Resilience strategies of Filipino irregular migrant domestic workers in the Netherlands during the COVID-19 pandemic

COVID-19 has brought a combination of health, socioeconomic and protection challenges to migrants everywhere, and a common view is that these effects have been harshest for those already in vulnerable situations before the pandemic. However, the lived experiences of Filipino irregular migrant domestic workers (IMDWs) in the Netherlands point to a range of impacts instead of a homogenous one. Drawing on interviews and participant observations, we analyse three specific pandemic consequences: income and financial remittance volatility, dual country or transnational precarity and physical and migration status immobility. We then analyse the resilience strategies deployed by IMDWs to navigate through such impacts. While our focus is on the microlevel, we also highlight the vital importance of the responses by the community on the mesolevel, and the government on the macrolevel. Following this relational approach, we put forward a conceptualisation of individual resilience as the capacity to navigate the negative impacts of a shock or crisis to maintain, adapt, or transform valued functionings. We argue that IMDWs cultivate resilience despite their precarious legal status;however, the effectiveness of strategies is contingent on personal circumstances as well as the sociopolitical context wherein they are deployed. The paper contributes to the literature by providing a more nuanced picture of the impacts of and responses to COVID-19 in relation to migrants with irregular status. The articulation of resilience in terms of valued functionings also paves the way for the advancement of the still nascent research agenda on migration and human development.

HUGS/Abrazos: A Novel Community Initiative to Improve Perinatal Mental Health in a High-Risk Urban Population

Objective: To evaluate the impact of a community-based intervention on perinatal mental health in an urban population during the COVID-19 pandemic Study Design: We performed a prospective cohort study of pregnant and postpartum individuals referred to a new community-based intervention, Helping Us Grow Stronger (HUGS/Abrazos). Participants received four virtual acute behavioral health sessions from a cognitive behavioral therapy (CBT) and trauma-informed care trained social worker, four resource navigation visits with a community health worker, and a care package. Participants completed validated survey instruments assessing mood, anxiety, stress, food insecurity, experience of discrimination, and program satisfaction before and after program completion. Result(s): 103 participants (Table) completed surveys before and after the program. In this urban obstetric population, there were high rates of food insecurity (54%), experiences of discrimination (61%), and COVID-19 infection in pregnancy (62%). Program satisfaction was high (Table). The program was associated with improvement in Edinburgh Postnatal Depression (EPDS) scores (mean 8.3 pre-HUGS vs 6.7 +-5.6 post, p=0.001), with significant reduction in those screened positive for depression (46/103 pre- vs 31/103 post, p< 0.001);improvement in Perceived Stress Scale (PSS) scores (mean 15.4 +- 8.0 (SD) pre vs 13.5+- 7.1 post, p=0.003) with significant reduction in those with moderate or high stress (56/103 pre vs 49/103 post, p< 0.001);and reduction in those screened positive on the PROMIS anxiety scale (46/103 pre vs 40/103 post, p< 0.001). In stratified analyses (Figure), food insecurity, COVID-19 in pregnancy, and experiences of discrimination were associated with improvement in PSS scores and PROMIS anxiety score. Conclusion(s): In a diverse urban cohort, this novel community-based intervention led to improvement in depression, perceived stress, and anxiety, particularly for those with toxic life stressors in pregnancy including food insecurity, discrimination, and COVID-19 infection. [Formula presented] [Formula presented] Copyright © 2022

Malignant hyperthermia in severe COVID-19: 2 case reports

Malignant hyperthermia is a rare but potentially fatal condition. We present 2 cases of young patients with coronavirus disease 2019 (COVID-19) requiring intubation for hypoxic respiratory failure who both developed significant hyperthermia post intubation and were suspected to have malignant hyperthermia. However, the 2 patients had different responses to conservative management and dantrolene. These cases highlight the increased challenge imposed by intubation complications when managing patients with COVID-19. Copyright © 2021 Shandong University, published by Wolters Kluwer, Inc.

Overview of the CLEF-2022 CheckThat! Lab on Fighting the COVID-19 Infodemic and Fake News Detection

We describe the fifth edition of the CheckThat! lab, part of the 2022 Conference and Labs of the Evaluation Forum (CLEF). The lab evaluates technology supporting tasks related to factuality in multiple languages: Arabic, Bulgarian, Dutch, English, German, Spanish, and Turkish. Task 1 asks to identify relevant claims in tweets in terms of check-worthiness, verifiability, harmfullness, and attention-worthiness. Task 2 asks to detect previously fact-checked claims that could be relevant to fact-check a new claim. It targets both tweets and political debates/speeches. Task 3 asks to predict the veracity of the main claim in a news article. CheckThat! was the most popular lab at CLEF-2022 in terms of team registrations: 137 teams. More than one-third (37%) of them actually participated: 18, 7, and 26 teams submitted 210, 37, and 126 official runs for tasks 1, 2, and 3, respectively.

