Spaniards hold their breath as sweeping virus measures end

Spaniards hold their breath as sweeping virus measures end

Spain will relax nationwide pandemic measures this weekend, including travel restrictions, but some regional chiefs are complaining that the six-month-long national state of emergency will be replaced by a patchwork of conflicting approaches.

Now that the country’s contagion rate has stabilized while vaccine rollout continues to speed up, Prime Minister Pedro Sánchez has refused to extend the sweeping order that gave legal coverage to curfews, social gathering curbs and travel bans across the country. The order expires at midnight on Saturday.

His Cabinet is instead handing over full control of the battle against infection spread to the country’s 19 regions and autonomous cities, telling them they can go to the country’s Supreme Court if lower-level judges rule against their attempts to curtail basic freedoms.

But by Friday, just over 24 hours before the end of the state of emergency, each region was taking a different path—and the response from courts was also varied.

Judges approved for the Balearic Islands, a tourist magnet in the Mediterranean Sea, and for the eastern Valencia region to keep a night-time curfew and bans on the number of people allowed to socialize. But a court in the northern Basque region refused to extend localized lockdowns, a 10 to 6 a.m. curfew and a 4-person cap on social gatherings.

The region, home to 2 million people, is grappling with a 14-day contagion rate of 463 new cases per 100,000 population, more than twice the national average of 202 new infections per 100,000.

Madrid, whose lockdown-skeptic regional chief was re-elected earlier this week, announced that there will be no more curfews or travel restrictions in and out of the region starting Sunday, and that the operation of bars and restaurants can be extended from the current 11 p.m. limit to midnight.

“There is no (legal) coverage to adopt restrictive measures such as the curfew,” said Madrid’s health chief, Enrique Ruiz Escudero, whose region has the second-highest infection rate with 323 new cases per 100,000 for the past two weeks.

“We trust in the citizens’ responsible behavior,” Ruiz Escudero said on Friday.

Sánchez’s left-wing coalition has been under fire from opposition parties and regional chiefs for not anticipating the legal mess by launching a legal reform to give regions more powers. The government says that the existing public health law from 1986 allows them enough room to maneuver.

Spain’s rollercoaster of a contagion curve surged sharply in January, coinciding with end-of-year celebrations, but bottomed down in mid-March before mildly picking up again.

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If You’re Worried About Your Child’s Well-Being, Add These Supplements In Their Diet to Boost Their Immunity

As a parent, nothing is more important than your child’s health and well-being. From the time that they’re babies and well after they’ve grown into self-functioning, self-sufficient adults, parents continue to worry about their child’s health.

Consider it a blessing in disguise or light at the end of the tunnel- due to COVID-19, we’ve all been granted a rare opportunity to spend a lot more time with our entire family. Of course, while maintaining social distancing practices. Plus, with the virus outbreak, parents have become even more invested in their child’s health than they were before.

During these times, it is absolutely vital to ensure that your child’s immune system is in perfect shape. To that measure, we’ve taken the liberty of listing some of the best supplements that can help in boosting your child’s immunity, and the best foods you can give them at this time.

1. Vitamin C

Vitamin C? More like the superstar of all the vitamins. It is impossible to overstate the role that this vitamin plays in your child’s well-being. The antioxidant is responsible for many vital functions of the body, including the formation of blood vessels, collagen, and muscle. It is also instrumental in the absorption of iron. Vitamin C is commonly found in berries, citrus fruits, broccoli, and red bell peppers.

2. Zinc

You must have guessed this would be on the list, too. Zinc plays a major role in the development and growth of your child. In fact, it is one of the most vital supplements that your brain needs for its proper growth and development. Zinc also plays an important role in ensuring that your child’s immune system functions properly. The supplement can be found in foods like nuts, legumes, shellfish, seeds, and whole grains.

3. Vitamin D

Also known as the sunshine vitamin due to its biggest source, Vitamin D does magical wonders for your child’s immunity. It helps your child boost their body’s ability to fight off infections. It also ensures that your child can build stronger bones.

So, a little extra playtime under the sun might not be so bad after all. Vitamin D can also be found in certain foods like fish oil or salmon. If your child is unable to get enough Vitamin D through these sources, you can always opt for gummy supplements. Make sure you consult a doctor before doing so.

4. Vitamin A

Vitamin A is absolutely essential for protecting your child’s vision. Apart from that, it also plays a significant role in boosting immunity. It can be foods in many foods, including carrots, sweet potato, cantaloupe, mango, and spinach.

