Search Results (1,442)

Background: Non-invasive respiratory supports (High-Flow Nasal Oxygen, HFNO; Continuous Positive Airway Pressure, CPAP; Non-Invasive Ventilation, NIV) are frequently used in Acute Hypoxemic Respiratory Failure (AHRF). However, the experience of assisted breathing may profoundly affect patients’ psychological balance, particularly during acute critical illness and subsequent rehabilitation. Aims and objectives: This longitudinal study investigated the psychological burden associated with non-invasive respiratory support use in patients with COVID-19-related AHRF, exploring changes in psychological functioning from acute hospitalization (RICU/ICU) (T0) to follow-up, conducted at a mean of 6.0 ± 3.1 months after respiratory rehabilitation (T1). Methods: Fifty-two patients (mean age = 66.9 ± 9.17 years) were assessed at T0 and T1. Standardized measures evaluated anxiety, psychological distress, post-traumatic stress symptoms, depression, and resilience, in relation to perceived illness severity and subjective experience of non-invasive respiratory support. Results: During acute care, patients reported high levels of fear and anxiety related to illness severity and uncertainty. The experience of non-invasive respiratory support, often perceived as a marker of critical condition, was associated with increased fear and anxiety (t(14) = 2.79, p = 0.014) compared to the recovery phase, leading to feelings of loss of control and diminished psychological well-being (t(17) = 2.35, p = 0.031). However, resilience significantly improved over time (t(16) = −4.78, p < 0.001). Conclusions: Non-invasive respiratory support may represent a psychologically demanding experience, often perceived as challenging to patients’ sense of safety and control. Encouragingly, psychological adaptation and resilience can improve during rehabilitation. Integrating structured psychological support within respiratory rehabilitation pathways may promote recovery and restore psychological balance in patients requiring assisted ventilation. Full article

In Psalm 91, the psalmist implores Jews not to become overwhelmed by fear, promising that God will protect and deliver the faithful from the troubles that threaten them. Foremost among these, as laid out in verse 6, are “pestilences” and “plagues.” Reciting or praying this psalm and this verse has been used for centuries as a way for Jews to remain hopeful in the face of challenges, especially during times of pandemic disease. This paper details how the rabbinic literature understood Psalm 91:6 as a description of a demonic force, and describes how Jews were told to protect themselves from this force, namely through faith and trust in God and through religious observance. The paper also discusses the Jewish experience with pestilential disease, from the 14th century plague pandemic to the 19th century cholera pandemics to the 1918 influenza pandemic and to the recent COVID-19 pandemic. Finally, the paper lays out how Jews have made use of Psalm 91:6 in responding to the threat of pandemics, especially during COVID-19, including through both prayer and more esoteric applications. Full article

The current paper examines how individual/personality factors are associated with the political legitimacy of government restrictions at the onset of the COVID-19 pandemic. A total of 1262 US-based participants completed an online survey comprising several scales (predictor factors), such as the Just World Scale, the Police Legitimacy Scale, and the Authoritarianism Scale measuring aggression, submission, and conventionalism. In addition, they completed scales measuring their Fear of COVID and Perceptions of Government (outcome factors). The results suggest that those who viewed the president or federal government as most responsible had lower legitimacy scores than those who reported their governor, state government, or local official or government to be responsible. Also, those who aligned with the Republican party had the lowest mean for fear of COVID, while the highest was in the “Other” political affiliation, followed by the Democrats, who had the second highest. It also turned out that whereas one’s relationships with those who have been hospitalized or died as a result of COVID and individual risk factors for COVID were not significant variables in predicting perceptions of the federal government’s handling of the pandemic, the most significant factors were Authoritarianism, Fear of COVID-19, (older) Age, Change in Federal Trust and Political Ideology. Fear of COVID-19 was the only significant factor predicting government legitimacy and individual decisions to engage in protection measures during the pandemic. Theoretical and practical implications are discussed. Full article

