Differences in infant negative affectivity during the COVID-19 pandemic.

This longitudinal study compared infant temperament rated at 3 months postpartum by 263 United-States-based women who gave birth during the COVID-19 pandemic and 72 who gave birth prior to the pandemic. All women completed questionnaires assessing perinatal mental health, social contact, and infant temperament. Mothers whose infants were born during the pandemic reported higher levels of infant negative affectivity as compared with mothers whose infants were born earlier (F(1, 324) = 18.28, p < .001), but did not differ in their ratings of surgency or effortful control. Maternal prenatal depressive symptoms, prenatal stress, and postpartum stress mediated differences in infant negative affectivity  between pandemic and pre-pandemic groups. Within the pandemic group, decreased postpartum social contact was associated with higher ratings of infant negative affectivity. These findings suggest that the pandemic has affected maternal perceptions of infant temperament, perinatal mental health, and social contact.

Este estudio longitudinal comparó el temperamento del infante evaluado a los tres meses después del parto por 263 mujeres con base en Estados Unidos, las cuales dieron a luz durante la pandemia del COVID-19 y 72 que dieron a luz antes de la pandemia. Todas las mujeres completaron cuestionarios para evaluar la salud mental perinatal, el contacto social y el temperamento del infante. Las madres cuyos infantes nacieron durante la pandemia reportaron más altos niveles de afectividad negativa del infante tal como se les comparó con madres cuyos infantes nacieron antes (F(1,324) = 18.28, p<.001), pero no difirieron en sus puntajes de rapidez y astucia o control esforzado. Los síntomas depresivos maternos mediaron la asociación entre la condición de pandemia y la afectividad negativa del infante. Dentro del grupo de pandemia, la baja en el contacto social posterior al parto fue asociada con más altos puntajes en la afectividad negativa del infante. Estos resultados proponen que la pandemia ha afectado las percepciones mentales de la salud mental y el contacto social del temperamento perinatal del infante.

Cette étude longitudinale a comparé le tempérament du nourrisson évalué à trois mois postpartum par 263 femmes basées aux Etats-Unis d'Amérique ayant donné naissance durant la pandémie du COVD-19 et 72 femmes ayant donné naissance avant la pandémie. Toutes les femmes ont rempli des questionnaires évaluant la santé mentale périnatale, le contact social et le tempérament du nourrisson. Les mères dont les nourrissons étaient nés durant la pandémie ont fait état de niveaux plus élevés d'affectivité négative du bébé comparées aux mères dont les bébés étaient nés avant (F(1 324) = 18,28, p <,001), mais n'ont pas divergé dans leurs évaluations du dynamisme ou du contrôle efficace. Les symptômes dépressifs maternels ont médiatisé le lien entre le statue pandémique et l'affectivité négative du nourrisson. Au sein du groupe pandémique le contact social postpartum décru était lié à des évaluations plus élevées de l'affectivité négative du nourrisson. Ces résultats suggèrent que la pandémie a affecté les perceptions maternelles du tempérament du bébé, la santé mentale périnatale et le contact social.

'Against everything that got you into the job': experiences of potentially morally injurious events among Canadian public safety personnel.

Background: Moral injury (MI) has become a research and organizational priority as frontline personnel have, both during and in the years preceding the COVID-19 pandemic, raised concerns about repeated expectations to make choices that transgress their deeply held morals, values, and beliefs. As awareness of MI grows, so, too, does attention on its presence and impacts in related occupations such as those in public safety, given that codes of conduct, morally and ethically complex decisions, and high-stakes situations are inherent features of such occupations.Objective: This paper shares the results of a study of the presence of potentially morally injurious events (PMIEs) in the lived experiences of 38 public safety personnel (PSP) in Ontario, Canada.Method: Through qualitative interviews, this study explored the types of events PSP identify as PMIEs, how PSP make sense of these events, and the psychological, professional, and interpersonal impacts of these events. Thematic analysis supported the interpretation of PSP descriptions of events and experiences.Results: PMIEs do arise in the context of PSP work, namely during the performance of role-specific responsibilities, within the organizational climate, and because of inadequacies in the broader healthcare system. PMIEs are as such because they violate core beliefs commonly held by PSP and compromise their ability to act in accordance with the principles that motivate them in their work. PSP associate PMIEs, in combination with traumatic experiences and routine stress, with adverse psychological, professional and personal outcomes.Conclusion: The findings provide additional empirical evidence to the growing literature on MI in PSP, offering insight into the contextual dimensions that contribute to the sources and effects of PMIEs in diverse frontline populations as well as support for the continued application and exploration of MI in the PSP context.

The objective of this study was to understand the types of events that Canadian public safety personnel (PSP) experience as potentially morally injurious events (PMIEs) as well as the impacts that they associate with these events.The findings illuminate that contextual dimensions are significant in the origin of PMIEs, which PSP experience in the completion of routine duties, because of the organizational culture, or as a result of issues in the broader healthcare system, which led to many negative consequences in their personal and professional lives.PMIEs reduced the trust PSP had in their leadership and the healthcare system to protect the public and themselves, were associated with feelings of anger, frustration, resignation, and helplessness, and connected to internal struggles marked by inner conflict and the erosion of self-concept.