5. Echinacea

If you’re having a hard time pronouncing that, don’t sweat it. Just repeat after us: eh-kuh-nay-shuh. Not so hard anymore, right? If you’re still looking for a simpler word, just go with purple coneflower. This little flower is packed with antioxidants, which will help your child’s body while battling different virals and infections. You can give this to your child in the form of gummies, syrup, or powder.

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Tracking the global movement of malaria parasites and their variants


An international collaboration of researchers have developed a computational method to identify malaria parasites as they move around the world with their human hosts—key to measuring impact of elimination campaigns.

Led by University of Melbourne Professor Karen Day, Laboratory Head at the Peter Doherty Institute for Infection and Immunity (Doherty Institute) and Bio21, the team collected parasites from 23 locations in 10 countries.

Malaria is the world’s most deadly parasitic disease, killing over half a million people every year. It is hampered by drug resistance and the first recently developed vaccine offers only partial protection.

The team sequenced parasite DNA from 1,248 malaria infected patients and established a global database of 32,682 variant surface antigen genes, to track down to country level where parasites originated. Findings from the 10-year project were published in PLOS Genetics.

“In malaria, we have to deal with tens of thousands of variants in one endemic area. This database is a significant step forward in tracking those variants, and understanding how malaria is moving around the world,” Professor Day said.

“The impact of this is we can follow contemporary patterns of parasite migration in a cost-effective manner without having to sequence the whole genome. The signature of the past is very much visible in what we found but now we can see if anything changes. It gives us another window into how we can adapt parasite genomics to inform malaria surveillance.”

Professor Day said these evolutionary findings have translational implications in providing a diagnostic framework for geographical surveillance of malaria.

“It can also inform efforts to understand the presence or absence of global, regional and local population immunity to specific variants,” she said.

“Our next step would be to grow our database in the Asia -Pacific, with more collaborators and opportunities for regional training.”

An example of what Professor Day and her research team are striving towards is similar to ‘FluNet’, a global web-based tool for influenza surveillance by the World Health Organization.

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Minorities value, perceive, and experience professionalism differently than their peers

Marginalized groups of people value professionalism more—and are more likely to leave a job at an institution due to issues of professionalism—compared to their white, male counterparts, according to a Penn Medicine study of staff, faculty, and students who were affiliated with a large, academic health system in 2015 and 2017. The findings, published today in JAMA Network Open, suggest that health care institutions must reevaluate and redefine professionalism standards in order to successfully make the culture of academic medicine more inclusive and to improve the retention of minorities and women.

This study is one of a series of research projects launched at Penn Medicine, under the leadership of Vice Dean Eve J. Higginbotham, MD, SM, as part of Office of Inclusion and Diversity’s mission to chart Penn Medicine’s course toward inclusivity for all groups.

“What does it actually mean to operationalize an anti-racist, inclusive workplace? It means understanding the factors in an environment that allow women and minorities to thrive in your organization,” said Jaya Aysola, MD, MPH, assistant dean of Inclusion and Diversity at the Perelman School of Medicine and executive director at the Penn Medicine Center for Health Equity Advancement. “We wanted to look at the ways that marginalized groups perceive and experience professionalism, so that we could move toward standardizing policies in a way that is really inclusive for all. Recruiting female and minority students and employees is not enough if an organization cannot retain them.”

Professionalism has been implemented as a core competency for medical education to govern how physicians conduct themselves in public, be it with patients or with each other. However, the medical field lacks a concise, unifying, and operational definition of professionalism, and the word is often misused or overused. Moreover, the historic definition of professionalism has largely centered around white, heterosexual male identity, and therefore the current understanding of what is deemed professional can often be non-inclusive or discriminatory. For instance, because of these cultural norms, the way that certain groups dress, speak, eat, or wear their hair might be deemed unprofessional.

The study authors wanted to examine perceptions and experiences of professionalism among faculty, trainees, staff, and students, in order to better understand, and then perhaps reevaluate, how professionalism standards are applied to different groups.

In the first part of the study, the researchers analyzed answers collected from the Diversity Engagement Survey, which is administered by Datastar, from February to April 2015. The dataset included 3,506 respondents—faculty, trainees, staff, and students—from two Philadelphia-area health systems and four medical/health professional schools.

