一般社会民众心理安全感状况的调查研究

目的调查一般社会民众的心理安全感状况,为民众心理安全感的维护与干预提供依据。方法采用总体幸福感指数、生活满意度评定量表、状态性愤怒量表、状态性焦虑量表对随机抽取的278名社会民众进行问卷调查。结果社会民众心理安全感处于中等水平(x-=3.069),心理确定感为中等偏上水平(x-=3.404),心理不安全感为中等偏下水平(x-=2.267);从性别、家庭来源、年龄、经济水平来看,民众的心理确定感未见显著差异,不同文化水平的民众在心理确定感(F=6.049,P=0.003)上差异显著;民众在性别、年龄、经济水平和文化水平维度上,不安全感得分差异不显著,而在不同来源的维度上达到边缘显著水平(t=1.861,P=0.064)。结论应从如何降低和减少不安全感上开展民众心理安全感的干预与维护。     

新型冠状病毒肺炎疫情期间心理应激障碍及应对措施

新型冠状病毒肺炎(COVID-19)疫情暴发和流行期间,由于其病原体新型冠状病毒(SARS-CoV-2)具有强的传染性、可致死性及难预测性等特点,给全社会民众包括正常人群、确诊病例及疑似病例带来了巨大的心理冲击。不良的心理应激往往对社会造成恐慌,对个人不仅可导致心理应激障碍如焦虑、抑郁,甚至诱发创伤后应激障碍(PTSD),更不利于COVID-19患者的康复,所以早期对疫情期间心理应激干预非常必要。本文通过分析此次COVID-19疫情期间不同人群心理应激障碍,并探讨其应对措施,有助于及时对个体进行心理疏导,避免心理应激障碍的发生,有利于COVID-19患者的康复。     

北京民众在SARS疫情中风险认知与心理行为的比较研究

目的：了解北京民众在非典高发期和消退期的风险认知和心理行为的变化特征。方法：采用问卷调查的方式，于2003年5月5日-11日和5月27日～6月7日对北京市民进行分层随机抽样。结果：在疫情后期，北京民众倾向于综合评价来自各个方面的不同信息后再作出判断；在疫情高发期，民众更多关注的是非典作为一种疾病本身的可控性，而在疫情消退期，民众更多的关注非典的传染性；在疫情高发期，对负性信息的关注能够显著提高民众的风险知觉，风险知觉能够显著预测我们提出的正性和负性预警指标；但在疫情后期，这种信息能够显著降低民众的风险知觉，风险知觉能够预测负性的预警指标，但对于正性预警指标不再具有预测作用。结论：在疫情后期，北京民众对信息的关注逐渐理性化，进而影响到他们的风险知觉，风险知觉对预警指标的预测作用也发生了变化。     

新冠肺炎疫情风险感知对囤积行为的影响：安全感的中介作用和生命史策略的调节作用

目的：考察新冠肺炎疫情风险感知对囤积行为的影响,探究安全感的中介作用和生命史策略的调节作用。方法：采用新冠肺炎疫情风险感知量表、安全感量表、囤积量表和简明生命史策略量表,通过线上调查形式测量1202名普通公众,构建了一个有中介的调节效应模型。结果：（1）新冠肺炎疫情风险感知显著正向预测个体的囤积行为。（2）安全感在新冠肺炎疫情风险感知与囤积行为之间起部分中介效应。（3）生命史策略在新冠肺炎疫情风险感知影响囤积行为的过程中起调节效应,即新冠肺炎疫情风险感知对囤积行为和安全感的影响均随着生命史策略的变慢而减弱。结论：新冠肺炎疫情风险感知通过安全感影响个体的囤积行为,且这一关系受到生命史策略的调节。     

几种认知治疗技术在危机干预中的应用

正武汉发生的新型冠状病毒疫情,对武汉市等湖北城市,以至对全国人民都造成了严重影响,极大地干扰了人们正常的生活、学习和工作等,与此同时还带来了前所未有的心理影响。面对如此严重的疫情和民众的心理反应,心理咨询师和志愿者该如何去帮助民众摆脱情绪困扰?如何尽快让民众恢复正常的生活?下面介绍几种行之有效的心理咨询基本技术。     