Measuring the Impact of COVID-19 on Hospital Care Pathways

Care pathways in hospitals around the world reported significant disruption during the recent COVID-19 pandemic but measuring the actual impact is more problematic. Process mining can be useful for hospital management to measure the conformance of real-life care to what might be considered normal operations. In this study, we aim to demonstrate that process mining can be used to investigate process changes associated with complex disruptive events. We studied perturbations to accident and emergency (A &E) and maternity pathways in a UK public hospital during the COVID-19 pandemic. Co-incidentally the hospital had implemented a Command Centre approach for patient-flow management affording an opportunity to study both the planned improvement and the disruption due to the pandemic. Our study proposes and demonstrates a method for measuring and investigating the impact of such planned and unplanned disruptions affecting hospital care pathways. We found that during the pandemic, both A &E and maternity pathways had measurable reductions in the mean length of stay and a measurable drop in the percentage of pathways conforming to normative models. There were no distinctive patterns of monthly mean values of length of stay nor conformance throughout the phases of the installation of the hospital's new Command Centre approach. Due to a deficit in the available A &E data, the findings for A &E pathways could not be interpreted. © 2023, The Author(s).

Sleep and day-to-day PTSD symptom variability: an ecological momentary assessment and actigraphy monitored study in trauma-exposed young adults.

BACKGROUND: Disrupted sleep and post-traumatic stress disorder (PTSD) are bi-directionally linked and have been found to mutually reinforce each other on a day-to-day basis. However, most of the previous research has focused on subjective measures of sleep only. OBJECTIVE: Here, we investigated the temporal relationship between sleep and PTSD symptoms using both subjective (sleep diary) and objective measures of sleep (actigraphy). METHODS: Forty-one non-treatment seeking, trauma exposed young adults (age M = 24.68, SD = 8.15) with a range of PTSD symptom severities (PTSS, 0-53 on PCL-5) were recruited. Participants completed two surveys per day over four weeks to measure day-time PTSD symptoms (i.e. PTSS and number of intrusions) and night-time sleep subjectively, while wearing an actigraphy watch to measure sleep objectively. RESULTS: Linear mixed models revealed that subjectively reported sleep disruptions were associated with elevated next-day PTSS and increasing number of intrusive memories both within and between participants. Similar results were found for daytime PTSD symptoms on night-time sleep. However, these associations were not found using objective sleep data. Exploratory moderator analyses including sex (male vs. female) found that these associations differed in strength between sexes but were generally in the same direction. DISCUSSION: These results were in line with our hypothesis with regards to the sleep diary (subjective sleep), but not actigraphy (objective sleep). Several factors which have implications on both PTSD and sleep, such as the COVID-19 pandemic and/ or sleep-state misperception, may be potential reasons behind those discrepancies. However, this study had limited power and needs to be replicated in larger samples. Nonetheless, these results add to the current literature about the bi-directional relationship between sleep and PTSD and have clinical implications for treatment strategies.

Elevated day-time PTSD symptom severity (PTSS) and more frequent intrusive memories were generally associated with subjectively reported disruptions in sleep and vice versa, but not with objective measures of sleep.While longer subjective sleep duration predicted reductions in PTSS and shorter sleep onset latency predicted reduced numbers of intrusions the next day, reduced daytime PTSS was only associated with reductions in distress associated with nightmares during the following night.Exploratory analyses showed that sex (men vs. women) moderated the bi-directional relationships between night-time sleep and day-time PTSD symptoms with longer sleep onset latency and lower sleep efficiency being related to worse PTSD symptoms the next day in women, but was not associated with men.

Evaluating global interest in biodiversity and conservation.

The first target of the Convention for Biological Diversity (Aichi target 1) was to increase public awareness of the values of biodiversity and actions needed to conserve it-a key prerequisite for other conservation targets. Monitoring success in achieving this target at a global scale has been difficult; however, increased digitization of human life in recent decades has made it easier to measure people's interests at an unprecedented scale and allows for a more comprehensive evaluation of Aichi target 1 than previously attempted. We used Google search volume data for over a thousand search terms related to different aspects of biodiversity and conservation to evaluate global interest in biodiversity and its conservation. We also investigated the correlation of interest in biodiversity and conservation across countries to variables related to biodiversity, economy, demography, research, education, internet use, and presence of environmental organizations. From 2013 to 2020, global searches for biodiversity components increased, driven mostly by searches for charismatic fauna (59% of searches were for mammal species). Searches for conservation actions, driven mostly by searches for national parks, decreased since 2019, likely due to the COVID-19 pandemic. Economic inequality was negatively correlated with interest in biodiversity and conservation, whereas purchasing power was indirectly positively correlated with higher levels of education and research. Our results suggest partial success toward achieving Aichi target 1 in that interest in biodiversity increased widely, but not for conservation. We suggest that increased outreach and education efforts aimed at neglected aspects of biodiversity and conservation are still needed. Popular topics in biodiversity and conservation could be leveraged to increase awareness of other topics with attention to local socioeconomic contexts.

Evaluación del interés mundial en la biodiversidad y la conservación Resumen La primera meta del Convenio sobre la Diversidad Biológica (Meta 1 de Aichi) era aumentar la conciencia pública sobre los valores de la biodiversidad y las acciones necesarias para conservarla, un requisito previo clave para otras metas de conservación. Ha sido difícil monitorear el éxito en la obtención de esta meta a escala mundial; sin embargo, la creciente digitalización de la vida humana en las últimas décadas ha facilitado la medición de los intereses de la gente a una escala sin precedentes y permite una evaluación más exhaustiva de la Meta 1 de Aichi que la que se había intentado previamente. Utilizamos datos sobre el volumen de búsquedas en Google de más de mil términos relacionados con distintos aspectos de la biodiversidad y la conservación para evaluar el interés mundial en la biodiversidad y su conservación. También investigamos la correlación del interés por la biodiversidad y la conservación en los distintos países con variables relacionadas a la biodiversidad, la economía, la demografía, la investigación, la educación, el uso del internet y la presencia de organizaciones ambientalistas. Las búsquedas mundiales sobre los componentes de la biodiversidad aumentaron de 2013 a 2020, impulsadas sobre todo por búsquedas de especies carismática (el 59% de las búsquedas correspondían a especies de mamíferos). Las búsquedas de acciones de conservación, impulsadas principalmente por búsquedas de parques nacionales, han disminuido desde 2019, probablemente debido a la pandemia de COVID-19. La desigualdad económica se correlacionó negativamente con el interés en la biodiversidad y la conservación, mientras que el poder adquisitivo se correlacionó indirectamente de manera positiva con niveles más altos de educación e investigación. Nuestros resultados sugieren un éxito parcial en la obtención de la Meta 1 de Aichi en el sentido de que aumentó ampliamente el interés por la biodiversidad, pero no por la conservación. Sugerimos que se necesitan mayores esfuerzos de divulgación y educación dirigidos a aspectos desatendidos de la biodiversidad y la conservación. Los temas populares de biodiversidad y conservación podrían aprovecharse para aumentar la conciencia sobre otros temas si se presta atención a los contextos socioeconómicos locales.

