Dichotomous analysis of gaseous emissions as influenced by the impacts of COVID-19 in Brazil: São Paulo and Legal Amazon

Atmospheric contaminants severely impact air quality in large global urban centers. The emergence of COVID-19 in China in December 2019 and its expansion around the world reduced human activities on account of the implementation of a social isolation policy. In Brazil, COVID-19 arrived in February 2020, and a policy of social isolation was adopted in March by state governments; this work aimed to evaluate pollutant gas emissions in Brazil in the face of the pandemic. In the city of São Paulo, the concentrations of nitrogen dioxide (NO₂) and carbon monoxide (CO) were analyzed at three automatic monitoring stations of the Environmental Company of the State of São Paulo (CETESB). In this way, reductions in concentrations of these gases were observed after the decree of social isolation on March 24, due to a noticeable drop in vehicle traffic in the city. A reduction in concentrations of NO₂, between 53.6 and 73%, and a decrease in concentrations of CO, from 50 to 66.7%, were obtained at the monitoring stations. Another impact caused by COVID-19 was the increase in deforestation and fires was identified in the Brazilian Legal Amazon after social isolation, due to the decrease in the inspection of environmental agencies. The fires produce thermal degradation of the biomass, generating polluting gases and material particulate. These atmospheric contaminants are extremely harmful to the health of Amazonian populations. Summed to the expansion of COVID-19 in this region, all these factors combined cause the public health system to collapse. CO_2eq emissions increase estimates, according to the Greenhouse Gas Emissions Estimation System technical report, ranged from 10 to 20% in 2020, compared to those from 2018. If Brazil maintains deforestation at this pace, it will be difficult to meet the emission reduction targets agreed at COP21.

Social Isolation, Loneliness, and Mobile Phone Dependence among Adolescents During the COVID-19 Pandemic: Roles of Parent-Child Communication Patterns

During the COVID-19 pandemic, mobile phone dependence (MPD) became a common addictive behavior among adolescents because of social isolation. To understand the underlying mechanisms of the impact of social isolation on MPD, this study examined the mediating role of loneliness and the moderating role of parent-child communication patterns on social isolation and MPD. Six hundred and eighty-three adolescents from a middle school in Huang'gang city, China, were recruited to complete a self-report questionnaire. Data analysis comprised latent profile analysis and structural equation modelling. The results showed that social isolation had a significant and positive indirect effect on MPD via loneliness. In addition, three types of parent-child communication patterns were observed: complex, adaptive, and maladaptive. For adolescents with complex parent-child communication, the indirect relation of social isolation to MPD via loneliness is weaker than that of adolescents with maladaptive parent-child communication. These findings suggested that the indirect effect of social isolation on MPD via loneliness was moderated by parent-child communication patterns. Psychological intervention for MPD should emphasize relieving adolescents' loneliness and improving the quality of  their communication with parents during the COVID-19 pandemic.

Combined effect of daily physical activity and social relationships on sleep disorder among older adults: cross-sectional and longitudinal study based on data from the Kasama study

Background

This study investigated whether daily physical activity of older adults, combined with social relationships, is associated with the risk of sleep disorder. Further, it determined whether a high level of one variable with a low level of the other, leads to a significantly lower risk of sleep disorder than low levels of both.

Methods

The sample comprised 1339 community-dwelling older Japanese adults: 988 in Study 1 and 351 in Study 2. The level of daily physical activity and range of social relationships were assessed using the Physical Activity Scale for the Elderly and the Lubben Social Network Scale, respectively. The Pittsburgh Sleep Quality Index was used to assess sleep disorder. To test the combined relationships and effects in Studies 1 and 2, the medians for the respective scores of each of the following four groups that the participants were categorized into, were calculated: (1) low activity group with low social relationships, (2) low activity group with high social relationships, (3) high activity group with low social relationships, and (4) high activity group with high social relationships. After adjusting for potential confounders, a logistic regression analysis was conducted in Study 1. After adjusting for potential confounders, a Cox proportional hazards regression analysis was conducted in Study 2.

Results

Study 1 revealed that the high activity group with high social relationships showed a significantly lower risk of sleep disorder (ORs: 0.585, 95% CI: 0.404–0.847) than the low activity group with low social relationships. Study 2 also revealed that the high activity group with high social relationships showed a significantly lower prevalence of sleep disorder (HRs: 0.564, 95% CI: 0.327–0.974) than the low activity group with low social relationships.