Coronavirus anxiety is defined as a psychological contrast characterized by excessive fear, obsessive thoughts, and reassurance-seeking behaviors associated with COVID-19. As current scales have been tested primarily in North American populations, we aimed to translate and culturally adapt three measures of dysfunctional coronavirus anxiety—the Coronavirus Anxiety Scale (CAS), the Obsession with COVID-19 Scale (OCS), and the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS)—for the first time in Greek-speaking populations. To translate existing scales, we followed best practices for cross-cultural comparisons using forward translation (English to Greek) and backward translation (Greek to English) with expert translation review, prior to conducting pilot testing and confirmatory factor analysis in a bespoke survey population. A total of 405 adults from Cyprus participated in this study. The results indicated that the Greek versions of these measures demonstrated adequate reliability (Cronbach’s alphas > 0.70) and strong factor structure, as supported through confirmatory factor analysis. However, only the CAS exhibited evidence of both convergent and divergent validity. Our study makes several innovative contributions which have broad implications for crisis preparedness, including providing a framework for mental health interventions in future pandemics or Black Swan events. Full article

The aim of this study is to thoroughly assess the informational content of the CBOE Volatility Index^® (VIX^® Index) in the context of various turbulent periods. The VIX Index is especially important from an investor perspective. It is often referred to as the “investor fear gauge”, because its level tends to spike during periods of market turmoil and other extreme events. Therefore, this index significantly differs from other market indices and financial instruments. Information theory and normalized Shannon entropy, combined with a rolling-window dynamic approach, are used to explore the evolution of the VIX Index over time. The research hypothesis states that the informational content of the VIX Index varies substantially across periods affected by crucial events. To verify this hypothesis, three important periods of the twenty-first century are analyzed: (1) the Global Financial Crisis, (2) the COVID-19 pandemic outbreak, and (3) the period covering the sub-periods before and after the Donald Trump’s Presidential Inauguration. The results provide no reason to reject the research hypothesis. The empirical findings show that the entropy values appear to be quite sensitive to the choice of discretizaton procedure. However, this evidence is consistent with the existing literature. Full article

In many parishes, lay communion from the chalice ceased during the COVID-19 pandemic, and has yet to return. This article summarizes the historical development of practice and theology regarding the chalice and proposes a symbolic and phenomenological account of communion with the blood of Christ. The practice of lay communion from the chalice in Western Christianity has gone through several distinct phases. From early Christianity into the medieval period, lay reception from the chalice was practiced regularly. In the twelfth century, the practice ceased due to increased focus on Christ’s real presence in the consecrated elements and increased fear of dropping or spilling Christ’s body and blood on the ground. The doctrine of concomitance arose to explain that in exceptional circumstances where communion was possible under only one species, communicants still received Christ whole and entire. Later, concomitance was used to support the practice of withholding the chalice from the laity, which lasted from the twelfth century until Vatican II. Without challenging the Council of Trent’s pronouncement that communion under both species is not required for salvation, this article argues that communion under both species maximizes the multivalent symbolism and the phenomenological experience of eucharistic communion for sacramental participants. Full article

Background/Objectives: The COVID-19 pandemic posed significant challenges to quality of life, particularly for individuals living with chronic physical and/or mental conditions. Psychological factors such as fear of COVID-19, psychological distress, and resilience may be associated with quality-of-life outcomes during prolonged public health crises. This study aimed to examine quality of life and its psychological correlates among individuals with chronic conditions during the later phases and aftermath of the COVID-19 pandemic crisis. Methods: A cross-sectional study was conducted among 293 adults with chronic physical and/or mental conditions attending the General Hospital of Argolida, Greece. Participants completed validated self-report measures assessing quality of life (MVQOLI), fear of COVID-19 (FCV-19S), depression, anxiety, and stress (DASS-21), and psychological resilience (CD-RISC-25). Descriptive statistics, Spearman correlation analyses, and multivariable regression models were used to examine associations and identify factors associated with quality-of-life domains. Results: Higher levels of fear of COVID-19 and depressive symptoms were significantly associated with poorer quality of life across multiple domains. Depressive symptoms showed consistent negative associations with functional, interpersonal, transcendent, and overall quality-of-life scores. In contrast, psychological resilience was positively associated with interpersonal, transcendent, and overall quality of life. Regression analyses showed that depressive symptoms were negatively associated with overall quality of life, while resilience was independently associated with better quality-of-life outcomes. Conclusions: Psychological distress, particularly depressive symptoms and fear related to COVID-19, was associated with lower quality of life among individuals with chronic conditions during the later phases and aftermath of the COVID-19 crisis. Psychological resilience was positively associated with better quality-of-life outcomes, underscoring its relevance for supporting well-being during and after public health crises. Full article