Safe haven in adolescence: Improving parental reflective functioning and youth attachment and mental health with the Connecting and Reflecting Experience.

Attachment security provides a well-documented protective developmental function for children exposed to individual- and community-level trauma, yet the effectiveness of prevention and intervention efforts targeting attachment during adolescence has been relatively underexplored. The Connecting and Reflecting Experience (CARE) program is a transdiagnostic, bi-generational, group-based, mentalizing-focused parenting intervention developed to dismantle the intergenerational transmission of trauma and support secure attachment relationships across the developmental spectrum within an under-resourced community. This exploratory study evaluated outcomes among caregiver-adolescent dyads (N = 32) in the CARE condition of a nonrandomized clinical trial at an outpatient mental health clinic within a diverse, urban U.S. community with disproportionate trauma exposure exacerbated by COVID-19. Caregivers predominantly identified as Black/African/African American (47%), Hispanic/Latina (38%), and/or White (19%). At pre- and post-intervention, caregivers completed questionnaires regarding parental mentalizing and their adolescents' psychosocial functioning. Adolescents completed scales regarding attachment and psychosocial functioning. Results showed a significant decrease in caregivers' prementalizing on the Parental Reflective Functioning Questionnaire, improvement in adolescent psychosocial functioning on the Youth Outcomes Questionnaire, and an increase in adolescents' reports of attachment security on the Security Scale. These preliminary findings suggest that mentalizing-focused parenting interventions may be effective in fostering improved attachment security and psychosocial functioning during adolescence.

La seguridad de la afectividad provee una bien documentada función protectora del desarrollo para niños expuestos al trauma individual y comunitario; aun así, la efectividad de los esfuerzos de prevención e intervención enfocados en la afectividad en la adolescencia ha sido relativamente poco explorada. El programa Conexión y Reflexión de la Experiencia (CARE) es una intervención de crianza transdiagnóstica, bigeneracional, con base en el grupo, enfocada en la mentalización, desarrollada para desarmar la transmisión intergeneracional de trauma y apoyar las relaciones de afectividad segura a lo largo del espectro del desarrollo dentro de una comunidad menos equipada con recursos. Este estudio exploratorio evaluó resultados entre díadas cuidador-adolescente (N = 32) bajo la condición CARE de un ensayo clínico no al azar en una clínica de salud mental ambulatoria dentro de una comunidad diversa y urbana en Estados Unidos, expuesta al trauma desproporcionadamente, lo cual fue exacerbado por COVID-19. A los cuidadores predominantemente se les identificó como negros/africanos/afroamericanos (47%), hispanos/latinas (38%), y/o blancos (19%). Antes y después de la intervención, los cuidadores completaron cuestionarios acerca de mentalización del progenitor y el funcionamiento sicosocial de sus adolescentes. Los adolescentes completaron escalas sobre la afectividad y el funcionamiento sicosocial. Los resultados mostraron una significativa disminución de la pre-mentalización en el Cuestionario del Funcionamiento con Reflexión del Progenitor, mejoras en el funcionamiento sicosocial de los adolescentes en el Cuestionario de Resultados de la Juventud, y un aumento en los reportes de los adolescentes sobre la seguridad de la afectividad en la Escala de Seguridad. Estos preliminares resultados sugieren que las intervenciones de crianza enfocadas en la mentalización pudieran ser efectivas para fomentar la mejorada seguridad de la afectividad y el funcionamiento sicosocial durante la adolescencia.

La sécurité de l'attachement offre une fonction protectrice au développement qui est bien prouvée pour les enfants exposés à un trauma individuel et communautaire. Cependant l'efficacité de la prévention et des efforts d'intervention ciblant l'attachement durant l'adolescence a été relativement peu exploré. Le programme de Connecting and Reflecting Experience (CARE, soit Expérience de Lien et de Réflexion) est une intervention de parentage transdiagnostique, bi-générationnel, basée sur un groupe, et ciblé sur la mentalisation développé afin de démonter la transmission intergénérationnelle du trauma et de soutenir des relations d'attachement sécure au travers du spectre développemental au soin d'une communauté manquant de moyens. Cette étude exploratoire a évalué les résultats chez des dyades personne prenant soin de l'adolescent-adolescent (N = 32) dans la condition CARE d'un essai clinique non-randomisé dans une clinique de santé mentale en consultation externe au soin d'une communauté américaine urbaine et diverse avec une exposition au trauma disproportionnée exacerbée par le COVID-19. Les personnes prenant soin des adolescents se sont en grande partie identifiés comme étant Noirs/Africains/Noir Américains (47%), Hispaniques/Latina (38%), et/ou Blanches (19%). Avant et après l'intervention les personnes prenant soin des adolescents ont rempli des questionnaires concernant la mentalisation parentale et le fonctionnement psychosocial de leurs adolescents. Les adolescents ont rempli des échelles concernant l'attachement et le fonctionnement psychosocial. Les résultats montrent une baisse importante de la pré-mentalisation des personnes prenant soin des adolescents concernant le Questionnaire de Fonctionnement de Réflexion Parental, une amélioration du fonctionnement psychosocial de l'adolescent au travers du Questionnaire des Résultats de Jeunesse (Youth Outcomes Questionnaire en anglais) et une augmentation dans les rapports de sécurité d'attachement faits par les adolescents au travers de l'échelle Security Scale. Ces résultats préliminaires suggèrent que les interventions de parentage focalisées sur la mentalisation peuvent être efficaces pour favoriser une sécurité de l'attachement améliorée et le fonctionnement psychosocial durant l'adolescence.