Conclusions

Our findings suggest that for older adults with high social relationships, being physically active is favorably associated with sleep quality. However, a high level of one variable with a low level of the other has not been confirmed in improving sleep quality among older adults.

Social transformation and social isolation of older adults: Digital technologies, nursing, healthcare

Background

The incidence of social isolation among older adults is on the rise in today's health care climate. Consequently, preventing or ameliorating social isolation through technology in this age group is now being discussed as a significant social and health issue.

Aim

The purpose of the opinion paper is to clarify social transformation through technology and shed light on a new reality for older adults in situations of social isolation. Our goal is to persuade the reader that our position on this topic is a valid one. We support our claims with practice-based evidence and published research studies.

Methods

To do so, we checked the most recent literature, most of which came from the last decade. Our literature survey focused primarily on what is known about technology and how technology can affect social transformation and perceptions of social isolation.

Findings

Two dominant transformative realities became the focal points: the precarious implications of loneliness for older adults and the emerging reality of social change through digital technology central to eHealth and mHealth.

Discussion

To benefit from new technologies and reduce the detrimental effects of social isolation, we must engage older adults in a meaningful way and adapt the system of smart devices to reflect the specific physiological and psychological characteristics of the ageing population.

Conclusion

Older adults need to comprehend the meanings of their social experiences to preserve their active lifestyle. Human interactions may be desirable, but technological dominance may also minimize the adverse effects of social isolation.

Loneliness and mental health among the elderly in Poland during the COVID-19 pandemic

Background

The unexpected changes caused by the COVID-19 pandemic related to the fear of developing the disease, and the need for social distancing and isolation have had an effect on people’s mental health. These drastic changes can result in the development of anxiety, depressive symptoms and sense of loneliness. Elderly and chronically ill individuals are at a particularly high risk of developing COVID-19, suffering severe illness and dying as a result of it.

Aim of the study

The aim of the study was to assess the prevalence of anxiety, depressive symptoms, irritability and loneliness in the elderly aged 60 years and older as a group exposed to the negative impact of the COVID-19 pandemic, and to analyze the relationships between loneliness and mental health of the respondents and sociodemographic variables and chronic diseases.

Materials and methods

The study was conducted in Poland among 221 individuals aged 60+. The study material was collected using a sociodemographic questionnaire, Hospital Anxiety and Depression Scale (HADS-M) and a revised University of California Los Angeles loneliness scale (R-UCLA). Women accounted for 47.51% and men for 52.49% of study participants; the mean age was 65.18 (SD = 4.06).

Results

In total, according to HADS-M, depressive symptoms were present in 19.15% of the participants and borderline states in 14.18% of them. Based on R-UCLA, moderate and moderately high sense of loneliness was present in 58.83% of the participants. Sense of loneliness was significantly correlated with the prevalence of depressive symptoms (p < 0.001).

Conclusions

In this study, one in five participants experienced anxiety and depressive symptoms. Two out of three participants experienced a moderate sense of loneliness. Individuals who displayed a higher level of loneliness also had a higher severity of anxiety level depressive symptoms and irritability. Elderly individuals should be under special care due to their high risk of experiencing physical and mental effects of the COVID-19 pandemic.

Regulation of maternal behavior, social isolation responses, and postpartum estrus by steroid hormones and vaginocervical stimulation in sheep

Periparturient ewes display several activities in addition to maternal behavior per se. They isolate themselves from the flock and, contrary to other mammals, do not show postpartum estrus. We investigated the possibility of a common hormonal control of maternal behavior, prepartum social isolation responses, and absence of postpartum estrus. We quantified responses to flockmate separation and incidence of sexual receptivity at several reproductive stages in intact ewes (Experiment 1). Responses to social isolation were lowest in preparturient ewes and at pregnancy day 149, intermediate at pregnancy day 147 and highest at day 136 and in non-pregnant ewes (P < 0.05 between the 3 levels). In a second experiment, we quantified the same parameters and maternal behavior in 1) ovariectomized ewes receiving medroxyprogesterone acetate only (ovxMPA); 2) ovariectomized ewes receiving MPA + estradiol benzoate (ovxSHORT); 3) intact ewes receiving a longer MPA + estradiol dipropionate treatment, before and after vaginocervical stimulation (VCS). Before VCS no steroid treatments decreased social isolation responses and maternal behavior was scarce or absent. Following VCS and interaction with lamb, maternal responses in the ovxSHORT group increased while social isolation responses decreased. Sexual receptivity occurred in non-pregnant ewes and in ovxSHORT group. Conclusion: some hormonal treatments +VCS can effectively induce maternal behavior and reduce social isolation responses. Long-term progestin treatment can inhibit postpartum estrus.