This study seeks to inform emergency preparedness efforts by summarizing the pandemic’s impacts on access to opioid use disorder (OUD) recovery support as reported by women in recovery. In-depth interviews were completed with adult women in recovery from OUD. We used a primarily deductive approach to coding and analysis. Two coders analyzed transcripts; discrepancies were resolved through discussion. Seventeen women completed interviews from June to October 2020. Pandemic impacts primarily focused on engagement in care and retention at community and interpersonal levels. Community-level barriers to engagement included facilities’ halting intake of patients and fear of COVID-19 infection in treatment settings. Interpersonal barriers to engagement included loss of childcare support and the sudden transition to virtual services. Community-level retention barriers included perception of facility staff’s lack of adherence to infection prevention protocols and strict enforcement of infection prevention protocols on residents within facilities. Interpersonal barriers to retention included reduced availability of mutual aid meetings. Participants also highlighted how the pandemic worsened the addiction crisis and increased women’s caretaking burden. Leaders and administrators must be prepared to simultaneously balance responses for two public health crises: a novel infectious disease and addiction. Lessons learned from the pandemic can mitigate barriers to care and recovery when future emergencies arise. Full article

Non-immersive (screen-based) virtual environments may offer a low-threshold way to elicit clinically relevant emotions while reducing barriers associated with immersive head-mounted displays. This study examined whether a non-immersive virtual scenario simulating a dirty public bathroom is associated with changes in disgust-related and anxiety-related responses in a non-clinical sample of university students, and explored links with obsessive–compulsive tendencies and contamination-related anxiety during the COVID-19 period. A total of 122 participants remotely explored the virtual environment. Before and after exposure, participants completed measures of state anxiety (EMAS-S) and disgust sensitivity (DSR); trait anxiety (EMAS-T), obsessive–compulsive symptoms (OCI-R), fear of COVID-19 (FCS), and engagement/activation during the experience were also assessed. Pre–post differences were tested using paired-sample t-tests, and associations among variables were examined via bivariate correlations. Results indicated a significant post-exposure increase in EMAS-S and DSR scores. Correlational analyses showed robust associations between disgust sensitivity and obsessive–compulsive symptoms, and between trait anxiety and fear of COVID-19. Gender and first-person videogame experience were related to subjective discomfort and activation, with higher levels reported by females and participants without gaming experience. The findings provide preliminary evidence that a remote, screen-based contamination scenario can elicit measurable disgust- and anxiety-related responses and that individual differences may shape subjective impact. However, because the study used a single-group pre–post design without a neutral VR condition or a non-VR control, causal conclusions about the effects of the virtual scenario cannot be drawn. Full article

The COVID-19 pandemic posed unprecedented challenges, requiring compliance with public health measures. Notably, guilt is a powerful motivator for rule adherence; however, different types of guilt could have fueled the decision to stay home. This study investigated how guilt propensity influenced Italians’ self-reported motivations for adhering to containment rules. The propensity to different types of guilt, namely deontological and altruistic, was assessed in a total of 393 participants (261 females, 66.4%; 132 males, 33.6%; M age = 34.4, SD = 12.6) in May 2020, between the first and the second phases of Italian lockdown. The survey assessed four guilt dispositions—Moral Norm Violation (MNV), Moral Dirtiness (MODI), Harm-based guilt (HARM), and Empathy-based guilt (EMPATHY)—alongside fear of COVID-19, trust in authorities, and motivations for rule compliance (e.g., protecting one’s own and others’ well-being, respecting authorities, and avoiding sanctions). MNV emerged as a positive predictor of prosocial, authority-based and personal motivations, whereas MODI predicted lower prosocial motivation. HARM selectively predicted prosocial motivation and was negatively associated with authority-based motivations, while EMPATHY negatively predicted self-focused motivations. Moderation analyses revealed small but significant interaction effects, indicating that fear of COVID-19 slightly amplified the influence of EMPATHY and attenuated the effect of HARM, whereas trust in authorities strengthened the link between EMPATHY and prosocial compliance and reduced the association between MNV and prosocial motivations. These findings suggest that compliance during the pandemic was shaped by distinct emotional–moral pathways and that the motivational impact of guilt depends on perceived threat and institutional trust, highlighting the relevance of specific guilt profiles in promoting cooperative and health-protective behaviors. Full article