On the survey, respondents were asked to rate their responses (from strongly agree to strongly disagree) to three statements related to professionalism: (1) “I have considered changing jobs due to inappropriate, disruptive, or unprofessional behavior by a coworker or supervisor.” (2) “I value institutional initiatives, policies, and/or educational resources related to professional behavior in the workplace.” (3) “My institution supports a culture of professionalism.”

In response to the statement “I value institutional initiatives, policies, and/or educational resources related to professional behavior,” 52 percent of women and 54 percent of

Black individuals agreed or strongly agreed, compared to 45 percent of male and 49 percent of white respondents.

Respondents who self-identified as female, LGBTQ, non-Hispanic Black individuals, when compared with white, heterosexual men, were also statistically significantly more likely to report considering changing jobs because of “unprofessional” behavior. No statistically significant adjusted differences were found among respondents who agreed with the statement “My institution supports a culture of professionalism.”

Aysola said that she suspects the greater value women and underrepresented minority groups place on professionalism may stem from what they perceive to be lacking in their work environment, as well as gaps that they perceive between institutional values and their lived experiences.

To probe that hypothesis further, the research team also analyzed responses to the open-ended question: “Tell us a time that you felt valued or devalued, or welcomed or not welcomed by your organization.” The researchers solicited narratives via email in 2017 from faculty, trainees, staff, and students across the organizations studied. They then analyzed 52 narratives pertaining to professionalism.

Many narrators who self-identified as members of marginalized populations expressed infringement on their professional boundaries during interactions at work or learning environments.

The infringements reported ranged from microaggressions to blatant racism, sexism, xenophobia, and homophobia. Other narratives stated that professional standards were applied differently to certain groups, and those groups perceived that they were subject to greater scrutiny. Experiences cited ranged from facing differential disciplinary practices and feeling unwelcomed, to experiencing pressure to conform and being asked questions about childbearing, living situations, and tattoos.

A consistent theme throughout the stories was that the respondents from underrepresented groups felt they were subjected to greater scrutiny, while simultaneously reporting greater infringements over their professionalism boundaries.

“The narratives that we collected reveal disparities in how we assess professionalism, with minorities and women reporting a microscope over their behaviors.” Aysola said. “A common theme was that being different was not perceived as being a good ‘fit,’ forcing individuals to alter their authentic selves to feel included.'”

These findings, according to Aysola, underscore the need to revisit the professionalism standards, which govern the practice of medicine and the engagement between members of the medical profession. These standards, she said, must be informed by diverse perspectives, in order to be more inclusive. They also must be operationalized in a way that ensures behaviors are subject to equal scrutiny, irrespective of the culture or background of the individual, she added.

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Rural hospitals are under siege from COVID-19 – here’s what doctors are facing, in their own words

It’s difficult to put into words how hard COVID-19 is hitting rural America’s hospitals. North Dakota has so many cases, it’s allowing asymptomatic COVID-19-positive nurses to continue caring for patients to keep the hospitals staffed. Iowa and South Dakota have teetered on the edge of running out of hospital capacity.

Yet in many communities, the initial cooperation and goodwill seen early in the pandemic have given way to COVID-19 fatigue and anger, making it hard to implement and enforce public health measures, like wearing face masks, that can reduce the disease’s spread.

Rural health care systems entered the pandemic in already precarious financial positions. Over the years, shifting demographics, declining revenue and increasing operating expenses have made it harder for rural hospitals to stay in business. The pandemic has made it even more difficult. In mid-March, most rural hospitals halted elective procedures to slow the spread of the virus, cutting their revenue further, and many have faced price gouging for supplies given extreme shortages.

I work with rural doctors and hospital administrators across the country as a researcher, and I see the stress they’re under from the pandemic. Here is what two of them—Konnie Martin, chief executive officer at San Luis Valley Health in Alamosa, Colorado, and Dr. Jennifer Bacani McKenney, who practices family medicine in Fredonia, Kansas—are facing. Their experiences reflect what others are going through and how rural communities are innovating under extraordinary pressure.

I’ll let them explain in their own words.

Konnie Martin, Alamosa, Colorado

COVID-19 fatigue is real. It’s wearing on people. Everyone wishes we were past this. I read the other day about health care workers being the “keeper of fears.” During COVID-19, patients have disproportionately placed their fears on clinicians, many of whom experience the same fears themselves. I focus on building resilience, but it’s hard.