Virtual Partial Hospitalization: A Treatment Model for Youth and Young Adults With ASD and Developmental Disorders

Objectives: This session describes a partial hospitalization program (PHP) treatment model for youth and young adults with ASD that can be implemented in person or virtually. Method(s): Youth and young adults who have ASD and other developmental disorders experience a disproportionate amount of inpatient psychiatric hospitalizations (Croen et al, 2006). At the same time, due to the COVID-19 pandemic, wait times for psychiatric hospital admissions are longer than ever. An alternative to psychiatric hospitalization for people with ASD and other developmental disorders is a specialized PHP. Such programs are flexible because they can be delivered traditionally, in person, and since COVID-19, virtually through telemedicine. A PHP that utilizes multiple evidence-based treatments (Regulating Together, Skillstreaming, and a Check-In/Check-Out intervention) delivered by an interdisciplinary team of a psychiatrist, psychologist, social worker, and supported by paraprofessionals, is presented. Result(s): We describe a successful evidence-informed treatment model for both in-person and virtual provision of this service. The benefits and drawbacks of virtual PHP, patient demographics, and selection criteria for patients likely to be successful in a virtual partial hospitalization are discussed. Preliminary outcomes data utilizing pre- and posttreatment administration of the Emotion Dysregulation Inventory suggests that the intervention may be clinically effective. Conclusion(s): PHPs provide a viable alternative to inpatient hospitalization for youth and young adults who have ASD and developmental disorders. Although PHPs have typically been provided in person, a virtual program option can meet patients' needs during a pandemic and potentially in the future, overcoming geographic and other access barriers. ASD, PAH Copyright © 2022

VIRTUAL AND IN-PERSON CARE DURING THE COVID-19 PANDEMIC LED TO EQUIVALENT PATIENT SATISFACTION FOR REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY (REI) PATIENTS

OBJECTIVE: To evaluate whether a shiftto virtual care during the COVID-19 pandemic negatively impacted patient satisfaction among REI patients. MATERIALS AND METHODS: A modified version of a validated multiple-choice survey assessing satisfaction with care was sent to current patients who agreed to participate in research at a tertiary medical center. The survey evaluated satisfaction with multiple aspects of care. Respondents were categorized by visit type: in-person only (n=23), virtual-only (n=12), and a mix of both settings (n=52). Responses were dichotomized into “Agree” or “Disagree”, with neutral grouped with “agree”. Chi-squared tests of independence to assess differences between groups were conducted in R (Version 3.4.4). P<0.05 was interpreted as statistically significant. The study was approved by the University of California San Francisco Institutional Review Board. RESULTS: Out of 1282 patients who received an invitation to participate, 526 patients (41.0%) completed our survey. Eighty-seven of these were seen by the Division of REI and included in this study. Median participant age was 36.5 (range: 21-76). There were no significant differences in respondents' satisfaction with the type of care received (in-person vs. virtual vs. mixed, p=0.43). There were no statistically significant differences in respondents' ability to develop a relationship with their provider (p=0.25), provider's friendliness (p=0.50), skills or knowledge (p=0.71), and concern (p=0.80) as rated by respondents. The frequency of visits starting on time (p=0.50), convenience of the visit date and time (p=0.78), and the amount of time spent with the provider (p=0.89) were also similar across all three groups. Although 56% of respondents who had mixed care reported that virtual visits may have compromised their health, this was not shown in either the virtual-only or in-person only groups, introducing the possibility of a confounder. Sixty-eight percent of respondents seen virtually were likely to recommend virtual visits to others. When asked about preferences for primary visit type after the COVID-19 pandemic, at least 50% of participants in all groups preferred in-person visits, with a minority choosing virtual visits (22%), alternating between virtual and in-person (16%), or expressing no preference (5%). CONCLUSIONS: A shift to virtual care during the COVID-19 pandemic did not appear to impact patient satisfaction with the care received as patients were highly satisfied regardless of the setting in which they received care. A majority of patients seen virtually were likely to recommend virtual visits to others. Nonetheless, a plurality of patients in all three groups preferred their primary visit type to be in-person. IMPACT STATEMENT: This study shows no significant differences in patient satisfaction regardless of visit type. Further research is needed to understand how to optimize virtual care delivery after the COVID-19 pandemic.

Reflections on New Evidence on Crisis Standards of Care in the COVID-19 Pandemic

Crisis standards of care have been widely developed by healthcare systems and states in the United States during the COVID-19 pandemic, and in some rare cases have actually been used to allocate medical resources. All publicly available U.S. crisis standards of care with a mechanism for allocating scarce resources make use of the Sequential Organ Failure Assessment (SOFA) score in hopes of assigning scarce resources to those patients who are more likely to survive. We reflect on the growing body of evidence suggesting that the SOFA score has limited accuracy in predicting mortality among patients hospitalized with COVID-19 and that the SOFA score systematically disfavors Black patients. Use of the SOFA score for allocating scarce resources may therefore result in Black patients with equal likelihood of survival being deprived of life-saving medical resources. There is also a risk of injustice for patients with non-COVID-19 diagnoses, for whom the SOFA score may be a more accurate prognostic score, but who might nevertheless be unfairly (de)prioritized when assessed alongside COVID-19 patients using the same scoring system. For these reasons we recommend that the SOFA score not be used for triage purposes during the COVID pandemic, and that a national effort be made to develop and empirically test crisis standards of care in advance of the next public health emergency.

A dynamic risk-based approach to managing a pandemic

A pandemic is a unique natural disaster that will pose challenges for any organisation. During the COVID-19 pandemic, for example, organisations of all types have struggled to maintain operations while assuring the health and wellbeing of the various persons who work on their behalf. Certainly, many organisations have found that their risk management and business continuity plans fail to consider adequately the disruption associated with a pandemic caused by a novel pathogen. As this paper discusses, this suggests a need to revisit risk assessments and business impact analyses;the assumptions and timeframes on which they are based;and the plans that they have generated. The paper argues that static plans are ill-suited to address the evolving threat of pandemic, and that effective planning and management of pandemic response must be dynamic in nature.