'Caring for the helpers': factors associated with professional quality of life among Hong Kong nurses during the fifth wave of the COVID-19 pandemic.

BACKGROUND: Western studies have found that nurses are likely to experience both positive and negative emotions in their job, as a helping profession [professional quality of life (ProQoL)] during the coronavirus disease 2019 (COVID-19) pandemic, and that psychosocial and work-related variables (e.g. pandemic-related stressors, interpersonal and organizational support, coping strategies) are associated with such outcomes. However, relevant studies on nurses in the Asian context are limited. OBJECTIVE: This study examined the psychosocial correlates of three indicators of ProQoL, i.e. compassion satisfaction, secondary traumatic stress (STS), and burnout, among nurses during the fifth wave of the COVID-19 pandemic in Hong Kong. METHOD: Nurses in Hong Kong (N = 220) working in hospitals and community settings during the COVID-19 pandemic were recruited between 24 May and 27 June 2022 through nursing associations to complete an online survey measuring the aforementioned psychosocial variables. RESULTS: Hierarchical regression results found that stressors from clinical work environments, insufficient emotional support, and less positive reframing were associated with poorer ProQoL (i.e. lower compassion satisfaction; higher STS and burnout) (ß from 0.16, p > .05, to 0.44, p > .001). In addition, COVID-19-related worries/uncertainties and emotional processing were associated with higher STS (ß from 0.21 to 0.23, p < .01), whereas insufficient organizational support for communication with the healthcare system was associated with higher burnout (ß = 0.12, p < .05). CONCLUSIONS: Our findings identified the important psychosocial determinants in ProQoL among nurses in Hong Kong and provide recommendations for services supporting the mental health of these nurses. Providing workshops for nurses to train their skills in coping with COVID-19-related uncertainties, worries, and stressors from the clinical work environment, in using adaptive coping strategies (e.g. positive reframing), and in soliciting emotional support from important others could facilitate their ProQoL. Moreover, the provision of organizational support through timely and transparent communication with the healthcare system could reduce STS in nurses.

Stressors from clinical work environments, insufficient emotional support, and less positive reframing were associated with poorer professional quality of life among nurses in Hong Kong during the COVID-19 pandemic.COVID-19-related worries/uncertainties and emotional processing were associated with higher secondary traumatic stress.Insufficient organizational support for communication with the healthcare system was associated with higher burnout.

Plague God Image in the Clinic.

This paper selects four dreams before and during COVID-19 which constellated the Plague God image in Chinese culture. The author argues that this shows evidence that the origins of the modern psyche, although hidden, are preserved and living within the ancient anima mundi.

Cet article sélectionne quatre rêves produits avant et pendant la pandémie de COVID-19 et qui montrent la constellation de l'image divine de la peste dans la culture Chinoise. L'auteur soutient que ceci montre la preuve que les origines de la psyché moderne, bien que cachées, sont préservées et vivantes au sein de l'ancien anima mundi.

El presente artículo selecciona cuatro sueños antes y durante la pandemia del COVID-19 que constelan la imagen del dios de la peste en la cultura China. El autor argumenta que esto demuestra que los orígenes de la psique moderna, aunque ocultos, se conservan y viven dentro de la antigua anima mundi.

'Feeling disconnected' - risk factors for PGD and themes in grief counselling during the COVID-19 pandemic. A mixed-method study.

Background: Due to its high death toll and measures to curb the pandemic, COVID-19 has affected grieving experiences and may contribute to risk factors for Prolonged Grief Disorder (PGD). Persons at risk for PGD often seek support from grief counselling.Objective: To explore whether pandemic-associated risk factors have become more important topics in counselling in a mixed-method design.Method: German grief counsellors (n = 93) rated whether pre-defined risk factors had become more important in grief counselling and indicated additional important themes in an open format.Results: The counsellors indicated that all pre-defined risk factors had become more important, though differing significantly in their frequency. Most frequently endorsed risk factors were lack of social support, limited possibilities to accompany a dying loved one and absence of traditional grief rituals. Qualitative analysis identified three additional themes: the societal impact of the pandemic, its impact on bereavement support and health care, and a chance for personal growth.Conclusions: The pandemic has affected bereavement experiences and grief counselling. Counsellors should monitor grief processes and specific risk factors to provide the best possible care for bereaved people when needed.

Pandemic-associated risk factors for PGD have become more important topics in grief counselling during COVID-19.Risk factors include especially a lack of social support, limited possibility to accompany a dying significant other and absence of traditional grief rituals.Future research is needed to investigate whether monitoring and addressing these risk factors can improve bereavement care.

Acute severe non-A-E-hepatitis of unknown origin in children - A 30-year retrospective observational study from north-west Germany.