My hospital currently has seven patients with COVID-19 and can make room for as many as 12. Back in the spring, we converted a visiting specialist center into a temporary respiratory clinic to keep potentially infectious patients separate and reduce pressure on our emergency department.

It’s all about making sure we have enough staff and hospital capacity.

There isn’t any hospital that isn’t under siege, which means that getting patients to the right level of care can be a challenge. In the past few days, we have accepted three transfers from facilities that are on the front range. We’ve never had to do this before. With six ICU beds and 10 ventilators, we are trying to help others.

Influenza hasn’t arrived yet in our community, and I worry about when it comes. We have nearly 40 staff out right now on isolation or quarantine, a staggering number for a small facility. We are having to shift staffing coverage in half-day increments to keep up.

We are not at a point where we are even contemplating bringing COVID-19-positive staff back to work, like the governor of North Dakota suggested. I hope we never get there. We are, however, considering high-risk versus low-risk exposures. If a clinician is exposed to COVID-19 during an aerosolizing medical procedure, that’s high risk. If a clinician is exposed in a classroom of 50 people who were all socially distanced and wearing masks, that’s low risk. If we face critical workforce needs, we may bring back health care workers that have had low-risk exposures.

We have gained a lot of knowledge this year, and we all feel wiser now, but definitely older, too.

Dr. Jennifer Bacani McKenney, Fredonia, Kansas

We chose to live in a rural community because we look out for one another. Our one grocery store will deliver to your home. Our sheriff’s department will drive medications outside of city limits. If we could return to our rural values of caring for and protecting one another we would be in a better position. Somewhere along the way, these values took a back seat to politics and fear.

Wilson County, where I practice in Southeast Kansas, didn’t see its first COVID-19 case until April 15. By August, you could still count the number of cases on two hands. But by mid-November, the total was over 215 cases in a county with a population of about 8,500—meaning about one out of every 40 residents has been infected.

Our 25-bed critical-access hospital doesn’t have dedicated ICU beds, and it has only two ventilators. Emergency department calls are split among the five physicians in Fredonia. In addition to dealing with COVID-19 cases, we’re managing every other illness and injury that walks through the door, including strokes, heart attacks, traumatic injuries and rattlesnake bites.

We have sectioned off a hallway of rooms for suspected COVID-19 cases. Without an ICU, however, we have to rely on other hospitals. Recently, my partner had to transfer a patient who had a gastrointestinal bleed. She had to call 11 different hospitals to find one that could take the patient.

I feel lucky to have on-site testing in the hospital lab. But like many of my rural peers, getting enough face masks and other personal protective equipment early on was tough.

The community is tired, frustrated and stubborn. Politicians talk about relying on personal responsibility to end the pandemic, but I don’t see a majority of people wearing masks in public spaces despite pleas from health professionals. Some people are scared. Others act as if COVID-19 doesn’t exist.

Politics is making things harder. I have been Wilson County’s health officer for the past eight years. This year, county commissioners gained more control over COVID-19 health decisions.

When I proposed a mask mandate early in the pandemic, one county commissioner argued it would violate his rights. Another commissioner balked at one of my reports, saying I had no right to tell schools how to evaluate kids before they can return to sports, despite the health risks.

I recently proposed a new mask mandate given our rising numbers. I explained that masks would not only save lives, they would help businesses stay open and keep employees at work. The commissioners voted it down 3-0.

Preparing for the next pandemic

We live in an interconnected world where commerce and people cross state and national borders, and with that comes the risk of new diseases. America will face another pandemic in the future.

Rural health care delivery systems can leverage lessons from COVID-19 to prepare. Among other things, their emergency preparedness “tabletop exercises” can include planning for infectious disease outbreaks, in addition to fire and floods; mass casualty incidents; and chemical spills.

They can permanently diversify supply chain options from other industries, such as construction and agriculture, to help ensure access to needed supplies. To avoid staff and supply shortages, they can create regional rural health care networks for swapping staff, conducting testing and acquiring supplies.

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It’s not if, but how, people use social media that impacts their well-being

New research from UBC Okanagan indicates what’s most important for overall happiness is how a person uses social media.

Derrick Wirtz, an associate professor of teaching in psychology at the Irving K. Barber Faculty of Arts and Social Sciences, took a close look at how people use three major social platforms—Facebook, Twitter and Instagram—and how that use can impact a person’s overall well-being.

