The Role of a Tertiary Level Safety Net Hospital in New York City's 2022 Mpox Outbreak.

Similar to the early phases of the COVID-19 pandemic, New York City was the national epicenter of the ongoing 2022 mpox (formerly monkeypox) outbreak. Cases quickly began to rise in July 2022, primarily in gay, bisexual, or other men who have sex with men. Tools in the form of a reliable diagnostic test, an effective vaccine, and a viable treatment option have been available from the onset, although logistically complex to roll out. The special pathogens program at NYC Health + Hospitals/Bellevue, the flagship facility for the largest public hospital system in the United States, collaborated with multiple departments within Bellevue, the hospital system, and the NYC Department of Health and Mental Hygiene, to swiftly establish ambulatory testing, immunizations, patient-centered inpatient care, and outpatient therapeutics. With the ongoing mpox outbreak, hospitals and local health departments must prepare a systemwide response to identify and isolate patients and provide high-quality care. Findings from our experience can help guide institutions in developing a multipronged, comprehensive response to the ongoing mpox outbreak.

Effect of the COVID-19 pandemic on the mental health, daily and occupational activities among health professionals in Colombia: a national study.

BACKGROUND: The COVID-19 pandemic has placed an unprecedented physical and mental burden on healthcare workers who are frequently at high risk of infection, particularly in low-income countries. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress, as well as changes in daily and occupational activities among healthcare professionals due to the COVID-19 pandemic in Colombia. METHODS: An observational, cross-sectional study was conducted between February and June 2021. The survey incorporated validated mental health tools such as the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10. Multivariable ordinal logistic regression analysis was performed to determine the factors associated with severe mental health outcomes. RESULTS: Among 1345 healthcare workers the prevalence of anxiety, depression, and stress were 75.61, 59.18, and 53.09%, respectively. Anxiety (OR:1.44; 95%CI:1.16-1.8), depression (OR:1.74; 95%CI:1.27-2.37), and stress (OR:1.51; 95%CI:1.18-1.94) were more frequent in women, and individuals who expressed fear of a negative outcome (death, sequelae) (OR:2.25; 95%CI:1.60-3.25), (OR:1.49; 95%CI:1.03-2.16) and (OR:2.36; 95%CI:1.69-3.29) respectively. Age was negatively associated with anxiety (OR:0.98; 95%CI:0.98-0.99), stress (OR:0.98; 95%CI:0.97-0.99), and depression (OR:0.97; 95% CI:0.96-0.98). Reduction in consultations and surgeries (OR:1.01; 95%CI:1.0-1.01) was positively associated with anxiety. Due to the pandemic, most specialists expected to incorporate drastic long-term (> 1 year) changes in their clinical setting and daily activities. CONCLUSIONS: The prevalence of anxiety, depression, and stress is higher among Colombian healthcare workers compared to previous reports. Further research regarding these psychological outcomes is needed to achieve early mental health intervention strategies. TRIAL REGISTRATION: Hospital Universitario Fundación Santa Fe, Ethical Committee Registration ID: CCEI-12992-2021.

Impact of the COVID-19 national lockdown in the allergic rhinitis symptoms in patients treated with immunotherapy at two allergy referral centers in Bogotá, Colombia.

