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Jesús Muyor-Rodríguez ◽  
Francisco Caravaca-Sánchez ◽  
Juan Sebastián Fernández-Prados

Worldwide, previous studies have expressed concerns regarding the broad psychological effects of the COVID-19 pandemic among college students as they are considered an especially vulnerable group. However, few studies have examined the prevalence of, risk of, and protective factors associated with fear of COVID-19 among college students in Europe. We have sought to address gaps in the literature by conducting a cross-sectional survey among 517 college students (79.1% women and 20.9% men) from a public university in the southeast of Spain. Participants were asked to complete the Fear of COVID-19 scale (FCV-19S) questionnaire and answer questions related to resilience, social support, anxiety, and suicide risk levels using validated scales. The results of the analysis of the variables associated with fear of COVID-19 suggest that, in addition to gender, the factor of anxiety shows a robust positive association and effect with COVID-19 fear (p < 0.001). According to our results, university institutions must adopt support mechanisms to alleviate psychological impacts on students during this pandemic, treating it similarly to other disasters. Implications for social work to reduce COVID-19 fear are also discussed.

2021 ◽  
Lauren Haire ◽  
Jennifer Elisabeth Symonds

The construct of pathological demand avoidance (PDA) is relatively new and contested. Clinical reports indicate a population who obsessively resist everyday demands and have a need for control which is pervasive and extreme in nature. Individuals struggle in their daily lives with significant impact on families. The construct has no agreed definition, and the diversity of conceptualisations of PDA have impacted the research on PDA and clinical guidance for PDA. The proposed scoping review aims to map this initial evidence base with a focus on how PDA is conceptualised, and the methods used to study PDA, in samples of children and adolescents. The methodological framework provided by Arksey and O’Malley (2005) and the PRISMA-ScR checklist will be employed. There is a need to identify rigorous and reliable methodological approaches to support future researchers in making balanced judgements about how to research PDA and to provide guidance for clinicians who are supporting a vulnerable group.

2021 ◽  
Vol 148 (1) ◽  
pp. 1-22
Kamil Matuszczyk

A significant proportion of migrant workers around the world have difficult access to social protection, especially long-term benefits such as pensions. Domestic care workers are a particularly vulnerable group in this regard. Analysing the example of Polish migration to Germany, the aim of this paper is to present the strategies that migrants aged 45 and over undertake in the context of pension plans and ensuring an adequate level of social protection while working abroad. Using empirical material collected during semi-structured interviews with migrant care workers, representatives of employment agencies and experts, the article sheds light on the diverse conditions that influence the strategies of individual workers. Depending on the general knowledge of their social rights, their migration strategy or their personal situation, migrants adopt three main strategies called (1) escape from problems instead of social security, (2) secure and legal work above all and (3) an informed and inquisitive insured worker.

2021 ◽  
Vol 21 (1) ◽  
Astrid Juhl Andersen ◽  
Murielle Mary-Krause ◽  
Joel José Herranz Bustamante ◽  
Mégane Héron ◽  
Tarik El Aarbaoui ◽  

Abstract Background To cope with the COVID-19 pandemic, social distancing restrictions where implemented in France, which could have led to social isolation. This is expected to have affected the mental health situation, including increasing risk of symptoms of anxiety and depression in the general population. Persons with prior mental health difficulties could be an especially vulnerable group, however, few studies have tested this empirically considering preexisting mental health difficulties. We examine the association between preexisting symptoms of anxiety/depression and anxiety/depression during lockdown due to the COVID-19 pandemic in a longitudinal community sample. Methods A longitudinal follow-up during lockdown (data collection March–June 2020) was implemented among participants of the TEMPO cohort. Prior knowledge of anxiety/depression was included from prior waves of data collection. Generalized estimation equations models were used to estimate the association between preexisting symptoms of anxiety/depression and symptoms of anxiety/depression during lockdown among 662 mid-aged individuals. Results Individuals with symptoms of anxiety/depression measured prior to lockdown had 6.73 higher odds [95% CI = 4.45–10.17] of symptoms of anxiety/depression during lockdown. Additionally, the likelihood of symptoms of anxiety/depression during lockdown was elevated among women (OR = 2.07 [95% CI = 1.32–3.25]), subjects with low household income (OR = 2.28 [1.29–4.01]) and persons who reported being lonely (OR = 3.94 [95% CI = 2.47–6.28]). Conclusions Our study underlines the role of preexisting symptoms of anxiety/depression as a vulnerability factor of anxiety/depression during lockdown. Interventions focusing on individuals with mental health difficulties as well as people feeling lonely should be considered, to reduce the psychological impact of the COVID-19 pandemic.