Social Isolation and Anxiety Disorder During the COVID-19 Pandemic and Lockdown in China

The COVID-19 pandemic and lockdown measures have had a profound impact on the emotions, anxiety, and mental health of affected communities. Despite this, there is a lack of knowledge about the possible generational and geographical differences in the effects on the mental health of individuals. This study examines the impact of COVID-19 related quarantine on symptoms of generalized anxiety disorders (GAD) among parents and children (N = 4503). It also compares the outcomes of residents from the initial COVID-19 epicenter of Wuhan to those in surrounding areas. Subgroup analyses were conducted by child and parent samples, and by Wuhan city and other cities in the Hubei province. Propensity score radius matching and ordinary least squares regressions were used to examine the relationship between quarantine and GAD symptoms. Results showed that quarantine had more psychological impact on parents than children, regardless of geographic location. Parents that experienced quarantine in Wuhan city, reported a significantly higher level of symptoms of GAD than those that did not. Parents from other cities showed no such difference. For both children and parents, interpersonal communication about COVID-19 and social media exposure to pandemic-related information were linked to GAD symptoms. Targeted policies and interventions are needed to address the psychological impacts of COVID-19 lockdown.

Social support and social isolation in adults with cystic fibrosis: An integrative review

Background Adults with cystic fibrosis have unique barriers that may decrease their ability to receive adequate social support and socialization, leading to social isolation. Social isolation has been correlated with negative health outcomes in other populations. In those with cystic fibrosis, social isolation may present additional physiological and psychological challenges, potentially interfering with clinical outcomes and quality of life. However, there is a lack of understanding as to how social isolation presents in this population. Methods The purpose of this integrative review is to identify and critically analyze how social support and social isolation are reported for adults with cystic fibrosis. PubMed, Scopus, and CINAHL Complete were searched for related publications, resulting in an initial yield of 1767 articles. After eligibility screening, 21 studies met the criteria for this review, which were all then critically analyzed and synthesized. Results There is a scarcity of literature focusing on social isolation and social support in this population. Reduced physical and mental health were the most commonly reported variables associated with reduced social functioning and social support. Conclusion Preliminary studies are warranted to understand how adults with cystic fibrosis experience social isolation, as well as its relationship to social support. This knowledge can guide future research focusing on physical and psychological effects of social isolation, along with interventions that facilitate socialization and support.

Loneliness among adolescents and young adults with cancer during the COVID-19 pandemic: a cross-sectional survey

Background

Adolescents and young adults (AYAs) diagnosed with cancer are at an increased risk of experiencing social isolation and loneliness secondary to their cancer and its treatment. The physical distancing measures implemented during the COVID-19 pandemic may have further increased loneliness among this group. This study examined the prevalence of loneliness and factors associated with loneliness among AYAs with cancer during this pandemic.

Methods

We conducted a self-administered, online, cross-sectional survey of Canadian AYAs diagnosed with cancer between 15 and 39 between January and February 2021. Loneliness was measured using the 3-item UCLA Loneliness Scale. Factors associated with higher levels of loneliness were identified using multiple logistic regression.

Results

The analysis included 805 AYAs. The prevalence of loneliness was 52.2% [N = 419, 95% CI (confidence interval) 48.7 to 55.6%]. Individuals who were 18–25 years old [AOR (adjusted odds ratio)1.60, CI 1.03–2.47, p = 0.035], currently undergoing cancer therapy (AOR 1.46, 95% CI 1.03–2.07, p = 0.035), who self-disclosed the presence of a pre-pandemic mental health condition (AOR 2.09, 95% CI = 1.22–3.58, p = 0.007), or were not in a relationship (AOR 2.22, 95% CI 1.57–3.14, p < 0.001) were more likely to report loneliness than others. Participants that lived in rural or remote locations were less likely to experience loneliness (AOR 0.59, 95%CI 0.40–0.87, p = 0.008).

Conclusion

One in two AYAs with cancer are feeling lonely during the COVID-19 pandemic. Future studies for developing interventions to target loneliness, particularly for those at greater risk, are necessary to improve the health and quality of life of AYAs with cancer.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00520-021-06628-5.