The aim of this study was to examine the factors associated with COVID-19-related fear in older adults from Kazakhstan, and to explore its associations with sociodemographic characteristics, health status and multiple domains of quality of life in a regional context. A total of 445 individuals aged 60 and above from both urban and rural locations in Kazakhstan participated in this cross-sectional study. To assess the quality of life among older people we used the OPQoL (Older People’s Quality of Life) Scale. Further variables were evaluated: sociodemographic (age, gender, education level, marital status, and place of residence); health-related (self-reported overall health, hypertension, diabetes, cerebrovascular disease, cardiovascular disease, and chronic obstructive pulmonary disease (COPD); and COVID-19-related fear variable. Female gender (OR = 2.344; p = 0.001), present hypertension (OR = 2.106; p = 0.008), the specialized secondary educational level (OR = 2.321; p = 0.012) and at the border of significance university educational level (OR = 1.832; p = 0.051) were variables significantly associated with the COVID-19-related fear in older adults. For individuals with reported COVID-19-related fear, advanced age was significantly negatively associated with leisure and activities domain (B = −0.747; p = 0.020) of OPQoL; better self-reported overall health was significantly positively associated with life overall domain (B = 0.691; p < 0.001), health domain (B = 1.320; p < 0.001), psychological and emotional well-being domain (B = 0.395; p = 0.001), home and neighborhood domain (B = 0.249; p = 0.036), independence, control over life and freedom domain (B = 1.082; p < 0.001), financial circumstances domain (B = 1.132; p < 0.001), and leisure and activities domain (B = 0.556; p = 0.026) of OPQoL; present hypertension was significantly negatively associated with health domain (B = −0.888; p = 0.004) of OPQoL; present cardiovascular disease was significantly negatively associated with life overall domain (B = −0.588; p = 0.027), health domain (B = −0.967; p = 0.009), and independence, control over life and freedom domain (B = −0.542; p = 0.039) of OPQoL; being single was significantly negatively associated with life overall domain (B = −0.481; p = 0.033), social relations domain (B = −0.671; p = 0.014) and financial circumstances domain (B = −0.694; p = 0.036) of OPQoL; and urban place of residency was significantly positively associated with health domain (B = 0.735; p = 0.011) and psychological and emotional well-being domain (B = 0.483; p = 0.010) of OPQoL. Our findings pointed that numerous variables were associated with the COVID-19-related fear and quality of life domains regarding COVID-19-related fear in older adults from Kazakhstan during pandemics. Full article

Background: The COVID-19 pandemic significantly disrupted health systems, including the delivery of childhood immunizations. This study assessed COVID-19 vaccination coverage in families of children with incomplete routine immunization and explored why adults accepted COVID-19 vaccines despite skipping routine vaccination for their children in the district of Swat, Khyber Pakhtunkhwa, Pakistan. Methods: A mixed-methods study was conducted in Swat District during March 2022–April 2023. A cross-sectional survey assessed COVID-19 vaccination in household members of children under 2 years of age for whom vaccination registries showed missed routine vaccinations. In-depth interviews with 18 household members explored motivations for vaccine acceptance through thematic analysis. Results: Among 249 families of children with incomplete immunization found through vaccination records, 237 families (88% response) were interviewed. Among 382 children below 2 years of age in these families, 29.5% (n = 113) were fully vaccinated, 67.5% (n = 258) were incompletely vaccinated according to age, and 2.9% (n = 11) had not received any vaccine. Data from 237 of the defaulter children—one per household—was included in further analysis. Among household members above 12 years of age, 87% (964/1103) of males and 82% (n = 901/1093) of females were vaccinated against COVID-19. Households with at least one fully vaccinated child were significantly more likely to have vaccinated family members. Multivariable analysis showed maternal COVID-19 vaccination (AOR 2.08, 95% CI: 1.15–3.76) and urban residence (AOR 2.08, 95% CI: 1.14–3.79) were associated with full childhood vaccination. In-depth interviews revealed that key motivators for COVID-19 vaccination included the perception that it was mandatory, house-to-house vaccination, and fear of hospitalization or death. Conclusions: Vaccine requirements and ease of access to vaccination services enhanced coverage with COVID-19 vaccines among families of children with incomplete routine immunization. Ethical use of vaccine requirements and community education to enhance levels of risk perception of vaccine-preventable diseases could potentially improve childhood immunization. Full article