BACKGROUND & AIMS: The etiology of the current acute severe non-A-E hepatitis epidemic in children remains unclear. We aimed to describe the occurrence and outcomes of acute severe hepatitis in pediatric patients in North-West Germany over a period of more than 30 years and in the context of the current epidemic. METHODS: We analyzed all cases of acute severe hepatitis in childhood, as defined by the World Health Organization, at Hannover Medical School from 1990 and at the University Hospital of Essen from 2009 to 16 May 2022. We separated cases into a historic cohort (1990-2018) and a COVID-19 era cohort (2019-2022). RESULTS: After application of exclusion criteria, 107 patients with acute severe hepatitis were identified (2.32 cases/center/year). Annual incidence per center rose significantly from 2.2 (historic cohort until 2018) to 4.25/center/year (from 2019, p = 0.002). Of all cases, 75.7% presented with jaundice, while 53.3% had clinical signs of infection. Two cases of adenovirus were proven (2004/2016), other pathogens detected were HHV-6 (4), CMV, HSV, EBV(3). Sixty-nine patients (64.5%) met the criteria of pediatric acute liver failure, with 44 requiring liver transplantation. In the current cohort, patients with infection, gastrointestinal symptoms and higher alanine aminotransferase had a better chance of transplant-free survival, whereas hepatic encephalopathy, higher international normalized ratio and bilirubin predicted a poor outcome. Twenty-five patients developed hepatitis-associated aplastic anemia and 19 patients (17.8%) died. CONCLUSIONS: Acute non-A-E-hepatitis in children is a rare but severe entity, often leading to acute liver failure. Clinical presentation in our current cohort resembles 2022 NAEH cases, with improved outcomes compared to historic controls. The rising incidence of NAEH in our centers since 2019, in the absence of adenoviral infection, indicates other potential triggers of similar NAEH cases. IMPACT AND IMPLICATIONS: As the current epidemic of severe acute non-A-E-hepatitis cases in children highlights our limited understanding in the field, we aim to describe current cases, characterizing the presentation over time, and defining similarities and discrepancies before and during the COVID-19 pandemic. Our data show a rising incidence of non-A-E-hepatitis cases since the beginning of the COVID-19 pandemic. These cases were not associated with adenoviral infections, suggesting that the recently described accumulation of adenovirus infections in relationship to hepatitis is a new trigger for a known phenomenon, rather than a new disease entity. Therefore, the role of protective isolation and subsequent lack of contact with trivial infections in children during the pandemic should be the subject of further examinations. We expect our data to contribute to a better understanding of severe acute hepatitis in childhood, increased vigilance for this potentially lethal disease beyond the current epidemic, and ultimately improved clinical diagnosis and care.

The Anima as an Archetype of Human Resilience in the Face of Calamity.

This paper will provide a theoretical basis for looking at a dream in the analysis of a client during a calamity. Finding the archetype of the anima is a way of responding to a crisis, in this case to the COVID-19 pandemic period. With all the basic instincts disrupted by a catastrophe, the emergence of the anima, as archetype of life, is there to remind us how to survive and recover. The anima archetype, often representing psychological resilience in ancient myths, shows up in dreams to guide human transformation from the struggle to survive trauma to the art of living a full life.

Cet article fournira un fondement théorique pour l'exploration d'un rêve dans l'analyse d'un client durant un désastre. Trouver l'archétype de l'anima est une manière de répondre à une crise, ici à la période de pandémie. Lorsque que tous les instincts fondamentaux sont perturbés par la catastrophe, l'émergence de l'anima en tant qu'archétype de la vie vient nous rappeler comment survivre et se remettre. L'archétype de l'anima, qui représente souvent la résilience psychologique dans les mythes anciens, apparait dans les rêves pour guider la transformation humaine dans la lutte pour survivre au traumatisme et pour aller vers l'art de vivre une vie pleine.

Este artículo ofrece una base teórica para observar un sueño en el análisis de un cliente durante una calamidad. Encontrar el arquetipo del ánima es una forma de responder a una crisis, en este caso al periodo pandémico. Con todos los instintos básicos perturbados por una catástrofe, la aparición del ánima como arquetipo de la vida está ahí para recordarnos cómo sobrevivir y recuperarnos. El arquetipo del ánima, que a menudo representa la resiliencia psicológica en los mitos antiguos, aparece en los sueños para guiar la transformación humana en la lucha por sobrevivir al trauma hacia el arte de vivir una vida plena.

Characterizing the mental health and functioning of Canadian respiratory therapists during the COVID-19 pandemic.

Introduction: Healthcare professionals (HCPs) appear to be at increased risk for negative psychological outcomes [e.g. depression, anxiety, post-traumatic stress disorder (PTSD), moral distress] and associated impacts on functioning throughout the COVID-19 pandemic. HCPs working on designated COVID-19 units may be further impacted than their colleagues not on these units given added demands of patient care and risk of contracting COVID-19. Little is known, however, about the mental health and functioning of specific professional groups beyond nurses and physicians, including respiratory therapists (RTs), over the course of the pandemic. Accordingly, the purpose of the present study was to characterize the mental health and functioning of Canadian RTs and compare profiles between RTs working on and off designated COVID-19 units.Methods: Canadian RTs completed an online survey between February and June 2021, including demographic information (e.g. age, sex, gender,) and measures of depression, anxiety, stress, PTSD, moral distress and functional impairment. Descriptive statistics, correlation analyses and between-groups comparisons were conducted to characterize RTs and compare profiles between those on and off COVID-19 units.Results: Two hundred and eighteen (N = 218) RTs participated in this study. The estimated response rate was relatively low (6.2%) Approximately half of the sample endorsed clinically relevant symptoms of depression (52%), anxiety (51%) and stress (54%) and one in three (33%) screened positively for potential PTSD. All symptoms correlated positively with functional impairment (p's < .05). RTs working on COVID-19 units reported significantly greater patient-related moral distress compared to those not on these units (p < .05).Conclusion: Moral distress and symptoms of depression, anxiety, stress and PTSD were prevalent among Canadian RTs and were associated with functional impacts. These results must be interpreted with caution given a low response rate, yet raise concern regarding the long-term impacts of pandemic service among RTs.