“Social network sites are an integral part of everyday life for many people around the world,” says Wirtz. “Every day, billions of people interact with social media. Yet the widespread use of social network sites stands in sharp contrast to a comparatively small body of research on how this use impacts a person’s happiness.”

Even before COVID-19 and self-isolation became standard practice, Wirtz says social media has transformed how we interact with others. Face-to-face, in-person contact is now matched or exceeded by online social interactions as the primary way people connect. While most people gain happiness from interacting with others face-to-face, Wirtz notes that some come away from using social media with a feeling of negativity—for a variety of different reasons.

One issue is social comparison. Participants in Wirtz’s study said the more they compared themselves to others while using social media, the less happy they felt.

“Viewing images and updates that selectively portray others positively may lead social media users to underestimate how much others actually experience negative emotions and lead people to conclude that their own life—with its mix of positive and negative feelings—is, by comparison, not as good,” he says.

Wirtz notes that viewing other people’s posts and images while not interacting with them lends itself to comparison without the mood-boosting benefits that ordinarily follow social contact, undermining well-being and reducing self-esteem. “Passive use, scrolling through others’ posts and updates, involves little person-to-person reciprocal interaction while providing ample opportunity for upward comparison.”

As part of his research, study participants were asked about four specific functions of Facebook—checking a news feed, messaging, catching up on world news and posting status or picture updates. The most frequently used function was passively checking one’s news feed. Participants primarily used Facebook without directly connecting with other users, and the negative effects on subjective well-being were consistent with this form of use.

During COVID-19, Wirtz notes people naturally turn to social media to reduce feelings of social isolation. Yet, his research (conducted before the pandemic) found that although people used social media more when they were lonely, time spent on social media only increased feelings of loneliness for participants in the study. “Today, the necessity of seeing and hearing friends and family only through social media due to COVID-19 might serve as a reminder of missed opportunities to spend time together.”

The more people used any of these three social media sites, the more negative they reported feeling afterwards. “The three social network sites examined—Facebook, Twitter and Instagram—yielded remarkably convergent findings,” he says. “The more respondents had recently used these sites, either in aggregate or individually, the more negative effect they reported when they responded to our randomly-timed surveys over a 10-day period.”

Wirtz’s study also included offline interactions with others, either face-to-face or a phone call. Comparing both offline communication with online, he was able to demonstrate that offline social interaction had precisely the opposite effect of using social media, strongly enhancing emotional well-being.

But all is not lost, Wirtz says, as this research also reveals how people can use social media positively, something more important than ever during COVID-19. He suggests people avoid passively scrolling and resist comparing themselves to other social media users. He also says people should use social media sites to enable direct interactions and social connectedness—for example, talking online synchronously or arranging time spent with others in-person, when possible and with proper precautions.

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Bushfires and COVID take their toll on new moms and babies

Almost seven in 10 pregnant women and new mothers (65%) in the ACT and southeast New South Wales say they were severely exposed to bushfire smoke in our recent summer.

Almost nine in 10 (85%) said they isolated themselves and their family at some point this year due to the COVID-19 pandemic.

These are early results of the Mother and Child 2020 (MC2020) survey being conducted by researchers from The Australian National University (ANU), University of Canberra and University of Wollongong, in partnership with Canberra Health Services and NSW Health.

The MC2020 study is examining the effects of this year’s bushfires and COVID-19 on the health and wellbeing of pregnant women and their babies. Mid-way through the survey, 750 women have participated.

The researchers are urging more women to enroll to increase the strength of the study findings. They are encouraging mothers from Aboriginal, Torres Strait Islander and multicultural communities to share their experiences.

The survey highlights the challenges women and their babies faced throughout the bushfires and pandemic as well as their adaptability and resilience in both the short and longer term.

Lead ANU researcher Professor Christopher Nolan said the results will be used to form a series of recommendations on how to improve our health system and emergency responses during major crises. “We need to listen to the experiences of these mothers and look at the challenges they faced during the bushfires and pandemic. Understanding these challenges is the only way we can look to improve these systems in the future,” Professor Nolan said. “We are very grateful for the women who have already joined the study.”

Ms Namita Mittal gave birth to twins during the lockdown and says that balancing looking after her newborn babies, helping her daughter do school from home and handling the pandemic without her family’s support caused her a great deal of anxiety. “None of my family could fly to visit me from India. Having a family member come to stay with you 24/7 to help with the babies is important to me and different from hiring help. There was extra work for me to do and not having that family support was the main thing that caused me anxiety,” Ms Mittal said.

