Impact of the COVID-19 Pandemic on the Employment and Educational Outcomes of Individuals in a First-Episode Psychosis Clinic.

OBJECTIVE: A central objective of early psychosis therapy is to restore social functioning (e.g., through employment and education). Employment and educational outcomes during the COVID-19 pandemic were examined in a well-defined cohort of patients receiving care in an early psychosis clinic. METHODS: Data were extracted from the electronic health records of 128 patients receiving care at McLean Hospital's first-episode psychosis (FEP) clinic between January 1 and September 21 in 2019 and 2020. Using a generalized linear model with a Gaussian distribution and robust standard errors, the authors compared the average changes in the weekly employment and education proportions before and after COVID-19 lockdowns with the same changes in 2019. RESULTS: Employment losses among patients with FEP were greater than among the general population and persisted through the end of follow-up. In 2020, average employment after a stay-at-home order was instituted was 33% lower than before the order compared with the change in employment during the same period in 2019. The effect was stronger among men and those who identified as non-White, were age <21 years, or did not have a college education. Although educational engagement recovered in the fall of 2020, it still remained below the 2019 levels. CONCLUSIONS: Employment disruptions were major and persistent among the FEP population, which might affect short- and long-term outcomes. Innovative approaches are needed to help patients transition to remote employment, file unemployment claims, and use online hiring platforms to ameliorate the indirect effects of the COVID-19 pandemic.

Breast Cancer Survivors and Sexuality: A Review of the Literature Concerning Sexual Functioning, Assessment Tools, and Evidence-Based Interventions.

BACKGROUND: Most breast cancer survivors (BCSs) experience sexual dysfunction from treatment-induced hormonal changes, making sexual assessment an important component of survivorship care. However, because many oncology healthcare providers do not perform such assessment, a number of BCSs endure unidentified sexual dysfunction. Barriers to assessment faced by providers must be identified, and further research should examine the perspectives of BCSs and their partners regarding preferences for sexual assessment and interventions. OBJECTIVES: The purpose of this literature review was to explore tools used to assess sexual functioning and evidence-based interventions used to treat sexual dysfunction in BCSs. METHODS: Articles published from 2003-2013 that reported on the effects of breast cancer and its treatment on sexual functioning in BCSs and located through online database searches (PubMed, the Cochrane Library, MEDLINE, CINAHL) were reviewed. FINDINGS: Sexual dysfunction is a common problem among BCSs. Using various assessment tools, providers should regularly assess sexual functioning in BCSs during and after treatment to improve quality of life for BCSs and their partners.