Effects of Safety Zone Implementation on Perceptions of Safety and Well-being When Caring for COVID-19 Patients

Background In March 2020, the caseload of patients positive for COVID-19 in hospitals began increasing rapidly, creating fear and anxiety among health care workers and concern about supplies of personal protective equipment. Objectives To determine if implementing safety zones improves the perceptions of safety, well-being, workflow, and teamwork among hospital staff caring for patients during a pandemic. Methods A safety zone process was implemented to designate levels of contamination risk and appropriate activities for certain areas. Zones were designated as hot (highest risk), warm (moderate risk), or cold (lowest risk). Caregivers working in the safety zones were invited to complete a survey regarding their perceptions of safety, caregiver well-being, workflow, and teamwork. Each question was asked twice to obtain caregiver opinions for the periods before and after implementation of the zones. Results Significant improvements were seen in perceptions of caregiver safety (P < .001) and collaboration within a multidisciplinary staff (P < .001). Significant reductions in perceived staff fatigue (P = .03), perceived cross contamination (P < .001), anxiety (P < .001), and fear of exposure (P < .001) were also seen. Teamwork (P = .23) and workflow (P = .69) were not significantly affected. Conclusions Safety zone implementation improved caregivers’ perceptions of their safety, their well-being, and collaboration within the multidisciplinary staff but did not improve their perceptions of teamwork or workflow.

Virtual Reality Reduces Pediatric Anxiety During Food Allergy Clinical Trials: A Pilot Randomized, Pragmatic Study

Phlebotomy procedures required in food allergy (FA) diagnosis and clinical trials often induce fear and anxiety for pediatric patients. The primary aim of this study was to determine whether virtual reality (VR) applications were effective in reducing anxiety for pediatric FA patients undergoing phlebotomy during FA clinical trials. Secondary aims assessed fear, pain, procedural compliance, and adverse events. Participants undergoing phlebotomy were enrolled and randomized to a VR group or standard of care (SOC) group for this prospective pilot randomized, pragmatic study. Participants in the VR group played interactive applications on a customized Samsung Gear VR headset and those in the SOC group received the standard of care. Participants' anxiety, fear, and pain were assessed with the Children's Anxiety Meter, Children's Fear Scale, and FACES pain scale pre, during, and post phlebotomy procedure. Compliance was assessed using the modified Induction Compliance Checklist during the procedure and compared between two groups. Forty-nine participants were randomized to VR (n = 26) and SOC (n = 23) groups. Although both the VR and SOC groups experienced a decrease in anxiety and fear from pre- to post-procedure, those in the VR group experienced less anxiety and fear during the procedure than SOC participants. Similarly, both groups experienced an increase in pain from pre- to post-procedure; however, the VR group reported less pain during the procedure than SOC. Fewer symptoms of procedural non-compliance were reported in the VR group. Interactive VR applications may be an effective tool for reducing fear, anxiety, and pain during phlebotomy for FA clinical trials.

Environmental Enrichment Facilitates Anxiety in Conflict-Based Tests but Inhibits Predator Threat-Induced Defensive Behaviour in Male Mice

<b><i>Introduction:</i></b> Environmental enrichment (EE) is a useful and sophisticated tool that improves rodents’ well-being by stimulating social behaviour and cognitive, motor, and sensory functions. Exposure to EE induces neuroplasticity in different brain areas, including the limbic system, which has been implicated in the control of anxiety and fear. However, the effects of EE on ethologically relevant naturalistic behaviours, such as those displayed by prey in the presence of predators, remain largely unexplored. <b><i>Material and Methods:</i></b> In the present study, we investigated anxiety- and panic attack-like behaviours in a predator (cat)-prey confrontation paradigm and compared them with those in classical assays, such as the elevated plus-maze (EPM), marble-burying, and open field tests (OFTs), using C57BL/6J male mice housed in enriched or standard environments for 6 weeks. <b><i>Results:</i></b> We observed that EE exposure caused enhancement of the levels of anxiety-like behaviours in the EPM and OFTs, increasing risk assessment (an anxiety-related response), and decreasing escape (a panic attack-like response) behaviours during exposure to the predator versus prey confrontation paradigm. <b><i>Conclusion:</i></b> Taken together, our findings suggest that enriched external environments can modify the processing of fear- and anxiety-related stimuli in dangerous situations, changing the decision-making defensive strategy.

Ghosts and Religious Life in Early China

For modern people, ghost stories are no more than thrilling entertainment. For those living in antiquity, ghosts were far more serious beings, as they could affect the life and death of people and cause endless fear and anxiety. How did ancient societies imagine what ghosts looked like, what they could do, and how people could deal with them? From the vantage point of modernity, what can we learn about an obscure, but no less important aspect of an ancient culture? In this volume, Mu-chou Poo explores the ghosts of ancient China, the ideas that they nurtured, and their role in its culture. His study provides fascinating insights into the interaction between the idea of ghosts and religious activities, literary imagination, and social life devoted to them. Comparing Chinese ghosts with those of ancient Egypt, Mesopotamia, Greece, and Rome, Poo also offers a wider perspective on the role of ghosts in human history.