The COVID-19 pandemic (2020–2023) profoundly disrupted healthcare systems and imposed sustained psychological burdens on healthcare professionals and trainees. Reliable instruments are essential for assessing these impacts. This study evaluated the construct validity and reliability of the Fear of COVID-19 Scale (FCV-19S) in a convenience sample of 1761 healthcare professionals, trainees, and academic staff at a single U.S. academic health sciences center (the University of Oklahoma Health Campus). Participants completed the FCV-19S; confirmatory factor analysis (CFA) examined its dimensional structure; and internal consistency was assessed using Cronbach’s α and McDonald’s ω. The one-factor model demonstrated good internal consistency (α = 0.89; ω = 0.89) but exhibited sub-optimal model fit (CFI = 0.89; TLI = 0.83; SRMR = 0.06; RMSEA = 0.18). The two-factor model, distinguishing emotional and somatic fear, showed substantially improved fit (CFI = 0.97; TLI = 0.96; SRMR = 0.03; RMSEA = 0.09) and acceptable internal consistency for both factors (α = 0.85 and 0.86; ω = 0.85 and 0.87), although RMSEA remained above conventional thresholds for close fit. Overall, findings support a two-factor structure as a comparatively superior and more nuanced representation of fear responses among an academic health workforce. The validated FCV-19S offers a reliable tool for assessing COVID-19-related distress in clinical and educational health settings, informing targeted interventions to strengthen workforce resilience. Full article

Background/Objectives: To assess the mental health of Chinese college students following the lifting of COVID-19 restrictions in December 2022. Methods: A three-wave cross-sectional study was conducted among students from 22 colleges in Guangdong, China, at three time points: Onset of COVID-19 (February 2020; T1; initial survey wave), during restrictions (June 2021; T2), and after restrictions (March to April 2023; T3). Participants at each wave were 164,101, 86,767, and 130,285, respectively. The standardized prevalence rates of depression, suicidal ideation (SI), anxiety, insomnia, acute stress, and fear of COVID-19 after restrictions were compared with those from the initial survey wave and restriction periods. Multivariate logistic regression was used to identify associated risk factors. Results: After restrictions were lifted, standardized prevalence rates of mental symptoms were as follows: anxiety (13.5%), depression (19.9%), insomnia (11.8%), acute stress (19.7%), fear of COVID-19 (16.2%), and suicidal ideation (31.8%). The standardized prevalence rates at T3 were higher than those at T1, with absolute increases of 10.9% for anxiety, 13.9% for depression, 9.1% for insomnia, and 23.5% for suicidal ideation. Acute stress showed a V-shaped pattern, with lower prevalence during the restriction period compared to T1, followed by an increase at T3. Fear of COVID-19 declined after the initial phase and remained stable. Students with a history of infection, those perceiving greater pandemic impact, and those who either neglected or excessively engaged in protective behaviors were at elevated risk for mental health symptoms. Conclusions: Our findings highlight the long-term adverse effects of the pandemic at the population level on Chinese college students’ mental health. Continuous monitoring, early prevention, and accessible mental health care should be prioritized in the coming years. Full article

Objective: Homeless individuals are vulnerable, and a high burden of mental health problems is suspected. We aim to identify the prevalence and key predictors of probable depression and anxiety among homeless individuals in Germany during the Coronavirus disease-2019 (COVID-19) pandemic. Study Design: Nationwide multicentre cross-sectional study including clinical, laboratory, and questionnaire-based data on the health of homeless individuals in Germany. Methods: Data were used from the National Survey on the psychiatric and somatic health of homeless individuals during the COVID-19 pandemic. Probable depression and anxiety were determined using the Patient Health Questionnaire 9 and the General Anxiety Disorder 2 questionnaire. Logistic regression analysis was used to identify key predictors of probable depression and anxiety. Results: A high prevalence of probable depression (26.8% [95% CI: 23.2–30.3]) and anxiety (27.2% [95% CI: 23.7–30.7]) was found. Logistic regressions showed both probable depression and anxiety associated with being female (depression: OR 1.80 [95% CI: 1.06–3.03]; anxiety: OR: 1.69 [95% CI: 1.03–2.76]), daily use of any illegal substances (depression: OR 3.20 [95% CI: 1.87–5.49]; anxiety: OR 2.04 [95% CI: 1.21–3.45]), and fear of contracting COVID-19 (little fear, depression: OR: 1.81 [95% CI 1.01–3.23], some fear, anxiety: OR: 2.52 [95% CI: 1.31–4.83]). Probable depression was associated with longer durations of homelessness (OR: 1.004, [95% CI: 1.001–1.007]. Conclusions: Probable depression and anxiety are highly prevalent in homeless individuals throughout. Key predictors may help to identify individuals in need and design targeted interventions. Full article