Research on RTs' mental health prior to and during the COVID-19 pandemic is scant, especially in comparison to other HCPs.RTs in the present study reported experiencing moral distress and clinically significant symptoms of depression, anxiety and PTSD, with associated functional impairment.One in three RTs screened positive for likely PTSD on the PCL-5.There is a need to provide RTs with adequate mental health supports and to understand the long-term impacts of pandemic service among RTs.

Working Online During the Contemporary COVID-19 Pandemic.

Within the psychoanalytic school there has been substantial and ongoing debate about the efficacy of teleanalysis. However, as a result of the current COVID-19 pandemic and the online work with which the Jungian analytic community has now had to engage, this paper initially focuses on analysts' actual experiences of working by teleanalysis. These experiences highlight a range of issues like "Zoom fatigue", "online disinhibition", dissonance, confidentiality, the frame and working with new patients. Alongside these issues, there were ample experiences by analysts of both productive psychotherapy apace with analytic work involving transference and countertransference phenomena, all indicating that a genuine and good enough analytic process can occur with teleanalysis. An overview of the research and literature both prior to the pandemic and as a result of it, confirms the validity of these experiences so long as analysts are cognizant of the specifics of such an online modality. Conclusions to do with the question, "what have we learned?", alongside training, ethics and supervision issues are subsequently discussed.

Au sein de l'école psychanalytique il y a encore un grand débat sur l'efficacité de la télé-analyse. Toutefois, du fait de la pandémie actuelle de COVID-19 et du travail en ligne que la communauté analytique Jungienne a dû entreprendre, cet article se concentre initialement sur les expériences actuelles de l'analyste dans l'analyse en ligne. Ces expériences soulignent une variété de problèmes tels la « fatigue Zoom ¼, la « désinhibition en ligne ¼, la dissonance, la confidentialité, le cadre, et commencer avec de nouveaux patients. Aux côtés de ces questions il y a eu pour les analystes nombre d'expériences à la fois de psychothérapie productive et de travail analytique, contenant des phénomènes de transfert-contretransfert. Cela indique qu'un processus authentique et convenable du point de vue analytique peut avoir lieu dans la télé-analyse. Un repérage des recherches et de la documentation effectuées à la fois avant la pandémie et suite à celle-ci confirme la validité de ces expériences, du moment que les analystes sont conscients de ce qui est spécifique à une telle modalité. L'article aborde ensuite des conclusions sur la question de ce que l'on a appris, sur la formation, l'éthique et la supervision.

Dentro de la escuela psicoanalítica ha habido un debate sustancial y continuo sobre la eficacia del teleanálisis. Sin embargo, como resultado de la actual pandemia de COVID-19 y el trabajo en línea con el que la comunidad analítica junguiana ha tenido que comprometerse, este artículo se centra inicialmente en las experiencias reales de los analistas de trabajar vía teleanálisis. Estas experiencias ponen de relieve una serie de cuestiones como la "fatiga de Zoom", la "desinhibición en línea", la disonancia, la confidencialidad, el marco y el trabajo con nuevos pacientes. Junto a estas cuestiones, hubo amplias experiencias por parte de los analistas tanto de psicoterapia productiva como de trabajo analítico con fenómenos de transferencia y contratransferencia, todo lo cual indica que puede darse un proceso analítico genuino y suficientemente bueno con el teleanálisis. Una visión general de la investigación y la literatura, tanto antes de la pandemia, y también como resultado de ella, confirma la validez de estas experiencias siempre y cuando los analistas sean conscientes de las especificidades de esta modalidad virtual. Posteriormente se discuten las conclusiones relacionadas con la pregunta "¿qué hemos aprendido?", junto con cuestiones de formación, ética y supervisión.

COVID-19, Virtual Engagement and the Psychoid Imagination.

The impact of the COVID-19 pandemic on analytic training and the delivery of educational content is explored here. The proliferation of Zoom therapy and teaching is creating a post-human platform to which nearly everyone in contemporary society has had to adapt. Looking at the possible meanings of the pandemic, a psychoid factor (the virus) engaging the imagination has come to the fore as a response to climate change. The striking similarity to the H1N1 viral pandemic ("Spanish flu") is noted, especially in the context of C. G. Jung having had a case in 1919 during which he experienced a number of visions and dreams. The imagery produced can be seen as an implicit attempt at "re-enchanting the world" found in The red book. Finally, a reconsideration of pedagogy in response to the pandemic is discussed with an eye to the archetypal aspects of internet communications.

Cet article étudie l'impact de la pandémie de COVID-19 sur la formation des analystes et sur la manière dont le contenu éducatif est dispensé. La prolifération de thérapie et de formation par Zoom crée une plateforme post-humaine à laquelle quasiment toute personne dans la société contemporaine a eu à s'adapter. En regardant les sens possibles que l'on peut donner à la pandémie, un facteur psychoïde (le virus) qui mobilise l'imagination a pris le devant de la scène en tant que réponse au changement climatique. L'article souligne la similarité frappante avec la pandémie virale H1N1 (la grippe espagnole), particulièrement dans le contexte où C.G. Jung l'a attrapée en 1919 et a fait l'expérience d'un certain nombre de visions et de rêves. L'imagerie produite peut être vue comme une tentative implicite de « ré-enchanter le monde ¼ telle qu'on la trouve dans le Livre Rouge. En conclusion, une reconsidération de la pédagogie issue de la pandémie est discutée en tenant compte des aspects archétypaux des communications par internet.