Sex differences in the alcohol-mediated modulation of BLA network states

About 85% of adults in the United States report drinking alcohol in their lifetime. Mood disorders, like generalized anxiety disorder and major depression, are highly comorbid with alcohol use. The basolateral amygdala (BLA) is an area of the brain that is heavily implicated in both mood disorders and alcohol use disorder. Importantly, modulation of BLA network/oscillatory states via parvalbumin-positive (PV) GABAergic interneurons has been shown to control the behavioral expression of fear and anxiety. Further, PV interneurons express a high density of δ-subunit-containing GABAA receptors (GABAARs), which are sensitive to low concentrations of alcohol. Our lab previously demonstrated that δ-subunit-containing GABAARs on PV interneurons in the BLA influence voluntary ethanol intake and anxiety-like behavior in withdrawal. Therefore, we hypothesized that the effects of alcohol may modulate BLA network states that have been associated with fear and anxiety behaviors via δ-GABAARs on PV interneurons in the BLA. Given the impact of ovarian hormones on the expression of δ-GABAARs, we examined the ability of alcohol to modulate local field potentials (LFPs) in the BLA from male and female C57BL/6J and Gabrd-/- mice after acute and repeated exposure to alcohol. Here, we demonstrate that acute and repeated alcohol can differentially modulate oscillatory states in male and female C57BL/6J mice, a process which involves δ-GABAARs. This is the first study to demonstrate that alcohol is capable of altering network states implicated in both anxiety and alcohol use disorders.

Physical Activity Experiences of People with Multiple Sclerosis during the COVID-19 Pandemic

During the COVID-19 pandemic, government and health officials introduced measures such as social distancing and facility closures that amplified barriers to physical activity. Certain groups, including people with multiple sclerosis (MS), have been underserved during the pandemic. In this qualitative study we aimed to: (1) explore the physical activity experiences of people with MS during the COVID-19 pandemic; (2) identify the facilitators and barriers to physical activity during COVID-19 for people with MS; and (3) make recommendations for inclusive physical activity policy and programming. We conducted semi-structured interviews with 11 adults (9 women) with MS during January and February 2021. Following an inductive thematic analysis, three themes were developed: (1) changing opportunities and adapting to new opportunities; (2) social isolation and physical activity; and (3) adapting physical activity to stay safe from COVID-19. Common facilitators identified included having knowledge and resources to adapt activities, social connections, and access to outdoor recreation opportunities. Identified barriers included fear and anxiety related to the spread of the virus, a loss of in-person activity options, and the closure of physical activity spaces. Online and at-home opportunities for physical activity were a valued and accessible way to address barriers to physical activity for people with MS, and should be maintained post-pandemic while considering flexibility to accommodate variable support needs.

Explaining Resident Medical Students’ Experiences of Performance During COVID-19: A Qualitative Study

Background: The COVID-19 crisis has created many problems, including a negative impact on student education. Objectives: The study aimed to understand the resident medical students' performance experiences during the COVID-19 pandemic, which is essential for future planning. Methods: The present qualitative study was performed on 15 resident medical students in Alborz University of Medical Sciences, Iran, from September to November 2020. Data were analyzed using conventional content analysis. Results: Analysis of the meaning units of interviews showed four categories describing the resident students' experiences of performance during COVID-19 as follows: Fear and anxiety, the need for support, the sense of responsibility, and the lack of educational facilities. Conclusions: The present study showed that the COVID-19 pandemic had posed incredible new challenges for resident students. Assessing the mental health of residents, providing adequate protective equipment, and support from authorities and community members can create empathy, reduce the feeling of fear, and increase their accompaniment with pandemic managing programs. Due to the problems created in the training of residents during the pandemic, it seems necessary to propose rehabilitation courses to improve the training program for residents in various fields.

A Study Determining the Health Literacy Levels of Young Adults During COVID-19

COVID-19 caused a massive quarantine around the world and also raised the need for individuals to obtain accurate information about their health. Health-related information that exists on the internet can be similar to misinformation, and this can confuse people and create fear and anxiety. Health literacy, defined as motivation with cognitive and social skills to obtain accurate information about health, understand and use the information to protect the health of individuals, is important in this context, especially as the COVID-19 pandemic period has demonstrated the importance of the ability to use digital communication tools. In this study, a survey was undertaken using field research methodology. The sample was a group of 407 people studying at Sakarya University, Selcuk University, and Konya Technical University. As a result of the research, it was determined that the general health literacy of the young adult group studying in the field of social sciences at the university was of a sufficient standard.

Mediating Effects of Psychological States on Work Performance of Visiting Nurses According to COVID-19 Workplace Quarantine Measures: A Multi-Group Path Analysis Study

This multi-group path analysis study investigated the effects of verbal abuse (suspicion of infection and disrespect) on difficulties in work performance according to the workplace quarantine measures of visiting nurses during the COVID-19 pandemic. A total of 262 visiting nurses in Korea completed the online questionnaire between 10 October and 30 November 2020, and their data were included in the final analysis. The study found that experiences of verbal abuse mediated fear and anxiety to affect difficulties in work performance. In the path model of the group with a high level of workplace quarantine measures, experiences of verbal abuse (suspicion of infection and disrespect) did not directly affect fear. The opposite was true for the group with low levels of workplace quarantine measures. The implications for the field are that the following is required: heightened awareness of verbal abuse; workplace quarantine policies; and mental health management systems and intervention programs to detect the early fear and anxiety of visiting nurses.