安全感对风险决策的影响

人类如何在风险情境下进行合理、高效地进行决策是心理学和经济学领域研究的重点问题。众多研究尝试从不同的领域探索风险决策行为及其背后的机制。但是在现代社会,由于人们普遍存在着心理安全感欠缺的问题,因此风险决策中不能忽略决策者的心理安全状态。本研究采用改编过的BART任务,通过试验探讨和比较了在经济领域中心理安全感高低对风险决策行为的影响。试验结果发现,心理安全感高的个体在风险行为中更加倾向于风险规避,心理安全感低的个体在风险行为中更加倾向于风险寻求。这一发现表明心理安全感的不同程度对风险决策行为有不同的影响。该影响可以用补偿机制进行解释。     

面对疫情，打赢心理攻坚战！

正面对新冠肺炎疫情的不断传播和发展,每个身处其中的普通民众都面对着未知的疾病风险。疾病的突发性及不确定性,非常容易引发焦虑及恐慌情绪。面对每天铺天盖地的信息爆炸,加上为了控制传染源和切断传播途径,普通民众对于疫情的情绪反应存在强烈的担忧、恐惧、愤怒,积极情绪明显减少,很多民众甚至由于消极情绪的持续存在和难以摆脱,导致正常的生活都受到明显的干扰。学会与焦虑情绪相处是打赢这场战役的心理疫苗。下面的方法能够提高广大普通民众居家自我心理调节能力,从而积极、理性应对疫情。     

突发事件后的心理应对

正新冠肺炎疫情是一次典型的突发公共卫生事件,对我们的心理带来多方面的冲击,不仅造成个体层面的恐慌和焦虑情绪,对心理健康产生影响,而且由于打乱了生活工作秩序,对社会稳定、经济发展乃至国际关系都有影响,因此在群体、组织和社会层面产生的心理冲击也比较大。疫情对心理的冲击有规律,掌握规律是有效应对的前提。     

新型冠状病毒肺炎疫情期间民众抑郁状况调查

目的:了解民众在新型冠状病毒肺炎疫情期间的抑郁状况。方法:2020年2月16日-22日以网络调查表的形式开展横断面调查,采用患者健康问卷抑郁症状群量表(PHQ-9)筛查民众在疫情期间的抑郁症状,采用视觉模拟标尺(VAS)评估民众在疫情发生前后的抑郁程度。结果:民众在疫情期间的抑郁症状检出率为36.5%;饮酒(OR=1.52,95%CI:1.15～2.02)为抑郁症状的危险因素,年龄45～65岁(OR=0.62,95%CI:0.41～0.95)、已婚(OR=0.53,95%CI:0.40～0.71)为抑郁症状的保护性因素;民众在疫情发生前后抑郁程度VAS评分分别为1(0,18)、5(0,24),疫情发生后高于疫情发生前(P0.001)。结论:新型冠状病毒肺炎疫情期间超过三分之一的民众存在抑郁症状,饮酒为抑郁症状的危险因素。     

新型冠状病毒肺炎疫情前后民众对在线医疗服务认知态度和使用意愿的变化及影响因素

目的:调查新型冠状病毒肺炎疫情前后民众对在线医疗服务的认知态度及使用意愿,分析影响民众对在线医疗服务态度和使用意愿变化的因素.方法:采用问卷法选取401名民众对在线医疗服务的认知态度和使用意愿进行调查,分析疫情前后民众在线医疗服务态度和使用情况的差异及年龄、学历、居住地及职业等因素对其影响.结果:73.30％的民众听说...     

Rifampicin for COVID-19

Vaccinations for coronavirus disease-2019 (COVID-19) have begun more than a year before, yet without specific treatments available. Rifampicin, critically important for human medicine (World Health Organization’s list of essential medicines), may prove pharmacologically effective for treatment and chemoprophylaxis of healthcare personnel and those at higher risk. It has been known since 1969 that rifampicin has a direct selective antiviral effect on viruses which have their own RNA polymerase (severe acute respiratory syndrome coronavirus 2), like the main mechanism of action of remdesivir. This involves inhibition of late viral protein synthesis, the virion assembly, and the viral polymerase itself. This antiviral effect is dependent on the administration route, with local application resulting in higher drug concentrations at the site of viral replication. This would suggest also trying lung administration of rifampicin by nebulization to increase the drug’s concentration at infection sites while minimizing systemic side effects. Recent in silico studies with a computer-aided approach, found rifampicin among the most promising existing drugs that could be repurposed for the treatment of COVID-19.     

