protection provided by international organizations and the conclusion of negotiations) had contributed to changes in the levels of mental distress.

Background:Research literature suggests that burnout, depression, and a low mental quality of life (QOL) are common among health care workers. Economic crisis might have increased the burden of burnout, depression and low QOL in health care workers.Objectives:To identify depression risk, burnout levels, and quality of life in a sample of workers of an Italian university hospital.Method:Cross sectional study with comparison with two community surveys database results (n = 2000 and 1500, respectively). Overall, 522 workers accepted to take part in the study, representing a 78% response rate (out of 669 individuals).Results:The frequency of positivity at the screener for Major Depressive Disorder among health care workers was more than double than that in the standardized community sample (33.3% vs 14.1%, pi.e.those who do not have contact with patients), showed a statistically higher frequency of positivity for depressive episodes compared to the controls. Among the medical staff, the highest risk was found in the surgeon units, while the lowest one was in the laboratories. Surgeons also were those most exposed to high risk of burnout, as measured by the Maslach Burnout Inventory.Conclusion:Since burnout is linked to patient safety and quality of patient care, and contribute to medical errors, dedicated interventions aimed at reducing poor mental health and low quality of life in medical staff are indicated.