“When my daughter was born my mum came, so I had no experience of how to handle everything myself. Recovering from a cesarean section with two newborns and one child doing school from home, I was really anxious having to do this without my mum.”

Dr Amita Bansal, from ANU, said mothers and babies have been disproportionately affected, and the long-term impact of bushfires, bushfire smoke and COVID-19 on the health of mothers and their babies is unknown.

“If a majority of women felt that exposure to smoke was severe, this may influence their stress levels. Isolation from COVID-19 most likely will add to this stress. Pregnancy itself is an overwhelming period for many women, and any additional stress can be detrimental for health of the mother and her child.”

Dr Bansal said it is important researchers get results that more accurately reflect the population to better prepare our emergency response and health care systems in the future.

“We want to hear the unheard, uncover the unknowns and best represent our diversity, so that we can better inform clinical practice and make policies that are more inclusive; inclusive of our women and children, and inclusive of our diverse perspectives and community,” she said.

“Through our study, we want to uncover if our multicultural community was indeed disproportionately impacted, so that we can improve our clinical practices and policies to reduce health disparities between ethnic groups.”

The survey is available to anyone who was pregnant or had a baby no older than three months on 1 February 2020 or became pregnant by 30 April 2020 in Canberra and Southeastern New South Wales.

The four-part survey asks mothers a series of questions about how the bushfires and pandemic impacted their pregnancy care, birthing and early months of having a new baby, including on their own mental and physical health, as well as the health of their baby.

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People in Soweto told us about their fears in the first weeks of South Africa’s lockdown

South Africa’s response to the novel coronavirus outbreak was swift and assertive. The country quickly instituted testing, tracing, and quarantining those affected with COVID-19. But the financial and social effects of quarantine hit people, who were already struggling, especially hard. Racial and economic inequalities were amplified in South Africa, as elsewhere, through the new coronavirus threat.

In March, the government introduced extreme lockdown restrictions barring South Africans from leaving their homes except to buy essential goods and seek medical care. We conducted a study to capture how people were coping during lockdown in Soweto, a large conglomerated urban area southwest of Johannesburg. Psychological assessments were done between April 2019 and March 2020; and again in the first six weeks of the lockdown.

We called 957 adults living in Soweto who had been enrolled in existing studies on the epidemiology of syndemics, or synergistic epidemics. We spoke to them about how they perceived and experienced lockdown and COVID-19. A large majority of our sample were female, middle aged (average age was 43 years old), and shared a room at home. Nearly 91% of adults in our sample reported having at least one underlying health condition or more—a potential risk factor for COVID-19 infection.

We already had some information about them, such as early childhood trauma and current mental and physical health as they are already participants in research we are currently undertaking. We also conducted a brief mental health questionnaire on the phone during lockdown.

Our results show that people who viewed their risk of COVID-19 infection to be higher than others in their community exhibited greater depressive symptoms. Furthermore, people who reported histories of childhood trauma had worse depressive symptoms as a result of their perceived risk of getting COVID-19. These findings confirm existing research that shows that people who face more adversity during childhood may be more vulnerable to the effects of stress and trauma in the future—such as the stressors of the pandemic.

We found a strong relationship between COVID-19 risk perceptions and depressive symptoms. But an overwhelming majority (74%) of respondents didn’t think that their life under lockdown and wider pandemic conditions affected their mental health. This discrepancy potentially highlights the ever-present stigma and lack of awareness around mental health in Soweto and the country at large. Our study reemphasises the importance of prioritizing and providing accessible mental health services for resource-limited communities in Soweto and across South Africa.

Public perceptions

Many people called it a “virus that kills” and suggested they feared the virus in some way. This most likely inspired people to say that they frequently used preventative measures, such as “I wash my hands and stay home” or “wear a mask” or “keep my distance from people.” Many described feeling some anxiety because they are “always thinking about it.” Most worried about those with preexisting conditions, like HIV, diabetes, or heart disease. They considered these community members most at risk.

Social challenges were common. Many had already lost their jobs and worried about putting food on the table. Others worried because “since lockdown, movement is very difficult.”

Residents were scared to leave the house. One participant was scared because a neighbor’s house was bulldozed and his family had nowhere to go.