Se exploran aquí las repercusiones de la pandemia de COVID-19 en la formación analítica y en la transmisión de contenidos educativos. La proliferación de la terapia y la enseñanza vía Zoom está creando una plataforma posthumana a la que casi todo el mundo en la sociedad contemporánea ha tenido que adaptarse. En cuanto a los posibles significados de la pandemia, un factor psicoide (el virus) que atrae la imaginación ha pasado a primer plano como respuesta al cambio climático. Se observa la sorprendente similitud con la pandemia viral H1N1 ("gripe española"), especialmente en el contexto de un caso que C.G. Jung tuvo en 1919 durante el cual experimentó una serie de visiones y sueños. La imaginería producida puede verse como un intento implícito de "reencantar el mundo" que se encuentra en El Libro Rojo. Por último, se plantea una reconsideración de la pedagogía en respuesta a la pandemia, teniendo en cuenta los aspectos arquetípicos de las comunicaciones por Internet.

EMDR for symptoms of depression, stress and burnout in health care workers exposed to COVID-19 (HARD): A study protocol for a trial within a cohort study.

Background: Stressful events during a pandemic are a major cause of serious health problems, such as burnout, depression and posttraumatic stress disorder (PTSD) among health care workers (HCWs). During three years, HCWs, on the frontline to fight the COVID-19 pandemic, have been at an increased risk of high levels of stress, anxiety, depression, burnout and PTSD. Regarding potential psychological interventions, Eye Movement Desensitization & Reprocessing (EMDR) is a structured, strongly recommended therapy based on its well-known efficacy in reducing PTSD symptoms and anxiety.Objectives: This study, designed as a trial within a cohort (TwiC), aims to 1) estimate the prevalence of depression, burnout and PTSD in a sample of HCWs after experiencing the COVID-19 emergency (cohort part) and 2) assess the efficacy and acceptability of 'EMDR + usual care' for HCWs from the cohort who report significant psychological symptoms (trial part).Methods: The study, designed as a TwiC, consists of a prospective cohort study (n = 3000) with an embedded, pragmatic, randomized open-label superiority trial with two groups (n = 900). Participants included in the trial part are HCWs recruited for the cohort with significant symptoms on at least one psychological dimension (depression, burnout, PTSD) at baseline, 3 months or 6 months, determined by using the Patient Health Questionnaire (PHQ-9), Professional Quality of Life (ProQOL) scale, and PTSD Checklist for the DSM-5 (PCL-5). The intervention consists of 12 separate EMDR sessions with a certified therapist. The control group receives usual care. The trial has three primary outcomes: changes in depression, burnout and PTSD scores from randomization to 6 months. All participants are followed up for 12 months.Conclusions: This study provides empirical evidence about the impact of the COVID-19 pandemic and the mental health burden it places on HCWs and assesses the effectiveness of EMDR as a psychological intervention.Trial registration NCT04570202.

Health care workers are at increased risk of stress, anxiety, depression, burnout and PTSD following the COVID-19 pandemic.In this study, the effectiveness of EMDR in reducing depression, burnout and PTSD in health care workers exposed to COVID-19 is investigated.In this study, an original 'trial within a cohort' (TwiC) design that consists of a cohort study with an embedded pragmatic randomized trial is used.The study is fully web-based, including online screening, consent and assessments.

Parent and child adjustment dual trajectories at the beginning of the COVID-19 syndemic.

Children and their families have been significantly impacted by the unfolding of the COVID-19 syndemic. We sought to identify (1) groups of families with distinct profiles of joint trajectories of parental anxiety and child emotional distress and (2) protective and risk factors associated with these dual-trajectory profiles. A sample of 488 parents (65% White; 77% mothers) with 3- to 8-year-old children (MAge  = 5.04, SDAge  = 1.59) was followed from late March to early July in 2020. Survey data on parent (i.e., anxiety symptoms) and child (i.e., emotional distress) adjustment were collected at three time points. Using multivariate growth mixture modeling, we identified one group with low parental anxiety and child emotional distress (42.7%) and three other distinct groups with varying risk levels among parents and/or children. We also identified protective (e.g., positive parenting) and risk (e.g., child negative affect, negative parenting, perceived stress with racism) factors in predicting parent and child adjustment. It can be concluded that, overall, our sample (mostly middle- and high-socioeconomic status families) demonstrated family resilience amid COVID-19, consistent with prior disaster coping literature. At the same time, our findings also indicated the need to identify at-risk families and modifiable factors for post-disaster public health interventions.

Haitian and Haitian American experiences of racism and socioethnic discrimination in Miami-Dade county: At-risk and court-involved youth.

We examine how juvenile justice-involved youth of Haitian descent in Miami-Dade County cope with structural racism and its impact on their mental health. Drawing on longitudinal ethnography, psychosocial assessment data, and a family-based clinical intervention funded by the National Institute on Drug Abuse, this article explores youth narratives of discrimination prior to and during the COVID-19 pandemic. We use critical race theory and theory of practice to understand youths' perceptions as racialized bodies and stigmatized selves, highlighting the experiences and perspectives of a particular black immigrant group, ethnic beings caught up in the everyday practices of racialization, sociocultural marginalization, and racism. We frame these experiences as a variation of the complex continuum of structural racism and racial domination in the US. These experiences have caused anger, fear, anxiety, chronic anticipatory distress, and hopelessness among youth of Haitian descent. We conclude with some recommendations for therapeutic support that encourages youth to process their experiences, promotes their development of a positive self-concept, and provides them with mind-body techniques to attenuate the physical impacts of discriminatory events. The clinical trial registration number for this study intervention is NCT03876171.