COVID-19 and Sepsis

The COVID-19 pandemic has created a major alteration in the medical literature including the sepsis discussion. From the outset of the pandemic, various reports have indicated that although there are some unique features pertinent to COVID-19, many of its acute manifestations are similar to sepsis caused by other pathogens. As a consequence, the old definitions now require consideration of this new etiologic agent, namely SARS-CoV-2. Although the pathogenesis of COVID-19 has not been fully explained, the data obtained so far in hospitalized patients has revealed that serum cytokine and chemokine levels are high in severe COVID-19 patients, similar to those found with sepsis. COVID-19 may involve multiple organ systems. In addition to the lungs, the virus has been isolated from blood, urine, faeces, liver, and gallbladder. Results from autopsy series in COVID-19 patients have demonstrated a wide range of findings, including vascular involvement, congestion, consolidation, and hemorrhage as well as diffuse alveolar damage in lung tissue consistent with acute respiratory distress syndrome (ARDS). The presence of viral cytopathic-like changes, infiltration of inflammatory cells (mononuclear cells and macrophages), and viral particles in histopathological samples are considered a consequence of both direct viral infection and immune hyperactivation. Thromboembolism and hyper-coagulopathy are other components in the pathogenesis of severe COVID-19. Although the pathogenesis of hypercoagulability is not fully understood, it has been pointed out that all three components of Virchow’s triad (endothelial injury, stasis, and hypercoagulable state) play a major role in contributing to clot formation in severe COVID-19 infection. In severe COVID-19 cases, laboratory parameters such as hematological findings, coagulation tests, liver function tests, D-dimer, ferritin, and acute phase reactants such as CRP show marked alterations, which are suggestive of a cytokine storm. Another key element of COVID-19 pathogenesis in severe cases is its similarity or association with hemophagocytic lymphohistiocytosis (HLH). SARS-CoV-2 induced cytokine storm has significant clinical and laboratory findings overlapping with HLH. Viral sepsis has some similarities but also some differences when compared to bacterial sepsis. In bacterial sepsis, systemic inflammation affecting multiple organs is more dominant than in COVID-19 sepsis. While bacterial sepsis causes an early and sudden onset clinical deterioration, viral diseases may exhibit a relatively late onset and chronic course. Consideration of severe COVID-19 disease as a sepsis syndrome has relevance and may assist in terms of determining treatments that will modulate the immune response, limit intrinsic damage to tissue and organs, and potentially improve outcome.     

Postexposure-vaccine-prophylaxis against COVID-19

During the COVID-19 pandemic, postexposure-vaccine-prophylaxis is not a practice. Following exposure, only patient isolation is imposed. Moreover, no therapeutic prevention approach is applied. We asked whether evidence exists for reduced mortality rate following postexposure-vaccine-prophylaxis. To estimate the effectiveness of postexposure-vaccine-prophylaxis, we obtained data from the Israeli Ministry of Health registry. The study population consisted of Israeli residents aged 12 years and older, identified for the first time as PCR-positive for SARS-CoV-2, between December 20th, 2020 (the beginning of the vaccination campaign) and October 7th, 2021. We compared “recently injected” patients—that proved PCR-positive on the same day or on 1 of the 5 consecutive days after first vaccination (representing an unintended postexposure-vaccine-prophylaxis)s—to unvaccinated control group. Among Israeli residents identified PCR-positive for SARS-CoV-2, 11 687 were found positive on the day they received their first vaccine injection (BNT162b2) or on 1 of the 5 days thereafter. In patients over 65 years, 143 deaths occurred among 1412 recently injected (10.13%) compared to 255 deaths among the 1412 unvaccinated (18.06%), odd ratio (OR) 0.51 (95% confidence interval [CI]: 0.41–0.64; p < 0.001). A significant reduction in the death toll was observed among the 55–64 age group, with 8 deaths occurring among the 1320 recently injected (0.61%) compared to 24 deaths among the 1320 unvaccinated control (1.82%), OR 0.33 (95% CI: 0.13–0.76; p = 0.007). Postexposure-vaccine-prophylaxis is effective against death in COVID-19 infection.     