Few cases of COVID-19 were detected in Soweto during the first month of lockdown, although many people still perceived their risk to be high. Many described deep anxiety and fear over personal well being, and caring for those they love.

We found people perceived their own risk for COVID-19 infection differently relative to others in their community. About 58% of adults thought they were at lower risk of COVID-19 than others, while 29% reported having the same risk, and 14% having more risk. This risk perception was unaffected by personal characteristics such as age, finances, education, or household density. Greater knowledge of how to prevent coronavirus transmission and to keep their families safe was associated with lower perception that they were at risk of infection.

One in three people in South Africa is expected to experience a common mental disorder like anxiety or depression in their lifetimes. During lockdown, most did not think that COVID-19 had affected or could hurt their mental health. Nevertheless, we found a variety of stressors that caused deep worry, anxiety, and rumination (“thinking too much”) in approximately 20% of adults.

We found that those who perceived their risk for COVID-19 to be higher had more depressive symptoms and more severe histories of childhood trauma. This was true regardless of people’s mental health before lockdown, what they knew about COVID-19, how they coped, and their family and financial backgrounds.

But these measures were collected simultaneously. So we don’t know if these adults were depressed because they felt at risk, or whether they felt at risk because they were depressed. Because we controlled for recent psychiatric status in the first wave of our study before COVID-19, we can be more sure that COVID-19 risk and depression are tightly linked regardless of people’s mental health going into the pandemic.

Finally, we found preliminary evidence that the depressive effects of COVID-19 risk were worse among adults with histories of childhood trauma. In other words, those with greater childhood adversity exhibited worse psychological outcomes during the first six weeks of the lockdown compared to those with fewer accounts of childhood trauma.

Research has shown that adversity during childhood can increase risk for major depression later in life. More childhood trauma also may influence the severity of adult depression and increase how people respond emotionally to future stressors like the coronavirus.

Urgent need for services

Childhood trauma is well-known to influence how severely and for how long people experience depression.

This study shows how those who have experienced social adversity growing up may be struggling more than others in this current moment.

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Study identifies brain cells most affected by epilepsy and new targets for their treatment

Epilepsy is one of the most common neurological diseases. It is caused by a malfunction in brain cells and is usually treated with medicines that control or counteract the seizures.

Scientists from the Faculty of Health and Medical Sciences, University of Copenhagen and Rigshospitalet have now identified the exact neurons that are most affected by epilepsy. Some of which have never been linked to epilepsy before. The newfound neurons might contribute to epileptogenesis—the process by which a normal brain develops epilepsy—and could therefore be ideal treatment targets.

“Our findings potentially allows for the development of entirely new therapeutic approaches tailored towards specific neurons, which are malfunctioning in cases of epilepsy. This could be a breakthrough in personalized medicine-based treatment of patients suffering from epileptic seizures,” says Associate Professor Konstantin Khodosevich from Biotech Research & Innovation Center (BRIC), Faculty of Health and Medical Sciences.

A major step towards more effective drugs

It is the first time a study investigates how every single neuron in the epileptic zone of the human brain is affected by epilepsy. The researchers have analyzed more than 117,000 neurons, which makes it the largest single cell dataset for a brain disorder published so far.

Neurons have been isolated from tissue resected from patients being operated as part of the Danish Epilepsy Surgery Programme at Rigshospitalet in Copenhagen.

“These patients continue to have seizures despite the best possible combination of anti-seizure drugs. Unfortunately, this is the case for 30-40% of epilepsy patients. Active epilepsy imposes serious physical, cognitive, psychiatric and social consequences on patients and families. A more precise understanding of the cellular mechanism behind epilepsy could be a major step forward for developing drugs specifically directed against the epileptogenic process compared to the current mode of action reducing neuronal excitability in general throughout the brain’ says associate professor Lars Pinborg, head of the Danish Epilepsy Surgery Program at Rigshospitalet.

From ‘neuronal soup’ to single cell analysis

The study from the Khodosevich Group differs from previous work by using single cell analysis. Earlier studies on neuronal behavior in regards to epilepsy have taken a piece of the human brain and investigated all the neurons together as a group or a ‘neuronal soup.” When using this approach, diseased cells and healthy cells are mixed together, which makes it impossible to identify potential treatment targets.

