Effective training practices for non-specialist providers to promote high-quality mental health intervention delivery: A narrative review with four case studies from Kenya, Ethiopia, and the United States

Mental health needs and disparities are widespread and have been exacerbated by the COVID-19 pandemic, with the greatest burden being on marginalized individuals worldwide. The World Health Organization developed the Mental Health Gap Action Programme to address growing global mental health needs by promoting task sharing in the delivery of psychosocial and psychological interventions. However, little is known about the training needed for non-specialists to deliver these interventions with high levels of competence and fidelity. This article provides a brief conceptual overview of the evidence concerning the training of non-specialists carrying out task-sharing psychosocial and psychological interventions while utilizing illustrative case studies from Kenya, Ethiopia, and the United States to highlight findings from the literature. In this article, the authors discuss the importance of tailoring training to the skills and needs of the non-specialist providers and their roles in the delivery of an intervention. This narrative review with four case studies advocates for training that recognizes the expertise that non-specialist providers bring to intervention delivery, including how they promote culturally responsive care within their communities.Copyright © 2023 The Author(s).

How behavioral science can inform policies to prevent discrimination against the asian community in the era of COVID-19

The Asian community in the United States has seen an enormous uptick in discriminatory experiences since the start of the COVID-19 pandemic. Asian individuals have reported discrimination within their workplaces, in their communities, and against Asian-owned businesses. Many for-profit organizations have failed to acknowledge this surge. We argue that organizations should adopt policies to protect their Asian employees and clientele. On the basis of behavioral science research and knowledge of best practices for promoting diversity and inclusion, we suggest that organizational leaders create crisis task forces to find ways to reduce discrimination against Asian employees and that the leaders more generally reaffirm organizational commitments to diversity and inclusion, communicate those commitments to stakeholders, visibly enact expected organizational norms related to diversity and inclusion, and establish or reassess accountability systems to ensure that policies and norms are followed. © 2020, Brookings Institution Press. All rights reserved.

Softening the blow: Incorporating employee perceptions of justice into best practices for layoffs during the COVID-19 pandemic

COVID-19 has led to staggering numbers of people being laid off or furloughed. The way these decisions are communicated to employees can critically affect how workers receive and process the news. Specifically, if employees perceive layoff decisions as unfair, both those who are let go and those who remain may suffer untoward mental and physical effects from the layoffs, and these effects, in turn, can have negative consequences for the organization (such as reputational damage). In this article, we draw on prior research into perceptions of justice—including distributive justice (focused on how resources and burdens are allocated), procedural justice (focused on how decisions are made and implemented), and interactional justice (focused on how decisions are communicated)— to offer behaviorally based policy recommendations that organizational leaders and managers can apply to buffer some of the negative effects that layoff decisions can have on both employees and organizations. © 2020, Brookings Institution Press. All rights reserved.

N95 respirator decontamination: a study in reusability.

The coronavirus disease 2019 (COVID-19) pandemic had caused a severe depletion of the worldwide supply of N95 respirators. The development of methods to effectively decontaminate N95 respirators while maintaining their integrity is crucial for respirator regeneration and reuse. In this study, we systematically evaluated five respirator decontamination methods using vaporized hydrogen peroxide (VHP) or ultraviolet (254 nm wavelength, UVC) radiation. Through testing the bioburden, filtration, fluid resistance, and fit (shape) of the decontaminated respirators, we found that the decontamination methods using BioQuell VHP, custom VHP container, Steris VHP, and Sterrad VHP effectively inactivated Cardiovirus (3-log10 reduction) and bacteria (6-log10 reduction) without compromising the respirator integrity after 2-15 cycles. Hope UVC system was capable of inactivating Cardiovirus (3-log10 reduction) but exhibited relatively poorer bactericidal activity. These methods are capable of decontaminating 10-1000 respirators per batch with varied decontamination times (10-200 min). Our findings show that N95 respirators treated by the previously mentioned decontamination methods are safe and effective for reuse by industry, laboratories, and hospitals.

Attenuation of circuit longevity in COVID-19 critical illness with AKI on continuous venovenous hemodiafiltration despite the use of regional citrate anticoagulation (RCA) and heparin-bonded an 69 (oxiris®) filter

Introduction: Critical illness in SARS-CoV-2 (COVID-19) infection can result in acute kidney injury (AKI). Continuous renal replacement therapy (CRRT) is part of the overall supportive ICU management. Case Description: CRRT was delivered as Continuous Veno-venous Haemodiafiltration (CVVHDF) using the Prismaflex (Baxter Inc.) system with heparinbonded AN69 filter (oXiris®). The filters were electively changed every 12 hours for first 5 days to augment cytokine adsorptive capacity. Regional citrate anticoagulation (RCA) was used to ensure filter longevity. Initial citrate dose was prescribed at 3.0 mmol/L. All 3 consecutive patients were male aged 66.7 ± 6.02 years. APACHE II score was 32.7 ± 6.51 and predicted mortality was 71%. Mean initial creatinine was 264.7 μmol/L, and urine output was 6.7 mL/hour. All patients were on vasopressor support, broad spectrum antimicrobials and mechanical ventilation. 30 oXiris filters were studied in the 3 patients. 6/30 (20%) filters clotted spontaneously before scheduled change. Mean filter lifespan (24/30) was 689.6 ± 42.3 min before elective change. For the filters that clotted, mean circuit longevity was 515.7 ± 126.2 min. The observed difference was significant, p = 0.002. Importantly, filter clotting occurred despite adequate citrate dose of 3.0 mmol/L and mean post-filter ionized calcium of 0.34 ± 0.06 mmol/L. Vascular access issues were excluded by review of access, return pressures. Citrate dose was increased to 3.2 mmol/ L for all patients and this reduced the frequency of filter clotting subsequently. Two patients were extubated and had full renal recovery - mean duration of CRRT dependence was 9.5 days. However, the third patient remained CRRT dependent until demise on the 28th day of ICU stay. Discussion: Attenuation of circuit lifespan was observed despite adequately dosed RCA and heparin bonded oXiris filters. We theorize that this could be due to a procoagulant state induced by the SARS-CoV-2 infection. Possibly, higher citrate dose to target even lower post-filter ionized calcium may be required to optimise anticoagulation and filter lifespan, thereby ensuring optimal effluent dose and solute clearance, for critically ill COVID-19 patients.