2021 ◽  
Rainer Weber ◽  
Lukas Eggenberger ◽  
Christoph Stosch ◽  
Andreas Walther

Background: Attachment anxiety and avoidance have been insufficiently studied in relation to psychotherapy use. Attachment theory, specifically attachment anxiety and avoidance, might explain gender differences in psychotherapy use, which is generally lower in those identifying as male. In addition, university students are a particularly vulnerable group for mental health problems, and understanding psychotherapy use, especially among mentally distressed male students, is pivotal.Methods: A total of 44,299 students from a German university were invited to participate in an online survey on the topic of "studying with mental stress", and 4,894 completed the survey (adjusted response rate of 11.04%). The students answered questions regarding psychotherapy use, and they completed the Patient Health Questionnaire (PHQ-D) identifying syndromes of depression, anxiety, alcohol use, somatoform and eating disorders. In addition, the Experiences in Close Relationships – Revised (ECR-RD12) questionnaire, was used to measure attachment anxiety and avoidance.Results: Significant gender differences for attachment anxiety and avoidance emerged showing higher attachment anxiety in female students and higher attachment avoidance in male students. In addition, male students used psychotherapy significantly less than female students, and they also intended less to use psychotherapy in the near future. Male students did not differ from female students with regard to mental distress. When exploring regressions to predict psychotherapy use, male students’ attachment anxiety and avoidance predicted use. For female students, only attachment anxiety emerged as a significant predictor. Attachment anxiety further emerged as a significant moderator of the association between suffering from a depressive or somatoform syndrome and current psychotherapy use. In essence, students not presenting a psychiatric syndrome and exhibiting higher attachment anxiety were more likely to use psychotherapy.Conclusion: Attachment anxiety and avoidance are positively associated with psychotherapy use; however, gender differences in attachment anxiety and avoidance may partially explain lower psychotherapy use in male university students. Lower attachment anxiety in male students emerges as a relevant factor explaining lower psychotherapy use in males, which is not balanced by higher attachment avoidance in males.

2021 ◽  
Vol 67 (3) ◽  
pp. 45-54
N. O. Khovasova ◽  
A. V. Naumov ◽  
O. N. Tkacheva ◽  
E. N. Dudinskaya

BACKGROUND: Older adults with osteoporosis (OP) and high risk of falls are the most vulnerable group of patients with respect to the development of fractures. Falls and fractures in elderly patients with OP are associated with geriatric syndromes and worse functional status.AIM: To аssess comorbidity and geriatric status in elderly and senile patients with and without OP.MATERIALS AND METHODS: The study included 607 patients over 60 years of age hospitalized in the geriatric department. According to the presence of OP, the patients were divided into 2 groups: group 1 — patients with OP (n=178, 29.3%), group 2 — patients without OP (n=429, 70.7%). All patients underwent a general clinical study, an assessment of comorbidity ­according to the Charlson index, and a comprehensive geriatric score.RESULTS: OPs had 178 (29.3%) patients, more often these were women. 55.6% of patients with OP were disabled. Age-­related diseases such as Alzheimer’s disease, Parkinson’s disease, osteoarthritis, anemia, thyroid disease, varicose veins were significantly more common in patients with OP. With almost all of these diseases, a univariate analysis revealed an association with OP. Geriatric syndromes such as frailty, hypodynamia, malnutrition, polypharmacy, urinary incontinence were significantly more common in group 1 patients. Patients with OP were more likely to live alone and use mobility aids compared to patients without OP.The univariate analysis demonstrated that OP is associated (OR 1.54 to 2.00) with frailty, hypodynamia, the use of aids in movement, sleep disorders, sensory vision deficiency, urinary incontinence. The Functional status of patients with OP was worse compared to patients without OP. Patients with OP suffered more fractures, and vertebral fractures were significantly more frequent.CONCLUSION: Patients with OP have a high comorbidity, a burdened geriatric status. In elderly patients, it is necessary not only to screen and diagnose OP, to assess the risk of 10-years probability of major pathological fractures using the FRAX algorithm, but also to conduct a comprehensive geriatric assessment to diagnose geriatric syndromes that weaken the course of OP and lead to more serious consequences.