Background: Coronavirus disease-19 (COVID-19) "lockdowns" caused an abruptly restricted access to health care services such as immunotherapy for allergic rhinitis (AR) and led to higher exposure to indoor allergens. This study aimed to assess the impact of COVID-19 lockdowns on AR symptoms reported by the patients treated with immunotherapy who attended the Hospital Fundación Santa Fe de Bogotá and Unidad Médico Quirúrgica de Otorrinolaringología, Colombia. Methods: Pre-post study that included patients with AR confirmed diagnosis (prick test), treated with immunotherapy before and after COVID-19 lockdowns on March-June 2020. Visual analog scales (VAS) and sociodemographic questionnaires were applied to assess AR symptoms (nasal obstruction, pruritus, rhinorrhea, and ocular symptoms) and their associated factors. Results: A total of 318 participants were included, and their mean age was 18.9 years (SD: 12.8). The median number of immunotherapy doses applied before isolation was 11 (interquartile range [IQR]: 6-19), and the median number of immunotherapy doses missed during isolation was three doses (IQR: 2-3). Up to 38.4% of the AR patients reported that their symptoms got worse during lockdowns. A pre-post mean difference in the VAS score of 0.5 was found for nasal obstruction (p = .01), 0.7 for pruritus (p < .001), 0.7 points for rhinorrhea (p < .001), and 0.8 for ocular symptoms (p < .001). Factors associated with worsening of AR symptom scores were pet ownership, atopic dermatitis, lower educational level, and a low number of immunotherapy doses applied before lockdowns. Conclusion: A large proportion of patients reported worsening of their AR symptoms, probably due to higher exposure to indoor AR allergens and interruption of immunotherapy during COVID-19 lockdowns.

Understanding the reason for variation in high school graduation rates of Latino males

This study explored and validated the knowledge, motivational and organizational (KMO) influences of teacher engagement strategies on Latino male high school completion of graduation requirements and disparities in graduation rates at the Port Century High School in the Port Century Unified School District (PCUSD) in Southern California. Clark and Estes' (2008) gap analysis theoretical framework undergirded the entire study that focused on examining whether there were gaps in current teacher performance and the performance of the PCUSD. A convergent parallel mixed methodology was used to explore multiple KMO influences that impact Latino male high school graduation rates through completion of graduation requirements by looking at teacher engagement methods and how they develop strong consistent relationships with Latino male students. The findings from surveys, interviews and document analysis validated nine influences or gaps related to the problem of practice in the areas of factual, conceptual, metacognitive knowledge, expectancy value, attributions, cultural models and cultural settings. It is important to note that results were collected for one organization during COVID-19 and the sample size was small. The results cannot be generalized to other organizations. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Hyperbaric oxygen as an adjuvant treatment for patients with COVID-19 severe hypoxaemia: a randomised controlled trial.

BACKGROUND: Hyperbaric oxygen (HBO2) therapy has been proposed to treat hypoxaemia and reduce inflammation in COVID-19. Our objective was to analyse safety and efficacy of HBO2 in treatment of hypoxaemia in patients with COVID-19 and evaluate time to hypoxaemia correction. METHODS: This was a multicentre, open-label randomised controlled trial conducted in Buenos Aires, Argentina, between July and November 2020. Patients with COVID-19 and severe hypoxaemia (SpO2 ≤90% despite oxygen supplementation) were assigned to receive either HBO2 treatment or the standard treatment for respiratory symptoms for 7 days. HBO2 treatment was planned for ≥5 sessions (1 /day) for 90 min at 1.45 atmosphere absolute (ATA). Outcomes were time to normalise oxygen requirement to SpO2 ≥93%, need for mechanical respiratory assistance, development of acute respiratory distress syndrome and mortality within 30 days. A sample size of 80 patients was estimated, with a planned interim analysis after determining outcomes on 50% of patients. RESULTS: The trial was stopped after the interim analysis. 40 patients were randomised, 20 in each group, age was 55.2±9.2 years. At admission, frequent symptoms were dyspnoea, fever and odynophagia; SpO2 was 85.1%±4.3% for the whole group. Patients in the treatment group received an average of 6.2±1.2 HBO2 sessions. Time to correct hypoxaemia was shorter in treatment group versus control group; median 3 days (IQR 1.0-4.5) versus median 9 days (IQR 5.5-12.5), respectively (p<0.010). OR for recovery from hypoxaemia in the HBO2 group at day 3 compared with the control group was 23.2 (95% CI 1.6 to 329.6; p=0.001) Treatment had no statistically significant effect on acute respiratory distress syndrome, mechanical ventilation or death within 30 days after admission. CONCLUSION: Our findings support the safety and efficacy of HBO2 in the treatment of COVID-19 and severe hypoxaemia. TRIAL REGISTRATION NUMBER: NCT04477954.