Life in a time of COVID: a mixed method study of the changes in lifestyle, mental and psychosocial health during and after lockdown in Western Australians

BACKGROUND

Since the beginning of the COVID-19 pandemic, the Western Australian government imposed multiple restrictions that impacted daily life activities and the social life. The aim of this study was to examine the effects of COVID-19 lockdown on the community's physical, mental and psychosocial health.

METHODS

Approximately 2 months after a three-month lockdown, a cross-sectional study was opened to Western Australian adults for an 8-week period (25th August - 21 October 2020). Participants competed a 25-min questionnaire adapted from the Western Australia Health and Wellbeing Surveillance system. Participants provided information on their socio-demographic status, lifestyle behaviours, mental health, and psychosocial health during and post-lockdown. Open-ended questions explored key issues in greater detail. Changes between the lockdown and post-lockdown period were assessed using Wilcoxon signed rank test and One-Sample Kolmogorov-Smirnov Normal tests as appropriate. Sex differences were examined using the Mann-Whitney U test. A content analysis approach examined responses to the open-ended questions with frequencies and variations in responses determined using Chi-Square tests.

RESULTS

A total of 547 complete responses were obtained. Compared to post-lockdown period, lockdown was associated with a significantly lower levels of physical activity, poorer mental well-being and sense of control over one's life, and a higher level of loneliness. Similarly, during lockdown, there was a significantly higher consumption of junk food, soft drinks and alcoholic drinks but no change in fruit and vegetable intake. Participants recalled health campaigns on hand washing and social distancing and there was a retrospective view that more timely and informative campaigns on physical activity, nutrition and mental well-being should have been available during lockdown.

CONCLUSIONS

While advice on infection control measures were appropriately provided, there is a need for concurrent health promotional information to help combat the changes in physical, mental and psychosocial well-being observed during quarantine to prevent negative health consequences in the community even if there are minimal effects of the pandemic itself.

The COVID-19 pandemic as experienced by the spouses of home-dwelling people with dementia - a qualitative study

BACKGROUND

Worldwide, restrictive measures have been taken to manage the spread of the COVID-19 pandemic. Social distancing and self-isolation have considerably affected the lives of people with dementia and their informal caregivers. The purpose of the study was to explore the consequences of the COVID-19 pandemic as experienced by the spouses of home-dwelling people with dementia in Norway.

METHODS

The study had a qualitative descriptive design using individual telephone interviews for data collection. A total sample of 17 spouses of people with dementia were included, 14 women and three men ages 52 to 82 years. A qualitative content analysis following six steps inspired by Graneheim and Lundman was used to identify the categories presented.

RESULTS

The participants emphasized four main perspectives: 1) Radical changes in available services, 2) Restrictions changed everyday life, 3) Impacts on health and well-being, and 4) Actions that made life easier. The participants also described how positive activities and easily accessible services helped them in this situation.

CONCLUSIONS

The governmental restrictions of the COVID-19 pandemic resulted in radical changes in available services with severe consequences for the lives and well-being of home-dwelling people with dementia and their spouses. Examples of coping strategies and possible psychosocial interventions compatible with virus precautions were identified. The potential of such interventions should be further explored to meet the needs of vulnerable groups in situations like a pandemic.

Italian version of the Edmonton Symptom Assessment System (ESAS)-Total Care (TC): development and psychometric validation in patients undergoing cancer treatment or follow-up

INTRODUCTION

The routine use of patient-reported outcomes (PROs) in clinical practice improves quality of care, it helps in reducing the access to emergency services and unscheduled visits, and it can improve cancer patients' time survival. The Edmonton Symptom Assessment System (ESAS) is a PRO largely used in different care settings to monitor physical and psychological symptoms. Nonetheless, along with these symptoms, literature also highlighted the presence and effect of spiritual pain, financial distress, and social isolation on quality of care, treatment effectiveness, and survival.

AIM

The aims of the current study were (a) to complete the Italian version of the ESAS validation process by adding the missing symptom "insomnia" and (b) to develop and validate the ESAS-Total Care (ESAS-TC) that is intended to evaluate and screen not only physical and psychological symptoms but also spiritual pain, discomfort deriving from financial problems associated with illness, and suffering related to social isolation.