2021 ◽  
pp. 1-5
Carola Deischinger ◽  
Doris Deischinger ◽  
Irina Gessl ◽  
Michael Krebs ◽  
Rodrig Marculescu ◽  

<b><i>Objective:</i></b> Similar to pregnant women, women taking an oral contraceptive (OC) might have elevated iodine requirements due to the altered hormonal state. This is the first study aimed at investigating the prevalence of iodine deficiency and possible influences of OC intake on urine creatinine and iodine levels in young women. <b><i>Methods:</i></b> One hundred fifty-five women between the age of 18 and 35 years (62 taking an OC and 93 controls) participated in a cross-sectional pilot study at the Medical University of Vienna, which included a 1-spot urine sample and a questionnaire on OC intake as well as a food questionnaire. <b><i>Results:</i></b> The median urinary iodine concentration (UIC) in this study was 68 μg/L (41, 111 μg/L) suggesting an inadequate iodine status in the women according to the WHO guidelines. Median UIC (OC: 89 μg/L, IQR 55–120; control: 59 μg/L, IQR 39–91, <i>p</i> = 0.010) and urine creatinine (OC: median = 99.0 μg/L, IQR 74.9–175.5; control: 77.0 μg/L, IQR 49.6–147.2, <i>p</i> = 0.030) levels were significantly higher in OC women than in the control group. UIC corrected for urine creatinine was comparable between both groups. <b><i>Conclusion:</i></b> With similar creatinine-corrected UICs in both groups, OC intake might not have a significant impact on iodine status. However, the low median UIC in a vulnerable group of young women potentially conceiving in the following years points at the necessity of optimizing the iodine intake in the Austrian population and reiterates the insufficiency of the current iodine supplementation measures.

2021 ◽  
Vol 4 (Special2) ◽  
pp. 395-401
Ann Mary Thomas ◽  
Babita Susan ◽  
Jacob Davies Kalliath ◽  
Vinu Cherian ◽  
Brilly M Rose ◽  

Background: Elderly constitutes a vulnerable group for depression, as they are especially prone to suffer adverse consequences of a depressive episode and have greater rates of completed suicides. This study aims to estimate the prevalence and determinants of geriatric depression.  Methods: A cross-sectional study was done among 250 elderlies from 1st January 2019 to 1st January 2020 in the different rural blocks of Ernakulam district, India. The multistage sampling technique and the Geriatric Depression Scale (GDS-30) were used to collect the data. A score of 0 9 is considered "normal", 10 19 is labeled as "mildly depressed", and 20 30 as "severely depressed". Statistical analysis was performed using the IBM SPSS software. The Chi-square test /Fisher's exact test was used to study the association between the socio-demographic and behavioral variables with depression. Results: The mean age was 69.33 ± 7.41years and male: female ratio was 0.55: 1.The overall prevalence of depression was 52.4%. Advanced age over 70years [OR=2.04;95% CI, 1.227 – 3.394; P=0.006], female gender[OR=2.844;95% CI,1.663-4.865; P =<0.001], lack of gainful employment [OR=3.504; 95% CI, 1.833–6.699; P =<0.001], physical dependence [OR=0.365;95% CI,0.162–0.821; P =0.012], financial dependence [OR=0.388; 95% CI, 0.219–0.687; P =<0.001], presence of medical co morbidities [OR=0.428; 95% CI, 0.212–0.866; P =0.016],poor lifestyle including the lack of regular exercise [OR =2.020; 95% CI,1.174–3.473; P =0.010], addiction to alcohol [OR=4.932;95%CI,1.600-15.208; P =0.004] and addiction to tobacco smoking [OR=2.905;95%CI,1.273-6.628; P =0.009] and poor family support [OR= 5.180;95% CI,716–15.636; P = 0.002] were found to be significantly associated with depression. Conclusion: The prevalence of depression among the elderlies was high, and hence early diagnosis and prompt treatment are essential to reduce its burden in the community.

