BackgroundMedical staff fighting the COVID-19 pandemic are experiencing stress from high occupational risk, panic in the community and the extreme workload. Maintaining the psychological health of a medical team is essential for efficient functioning, but psychological intervention models for emergency medical teams are rare.AimsTo design a systematic, full-coverage psychological health support scheme for medical teams serving large-scale emergent situations, and demonstrate its effectiveness in a real-world study in Leishenshan Hospital during the COVID-19 epidemic in Wuhan, China.MethodsThe scheme integrates onsite and online mental health resources and features team-based psychosocial support and evidence-based interventions. It contained five modules, including a daily measurement of mood, a daily mood broadcast that promotes positive affirmation, a daily online peer-group activity with themes based on the challenges reported by the team, Balint groups and an after-work support team. The daily mood measurement provides information to the other modules. The scheme also respects the special psychological characteristics of medical staff by promoting their strengths.ResultsThe scheme economically supported a special medical team of 156 members with only one onsite psychiatrist. Our data reflected that the entire medical team maintained an overall positive outlook (7–9 out of 10 in a Daily Mood Index, DMI) for nearly 6 weeks of continuous working. Since the scheme promoted self-strengths and positive self-affirmation, the number of self-reports of life-related gains were high and played a significant effect on the DMI. Our follow-up investigations also revealed that multiple modules of the scheme received high attention and evaluation levels.ConclusionOur quantitative data from Leishenshan hospital, Wuhan, China, show that the programme is adequate to support the continuous high workload of medical teams. This scheme could be applied to medical teams dealing with emergent situations.
Extensive evidence suggests that frontoparietal regions can dynamically update their pattern of functional connectivity, supporting cognitive control and adaptive implementation of task demands. However, it is largely unknown whether this flexibly functional reconfiguration is intrinsic and occurs even in the absence of overt tasks. Based on recent advances in dynamics of resting-state functional resonance imaging (fMRI), we propose a probabilistic framework in which dynamic reconfiguration of intrinsic functional connectivity between each brain region and others can be represented as a probability distribution. A complexity measurement (i.e., entropy) was used to quantify functional flexibility, which characterizes heterogeneous connectivity between a particular region and others over time. Following this framework, we identified both functionally flexible and specialized regions over the human life span (112 healthy subjects from 13 to 76 years old). Across brainwide regions, we found regions showing high flexibility mainly in the higher-order association cortex, such as the lateral prefrontal cortex (LPFC), lateral parietal cortex, and lateral temporal lobules. In contrast, visual, auditory, and sensory areas exhibited low flexibility. Furthermore, we observed that flexibility of the right LPFC improved during maturation and reduced due to normal aging, with the opposite occurring for the left lateral parietal cortex. Our findings reveal dissociable changes of frontal and parietal cortices over the life span in terms of inherent functional flexibility. This study not only provides a new framework to quantify the spatiotemporal behavior of spontaneous brain activity, but also sheds light on the organizational principle behind changes in brain function across the human life span.
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