METHODS

A sample of Italian native outpatients, who referred to the dedicated Supportive Care Unit of the Fondazione IRCCS, Istituto Nazionale deiTumori (INT), Milano, were asked to fill the ESAS-TC to assess item properties, factorial structure, internal consistency, test-retest reliability (patients were asked to retake the scale after 2-6 weeks), and external validity. Concerning the latter, other self-administered scales were employed to assess perceived stress (Perceived Stress Scale), unmet needs (using theNeed Evaluation Questionnaire that describes informative, assistance/care, relational, needs for psycho-emotional support, material needs), and perceived social support (administering the Multidimensional Scale of Perceived Social Support that evaluates perceived support of family, friends, and significant others in the wider social field).

RESULTS

The scales were administered to 243 patients with solid (90%) and hematologic (10%) cancers, mean age 62.6, female 76.5%. Analysis suggested that a single factor better represents the structure of the ESAS scales, their internal consistency and test-retest reliability were good, and evidence of construct and criterion validity were provided. Additionally, incremental validity of the ESAS-TC was proved showing that the added items offer a unique contribution in predicting the patient's stress. Finally, known groups validity was confirmed testing the differences in the ESAS scores due to the Karnofsky Performance Status.

CONCLUSIONS

The current study allowed to complete the validation of the Italian version of the ESAS and to develop a psychometrically sound scale, the ESAS-Total Care, that potentially helps in moving cancer research toward personalized total cancer care.

The impact of the COVID-19 pandemic on mental health and well-being of people living with a long-term physical health condition: a qualitative study

BACKGROUND

The COVID-19 pandemic and associated restrictions caused major global disruption. Individuals with long-term physical health conditions (LTCs) are at higher risk of severe illness and often subject to the strictest pandemic guidance, so may be disproportionally affected. The aim of this study was to qualitatively explore how living with a LTC during the COVID-19 pandemic affected people's mental health and wellbeing.

METHODS

Participants were people living with LTCs who participated in telephone/video call interviews based on a semi-structured topic guide. Key themes and subthemes were determined using deductive and inductive thematic analysis.

RESULTS

The sample included 32 participants with LTCs (most commonly cancer, respiratory conditions or cardiovascular diseases), mean age 57 (SD 13) years, 66% female and 72% white British. There were four overarching themes specific to living with a LTC. These were 1) high levels of fear and anxiety related to perceived consequences of catching COVID-19, 2) impact of shielding/isolation on mental health and wellbeing, 3) experience of healthcare during the pandemic and 4) anxiety created by uncertainty about the future. Fourteen subthemes were identified, including concerns about accessing essential supplies and the importance of social support. Individuals who lived alone and were advised to shield could be profoundly negatively affected.

CONCLUSIONS

This study found that there were a number of aspects of living with a LTC during the pandemic that had a significant impact on mental health and well-being. There should be focus on how best to provide practical and social support to people with LTCs during a pandemic, particularly if they have to shield or isolate.

Social isolation and Social Media Consumption among Graduate students during COVID-19: An Examination using Social Comparison Theory

The COVID-19 crisis transformed the way we communicate with each other. Pre-existing theoretical frameworks can build structure out of the chaos; social-interaction theory is one of these. During our social distancing and prior to the vaccine's arrival, physical distancing was adopted as the primary strategy to 'flatten the curve' of the virus's spread. The human desire to connect, however, led to increasing reliance on social-platform outlets. Yet meaningful communication in these forums is elusive and often results in unsatisfying interactions that lack the natural cadence of in-person communications. There is a need to reflect back on how and why our various styles of social-media consumption often paradoxically increase rather than ameliorate our feelings of social isolation. Following this overview, the authors will recommend ways to recognize and change such counterproductive patterns of online activity.

Determining the Religious Coping Styles of Adolescents in Turkey During COVID-19

We sought to evaluate the religious coping styles of adolescents during the coronavirus disease 2019 (COVID-19) pandemic and its restrictions. The study was conducted online during the 2020 academic year among students in three randomly selected high schools in a city center located in Eastern Turkey. The students studying in the chosen high schools who agreed to participate were included in the study (n = 514). We found that most adolescents were anxious, had been affected in terms of health and life satisfaction, and felt sad due to isolation. Almost all subjects attached importance to their religious beliefs. The adolescents' mean Religious Coping Scale score was 2.23 ± 0.50, their mean Positive Religious Coping subscale score was 2.91 ± 0.73, and their mean Negative Religious Coping subscale score was 1.54 ± 0.52. Specifically, male adolescents of ages 15-17 whose incomes were less than their expenditures and who lived in a broken family had the highest level of negative religious coping. In light of these findings, adolescents can be supported by teaching them to develop positive religious coping styles during the COVID-19 pandemic.