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Kjersti Berge Evensen ◽  
Vibeke Hervik Bull ◽  
Linda Ness

Purpose Prisoners have poorer oral health than the general population. Good oral health is essential for both social and physical well-being. For prisoners, poor oral health is also related to drug use after release, whereas good oral health is related to successful reintegration into society. The purpose of this study was twofold: to examine the effect of an intervention based on motivational interviewing (MI) on prisoners’ oral health-related behavior and to assess if the intervention is a good fit for this population. Design/methodology/approach In total, 16 prisoners in a Norwegian prison were offered a brief MI-based intervention focusing on changing their oral health-related behavior. An oral examination was also performed and the prisoners received a small package containing oral hygiene aids. Two weeks later, a second oral examination and a semi-structured interview were conducted to explore the effect of the intervention and examine the prisoners’ responses to the intervention. Qualitative data analyzes were guided by thematic analysis. Findings The findings indicate that the intervention had positive effects on both the prisoners’ motivation to use oral health-related behavior and their performance of oral health-related behavior. The findings also indicate that the intervention was well adapted to the target population. Originality/value This is one of the first studies that explore the effect of an intervention in improving prisoners’ oral health and bridges a knowledge gap in the literature. The findings may increase the understanding of how dental services should be organized and offered to provide dental health care to this vulnerable group.

2021 ◽  
Maria Kyranou ◽  
Charikleia Cheta ◽  
Eliada Pampoulou

Abstract Background: Modern protocols for light sedation in combination with the increased turnover of COVID-19 infected patients hospitalized in Intensive Care Units (ICUs) have increased the number of patients who are mechanically ventilated and awake. Nurses require specific skills to care for this vulnerable group of patients. At the same time, nurses report feeling inadequate and frustrated when they attempt to establish communication with mechanically ventilated, conscious patients. Methods: The purpose of this study was to explore nurses’ experiences taking care of conscious, intubated patients in the intensive care unit. The research questions aimed to identify i. the strategies that nurses use for communicating with patients, and ii. the barriers in communication between nurses and patients. This study employed a qualitative design. Data were collected using semi-structured interviews with 14 intensive care nurses working at ICUs in four different hospitals of Cyprus. The data were analyzed by applying thematic analysis.Results: We identified several strategies of unaided (movements -lips, hands, legs- facial expressions, gestures, touching) and aided forms of communication (pen and paper, boards, tablets, mobiles) used by nurses to communicate with patients. Additionally, barriers in communication were reported by participating nurses mainly pertaining to patients’, nurses’ characteristics and the ICU environment. The health protocols imposed by the pandemic added more barriers in the communication between nurses and patients mostly related to the use of protective health equipment.Conclusions: The results of this study, combined with those of others in different countries, point to the difficulties nurses face when trying to communicate with conscious patients during mechanical ventilation. It appears that the complex communication needs of this group of patients are not being met mainly due to the lack of nurses’ training and of appropriate equipment to facilitate alternative and augmentative communication. Our study is amongst the first to add that the protective health protocols due to the pandemic imposed further communication barriers. Undoubtedly, the recognition of such an important issue creates an urgent need to educate nurses in alternative ways of communication with mechanically ventilated, conscious patients during their ICU stay.

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