“By splitting the neurons into many thousands of single cells, we can analyze each of them separately. From this huge number of single cells, we can pinpoint exactly what neurons are affected by epilepsy. We can even make a scale from least to most affected, which means that we can identify the molecules with the most promising potential to be effective therapeutic targets,” says Khodosevich.

Next step is to study the identified neurons and how their functional changes contribute to epileptic seizures. The hope is to then find molecules that can restore epilepsy related neuronal function back to normal and inhibit seizure generation.

Expanding knowledge on underlying mechanisms of epilepsy

The study confirms expression from key genes known from a number of previous studies, but is also a dramatic expansion of knowledge on the subject. Previously, gene expression studies have identified a couple of hundred genes that changes in epilepsy.

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To safeguard children’s mental health during COVID-19, parents must look after their own

The negative mental health impacts of the COVID-19 pandemic are clear, but there is particular concern children will be most affected in the long run.

By the end of March school closures were impacting 91% of the world’s student population and are still affecting more than 60%. These closures limit children’s opportunities for important social interactions, which can harm their mental health.

In particular, home confinement, fears of infection, family stress and financial loss may have negative effects on the mental health of young people. And research carried out earlier in the pandemic suggested these effects may be most pronounced for children with pre-existing mental health problems.

Which children are most at risk?

Parents have an important role to play in safeguarding children’s mental health during COVID-19.

Research shows family relationships are more influential during situations that cause stress over an extended period of time than during acute periods of stress. This means family factors are likely to be even more important to childrens’ mental health during COVID-19 than during more fleeting traumatic experiences such as exposure to a natural disaster.

In our recent study, we found 81% of children aged 5-17 had experienced at least one trauma symptom during the early phase of COVID-19. For instance, some children had trouble sleeping alone, or acted unusually young or old for their age.

Our unpublished research relied on reports from parents from Australia and the United Kingdom. We also found increases in emotional problems were common. For instance, according to their parents 29% of children were more unhappy than they were before COVID-19.

Importantly, our study found several parent and family factors that were important in predicting changes in children’s mental health problems.

Here are four of our main findings.

1. Parents’ distress matters

Increased personal distress reported by parents was related to increases in their child’s mental health problems during COVID-19. This distress refers to both general stress in addition to COVID-specific worry and distress. It also includes anxiety related to problems that existed before COVID-19.

For this reason it’s important parents look after their own mental health and stress levels. Seeking psychological help is a good option for parents who are struggling to cope.

Through a GP referral, Australians can receive ten sessions of psychological care per year through Medicare. Victorians who are currently subjected to further restrictions can now receive up to 20 sessions.

2. Good family relationships help

Higher levels of parental warmth and family cohesion were associated with fewer trauma symptoms in children. “Parental warmth” refers to being interested in what your child does, or encouraging them to talk to you about what they think; “family cohesion” relates to family members helping and supporting each other.

In other research these factors have consistently been found to relate to children’s adjustment to stress and trauma.

Fortunately, there is a range of resources parents can use to help improve relationships with their children.

Some parents may also find taking part in a parenting course helpful. Partners in Parenting, Triple P and Tuning into Kids are available online.

3. Parents’ optimism can be contagious

While COVID-19 is having many negative impacts, some parents in our study also identified unexpected positive impacts, such as being able to spend more time with family. Children of these parents were less likely to experience an increase in some problems—particularly problems with peers such as being bullied.

Children observe parents’ behaviors and emotions for cues on how to manage their own emotions during difficult times. Trying to stay positive, or focus on the bright side as much as possible is likely to benefit children.

4. Some effects are greatest for vulnerable families

We found parents’ behavior was particularly influential in lower socioeconomic backgrounds and single-parent families. In poorer families, parental warmth was particularly important in buffering children’s trauma symptoms. And in single-parent families, parental stress was more likely to predict behavioral problems in children.

This may be because poorer and single-parent families already face more stress, which can negatively impact children. Parental warmth can counteract the effects of these stresses, whereas high parental stress levels can increase them.

Research has already shown the pandemic will have greater negative impacts on those who have less resources available to them. This points to a need for extra psychological and financial support for these families. Governments and other organizations will need to take this into account when targeting their support packages.

It’s important to keep in mind child-parent relationships are a two-way street. Our research examined relationships at only one point in time, so we don’t know the extent to which our findings reflect a) parents causing changes in their children’s mental health, or b) changes in children’s mental health impacting parents, or the way a family functions. Research needs to follow children and their families over time to tease apart these possibilities.

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