The Effect of Physical Activity on Social Isolation in Elderly

BACKGROUND

Elderly people who have poor social relationships have a higher risk of death than those who have strong social networks. Loneliness and social isolation are associated with an increased risk of coronary heart disease and stroke. Physical activity can reduce social isolation, diverting feelings of loneliness by socializing with other people and expanding social networks by participating in the community. This study aimed to determine the effect of physical activity on social isolation in the elderly.

METHODS

A Cross-sectional study was conducted to 181 respondents. The data is collected through interviewing respondents with the International Physical Activity Questionnaire (IPAQ) and social isolation questionnaires. The data was then analyzed descriptively and calculated using Fisher's exact test.

SETTING

Ardirejo and Panggungrejo villages, Kepanjen District, Malang Regency.

RESULTS

Based on the Fisher's exact between  physical activity and social isolation results were obtained p-value 0.000 (PR = 23.407; 95% CI = 3,117-175,800).

CONCLUSION

There is a significant relationship between physical activity and social isolation in the elderly in the community.

Use of walking modifications, perceived walking difficulty and changes in outdoor mobility among community-dwelling older people during COVID-19 restrictions

BACKGROUND

Outdoor mobility enables participation in essential out-of-home activities in old age.

AIM

To compare changes in different aspects of outdoor mobility during COVID-19 restrictions versus two years before according to self-reported walking.

METHODS

Community-dwelling participants of AGNES study (2017-2018, initial age 75-85) responded to AGNES-COVID-19 postal survey in spring 2020 (N = 809). Life-space mobility, autonomy in participation outdoors, and self-reported physical activity were assessed at both time points and differences according to self-reported walking modifications and difficulty vs. intact walking at baseline were analyzed.

RESULTS

Life-space mobility and autonomy in participation outdoors had declined (mean changes -11.4, SD 21.3; and 6.7, SD 5.3, respectively), whereas physical activity had increased (5.5 min/day, SD 25.1) at follow-up. Participants perceiving walking difficulty reported the poorest baseline outdoor mobility, a steeper decline in life-space mobility (p = 0.001), a smaller increase in physical activity (p < 0.001), and a smaller decline in autonomy in participation outdoors (p = 0.017) than those with intact walking. Those with walking modifications also reported lower baseline life-space mobility and physical activity, a steeper decline in life-space mobility and a smaller increase in physical activity those with intact walking (p < 0.001 for both).

DISCUSSION

Participants reporting walking modifications remained the intermediate group in outdoor mobility over time, whereas those with walking difficulty showed the steepest decline in outdoor mobility and hence potential risk for accelerated further functional decline.

CONCLUSION

Interventions should target older people perceiving walking difficulty, as they may be at the risk for becoming homebound when environmental facilitators for outdoor mobility are removed.

Sleep in times of crises: A scoping review in the early days of the COVID-19 crisis

During the early days of the pandemic and in the context of a seemingly unknown global threat, several potential major sleep disruptors were identified by sleep researchers and practitioners across the globe. The COVID-19 pandemic combined several features that, individually, had been shown to negatively affect sleep health in the general population. Those features included state of crisis, restrictions on in-person social interactions, as well as financial adversity. To address the lack of a comprehensive summary of sleep research across these three distinctive domains, we undertook three parallel systematic reviews based on the following themes: 1) Sleep in times of crises; 2) Sleep and social isolation; and 3) Sleep and economic uncertainty. Using a scoping review framework, we systematically identified and summarized findings from these three separated bodies of works. Potential moderating factors such as age, sex, ethnicity, socioeconomic status, psychological predisposition, occupation and other personal circumstances are also discussed. To conclude, we propose novel lines of research necessary to alleviate the short- and long-term impacts of the COVID-19 crises and highlight the need to prepare the deployment of sleep solutions in future crises.

Combined association of multiple chronic diseases and social isolation with the functional disability after stroke in elderly patients: a multicenter cross-sectional study in China

Background

Multiple chronic diseases (MCDs) and social isolation are independent risk factors related to stroke and disability, but it is unknown whether the combination of these two conditions resulted from aging-related to functional disability in stroke patients. This study aimed to probe the relationship between the combination of MCDs, social isolation, and functional disability after stroke in elderly patients.