Vaccines for COVID-19

Since the emergence of COVID-19, caused by the SARS-CoV-2 virus at the end of 2019, there has been an explosion of vaccine development. By 24 September 2020, a staggering number of vaccines (more than 200) had started preclinical development, of which 43 had entered clinical trials, including some approaches that have not previously been licensed for human vaccines. Vaccines have been widely considered as part of the exit strategy to enable the return to previous patterns of working, schooling and socializing. Importantly, to effectively control the COVID-19 pandemic, production needs to be scaled-up from a small number of preclinical doses to enough filled vials to immunize the world’s population, which requires close engagement with manufacturers and regulators. It will require a global effort to control the virus, necessitating equitable access for all countries to effective vaccines. This review explores the immune responses required to protect against SARS-CoV-2 and the potential for vaccine-induced immunopathology. We describe the profile of the different platforms and the advantages and disadvantages of each approach. The review also addresses the critical steps between promising preclinical leads and manufacturing at scale. The issues faced during this pandemic and the platforms being developed to address it will be invaluable for future outbreak control. Nine months after the outbreak began we are at a point where preclinical and early clinical data are being generated for the vaccines; an overview of this important area will help our understanding of the next phases.     

Autoimmune complications of COVID-19

Coronavirus disease 2019 (COVID-19) is still propagating a year after the start of the pandemic. Besides the complications patients face during the COVID-19 disease period, there is an accumulating body of evidence concerning the late-onset complications of COVID-19, of which autoimmune manifestations have attracted remarkable attention from the first months of the pandemic. Autoimmune hemolytic anemia, immune thrombocytopenic purpura, autoimmune thyroid diseases, Kawasaki disease, Guillain-Barre syndrome, and the detection of autoantibodies are the cues to the discovery of the potential of COVID-19 in inducing autoimmunity. Clarification of the pathophysiology of COVID-19 injuries to the host, whether it is direct viral injury or autoimmunity, could help to develop appropriate treatment.     

新型冠状病毒肺炎的病理学特征

新型冠状病毒病19(COVID-19)感染引起全身严重疾病并伴有肺功能不全.本文对近期发表的61例患者的病理学观察结果进行总结,发现肺脏组织学特征为:急性期弥漫性肺泡损伤、肺水肿、肺透明膜形成、弥漫性肺泡损伤、蛋白和纤维蛋白渗出,可见多核肺细胞;大多数病例有不同程度出血和血栓形成;浸润以淋巴细胞和单核细胞为主;免疫组化...     

COVID-19 associated mold infections: Review of COVID-19 associated pulmonary aspergillosis and mucormycosis

COVID-19-associated mold infection (CAMI) is defined as development of mold infections in COVID-19 patients. Co-pathogenesis of viral and fungal infections include the disruption of tissue barrier following SARS CoV-2 infection with the damage in the alveolar space, respiratory epithelium and endothelium injury and overwhelming inflammation and immune dysregulation during severe COVID-19. Other predisposing risk factors permissive to fungal infections during COVID-19 include the administration of immune modulators such as corticosteroids and IL-6 antagonist. COVID-19-associated pulmonary aspergillosis (CAPA) and COVID-19-associated mucormycosis (CAM) is increasingly reported during the COVID-19 pandemic. CAPA usually developed within the first month of COVID infection, and CAM frequently arose 10–15 days post diagnosis of COVID-19. Diagnosis is challenging and often indistinguishable during the cytokine storm in COVID-19, and several diagnostic criteria have been proposed. Development of CAPA and CAM is associated with a high mortality despiteappropriate anti-mold therapy. Both isavuconazole and amphotericin B can be used for treatment of CAPA and CAM; voriconazole is the primary agent for CAPA and posaconazole is an alternative for CAM. Aggressive surgery is recommended for CAM to improve patient survival. A high index of suspicion and timely and appropriate treatment is crucial to improve patient outcome.