Noninsulin-based antihyperglycemic medications in patients with diabetes and COVID-19: A systematic review and meta-analysis.

BACKGROUND: Patients with diabetes are more likely to suffer COVID-19 complications. Using noninsulin antihyperglycemic medications (AGMs) during COVID-19 infection has proved challenging. In this study, we evaluate different noninsulin AGMs in patients with COVID-19. METHODS: We searched Medline, Embase, Web of Science, and Cochrane on 24 January 2022. We used the following keywords (COVID-19) AND (diabetes mellitus) AND (antihyperglycemic agent). The inclusion criteria were studies reporting one or more of the outcomes. We excluded non-English articles, case reports, and literature reviews. Study outcomes were mortality, hospitalization, and intensive care unit (ICU) admission. RESULTS: The use of metformin rather than other glucose-lowering medications was associated with statistically significant lower mortality (risk ratio [RR]: 0.60, 95% confidence interval [CI]: 0.47, 0.77, p < .001). Dipeptidyl peptidase-4 inhibitor (DPP-4i) use was associated with statistically significantly higher hospitalization risk (RR: 1.44, 95% CI: 1.23, 1.68, p < .001) and higher risk of ICU admissions and/or mechanical ventilation vs nonusers (RR: 1.24, 95% CI: 1.04, 1.48, p < .02). There was a statistically significant decrease in hospitalization for SGLT-2i users vs nonusers (RR: 0.89, 95% CI: 0.84-0.95, p < .001). Glucagon-like peptide-1 receptor agonist (GLP-1RA) use was associated with a statistically significant decrease in mortality (RR: 0.56, 95% CI: 0.42, 073, p < 0.001), ICU admission, and/or mechanical ventilation (RR: 0.79, 95% CI: 0.69-0.89, p < .001), and hospitalization (RR: 0.73, 95% CI: 0.54, 0.98, p = .04). CONCLUSIONS: AGM use was not associated with increased mortality. However, metformin and GLP-1RA use reduced mortality risk statistically significantly. DPP-4i use was associated with a statistically significant increase in the risk of hospitalization and admission to the ICU.

Type 1 diabetes mellitus and SARS-CoV-2 in pediatric and adult patients - Data from the DPV network.

BACKGROUND: Data on patients with type 1 diabetes mellitus (T1DM) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are sparse. This study aimed to investigate the association between SARS-CoV-2 infection and T1DM. METHODS: Data from the Prospective Diabetes Follow-up (DPV) Registry were analyzed for diabetes patients tested for SARS-CoV-2 by polymerase chain reaction (PCR) in Germany, Austria, Switzerland, and Luxembourg during January 2020-June 2021, using Wilcoxon rank-sum and chi-square tests for continuous and dichotomous variables, adjusted for multiple testing. RESULTS: Data analysis of 1855 pediatric T1DM patients revealed no differences between asymptomatic/symptomatic infected and SARS-CoV-2 negative/positive patients regarding age, new-onset diabetes, diabetes duration, and body mass index. Glycated hemoglobin A1c (HbA1c) and diabetic ketoacidosis (DKA) rate were not elevated in SARS-CoV-2-positive vs. -negative patients. The COVID-19 manifestation index was 37.5% in individuals with known T1DM, but 57.1% in individuals with new-onset diabetes. 68.8% of positively tested patients were managed as outpatients/telemedically. Data analysis of 240 adult T1MD patients revealed no differences between positively and negatively tested patients except lower HbA1c. Of these patients, 83.3% had symptomatic infections; 35.7% of positively tested patients were hospitalized. CONCLUSIONS: Our results indicate low morbidity in SARS-CoV-2-infected pediatric T1DM patients. Most patients with known T1DM and SARS-CoV-2 infections could be managed as outpatients. However, SARS-CoV-2 infection was usually symptomatic if it coincided with new-onset diabetes. In adult patients, symptomatic SARS-CoV-2 infection and hospitalization were associated with age.

Impact of an in-person small group surgical skills course for preclinical medical students in an era of increased e-learning.

Objective: The COVID-19 pandemic led to a dramatic decrease in face-to-face teaching. This can particularly impact medical students' skills development. This prompted development of an in-person surgical skills course as guided by the General Medical Council "Outcomes for Graduates" facilitated by tutors with surgical experience. This study aimed to primarily assess participant confidence in surgical skills following the course. Design: This was an interventional study assessing both qualitative and quantitative data collected prior to, during, and post course completion. Data were collected from students via online forms, which included a mixture of "Yes/No" responses, self-assessed confidence levels via Likert scales, and free type questions. Setting: The study assessed feedback for a 5-session surgical skills course delivered at the authors' institution. This is a newly designed course using low-cost materials which was free for all attendees. Participants: Participants were all in the first or second year of medical school. There was capacity for 60 students, and all attendees provided informed consent to participate. Results: A total of 446 students applied for the course with 58 participants in the final study, 31% of whom had prior surgical skills experience. There was a statistically significant increase in student confidence levels following the course for all taught surgical skills (P = .0001). Participants were also more confident that they possessed the skills required for clinical placements (P = .0001) and to work as a junior doctor (P = .01). Thematic qualitative analysis revealed a reliance on third parties for previous surgical experience; this course improved knowledge and skills for future practice. Limitations included session duration and equipment choice. Conclusion: This study demonstrates high demand and student satisfaction from this course, offering a potential framework to improve undergraduate surgical skills teaching. The results presented here have the potential to inform wider curricula development across medical schools in the future. Competencies: Medical knowledge; practice-based learning and Improvement.