Methods

A multicenter and cross-sectional study was conducted in the Departments of Rehabilitation of 103 hospitals located in 23 cities across China. Stroke patients aged 60–90 years were selected for analysis. Demographic characteristics, lifestyles, and clinical information were investigated by questionnaires and medical records. MCDs (hypertension/ diabetes/ hyperlipidemia/heart disease/kidney disease) were categorized into three levels: 0, 1, and ≥ 2. Functional disability was assessed by the Barthel Index and categorized into four groups: no, mild, moderate, and severe disability. The multi-nominal logistic regression model was used to explore the independent and combined association of MCDs and social isolation with functional disability.

Results

A total of 4046 elderly stroke patients (55 % males) were included in the final analysis. The prevalence of social isolation, MCDs ≥ 2, and severe disability increased with aging. In the fully adjusted model, patients with social isolation or MCDs had a higher risk of functional disability significantly than those without. Patients with social isolation combined MCDs ≥ 2 were 35 times (95 % CI: 18.89–64.69) more likely to suffer severe disability after stroke, and 8 times (95 % CI: 18.89–64.69) for moderate disability than those without social isolation and MCDs.

Conclusions

MCDs, social isolation, and their combination were associated with a higher risk of functional disability after stroke in Chinese elderly patients. The elderly population should be encouraged to participate in more social activities, particularly in those with MCDs. Future secondary prevention and rehabilitation treatments to the functional ability of elderly stroke patients should underscore both social activity and the combined treatments of MCDs.

Trial registration

NO: ChiCTR2000034067.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02439-9.

Relationships between physical activity, social isolation, and depression among older adults during COVID-19: A path analysis

Background: There are known significant relationships between greater physical activity and less depression, and greater social isolation and greater depression; therefore, it is important to understand these relationships among older adults during COVID-19.

Methods: The Physical Activity Scale for Elders, Geriatric Depression Scale, and PROMIS Social Isolation were administered. Path analysis was performed to evaluate the relationship between physical activity, social isolation, and depression.

Results: 803 surveys were received. Consistent with our a-priori model, higher social isolation predicted greater depression. (p<0.001).

Conclusion: Older adults may suffer a high emotional price during times of imposed social distancing.

The Intersection of Pain Outcomes and Social Isolation Among African Americans

There is increasing evidence suggesting the influence social isolation has on health outcomes and mental well-being. Chronic medical conditions, such as pain, have been shown to impact social relationships and isolation among majority populations, but there is little evidence documenting this relationship among African Americans. To address this lack of scholarly work, the current study aimed to examine subjective and objective social isolation, pain interference with daily life, and problems with pain in a sample of African American adults 18 + years of age. Taken from the National Survey of American Life: Coping with Stress in the 21st Century (NSAL), results showed that participants who were objectively isolated from family only were more likely to have a chronic health problem that was associated with increased pain. Data further showed that those reporting subjective isolation from both family and friends experienced greater interference from pain than those who were not isolated from family and friends. Findings from this study acknowledge a larger issue that addresses the impact social isolation has on health, quality of life, and general well-being. Recognizing the influence of such may allow systems to acknowledge the determinants that perpetuate social isolation, while still recognizing the needs of marginalized groups.

Stigmatization, discrimination and illness perception among oncology patients: A cross-sectional and correlational study

PURPOSE

Many individuals who get cancer may be exposed to stigmatization from their close relatives and their entourage. This cross-sectional and correlational study was conducted in order to determine stigmatization, discrimination and perception of illness among oncology patients in Northern Turkey.

METHOD

The sample of the study consisted of 367 inpatients who were hospitalized in the oncology and hematology clinics of a University Hospital in northern Turkey between 31.01.2019 and 30.07.2019. Data were collected using the demographics form, Cataldo Lung Cancer Stigma Scale and Illness Perception Questionnaire.

RESULTS

The mean total score of the patients according to Cataldo Lung Cancer Stigma Scale is 30.4 ± 8.8. In this study, no statistically significant relationship was determined between Cataldo Lung Cancer Stigma Scale total score and Illness Perception Questionnaire sub-dimension scores (p > .05). It can be said that the oncology patients were exposed to stigmatization and discrimination, and that certain socio demographic and clinical characteristics such as sex, marital status, education level, employment status, diagnosis, and the clinical phase of the disease are significant predictors of Cataldo Lung Cancer Stigma Scale scores.

CONCLUSIONS

In order to help them express their feelings in oncology patients, reduce their anxiety, increase their adaptation to their illness and treatment, help them cope with the multi-faceted crisis caused by the disease and improve their quality of life, cancer stigmatization should be evaluated objectively.

Association between COVID-19 and anxiety during social isolation: A systematic review

BACKGROUND

The uncertainties about coronavirus disease 2019 (COVID-19), the change in routine, lifestyles and the reduction of physical contact can cause stress, anxiety, emotional overload, poor sleep and even physical health complications.

AIM

To evaluate the scientific publications available on the relationship between COVID-19 and anxiety experienced in the general population, during the period of social isolation, adopted by governmental organizations and public health policymakers as a measure to contain the spread of cases.

METHODS

A literature search was performed systematically exploring the PubMed and Medline databases using the following terms classified as MeSH descriptors: (“anxiety” AND “pandemic” AND “COVID-19”). For the search, in the Biblioteca Virtual em Saúde – BVS, Science.gov, Web of Science and National Library platforms, the following keywords were used: ("anxiety" AND "coronavirus" AND "social isolation"). Thirty-seven peer-reviewed articles were found. PRISMA and the Downs & Black checklist were used for qualitative evaluation.

RESULTS

After applying the inclusion criteria, seven (n = 7) original scientific articles were selected. The collated evidence demonstrated increased levels of symptoms of anxiety and depression during the period of social isolation. The population between 21 to 40 years was most affected. The risk of severe depression was twice as high at the epicenter of the pandemic. Sleep quality was significantly impaired. Questions about politics, religion, and consumption of products from China were found to generate fear and anticipate probable changes in the pattern of post-pandemic consumption. Social isolation exacerbated feelings of extreme hopelessness, sadness, loneliness and suicidal ideation.

CONCLUSION

We conclude that there is a potential relationship between social isolation during the COVID-19 pandemic and symptoms of anxiety. It is important to note that the direct and indirect costs of not identifying the detrimental effects of this phenomenon and neglecting strategies for intervention could lead to a significant psychological burden on society in several aspects after social isolation.

Understanding Psychological Distress and Protective Factors Amongst Older Adults During the COVID-19 Pandemic

OBJECTIVES

This study examined the emotional distress and loneliness during COVID-19 and the roles of resiliency and activities.

DESIGN

A cross-sectional national survey.

SETTING

Amazon Mechanical Turk (mTurk) and Prolific Research Platforms.

PARTICIPANTS

Five hundred and one U.S. dwelling English-speaking adults 60 years old and older.

MEASUREMENTS

Participants completed an online survey with the PHQ-9; GAD-7; Short Health Anxiety Inventory; 3-item UCLA Loneliness scale; PROMIS measures of global health, instrumental, and emotional support; 10-item Connor-Davidson Resilience Scale; and COVID-19 needs assessment.

RESULTS

Across the sample 13% reported moderate depressive symptoms, 9% reported moderate anxiety symptoms, and 26% endorsed being "lonely." The emotionally distressed group endorsed more loneliness, lower resiliency, less physical exercise, and worse physical health. The low Socio-Economic Status group endorsed less loneliness, less likely to engage in physical exercise and worse physical health.The lonely group endorsed less resilience, less physical exercise, and worse physical health. A multiple logistic regression found that resilience, socioeconomic status, and physical health were significant predictors of loneliness, whereas global health was the best predictor of emotional distress.

CONCLUSIONS

Even after prolonged social distancing, older adults in this study did not report greater psychological distress compared to earlier studies of older adults during COVID-19. Older adults with lower SES, worse physical health, and less resiliency, were more likely to report more loneliness. It is this group that should be the focus of intervention.

Social Isolation and Loneliness During the COVID-19 Pandemic: Impact on Weight

PURPOSE OF REVIEW

Social isolation and loneliness have long been identified as risk factors for poorer physical and mental health and increased mortality. These factors have also been shown to impact dietary behavior and physical activity which play a role in precipitating and maintaining obesity. Less is known about the impact of social isolation resulting from the COVID-19 pandemic in which social distancing is a major component of public health initiatives. This narrative review will examine the existing literature on the relationships between social isolation, loneliness, mental health, and weight as they relate to the COVID-19 pandemic.

RECENT FINDINGS

Individuals with obesity are at very high risk for worsening course of COVID-19, hospitalization, and death. This population may also be more significantly impacted by the dietary and physical activity consequences resulting from lockdown, social distancing, and isolation. The pandemic has led to significant lifestyle disruptions. However, early studies have largely relied upon cross-sectional studies or convenience samples. Future research will need to study the impact more rigorously, particularly among populations at greatest risk.