This narrative review aims to summarize initiatives developed during the COVID-19 pandemic to support healthcare workers’ emotional well-being within the context of a pre-existing framework of occupational mental health guidelines. This occupational mental health framework integrates principles from multiple disciplines to optimize prevention and management of mental health issues among employees. We conducted an online search on Medline/PubMed, Cochrane Library, and Embase for studies that reported on design or execution of medical institution-based interventions, aiming to support healthcare worker mental health during the COVID-19 pandemic. Inclusion criteria was intentionally broad in order to incorporate as many types of interventions at varying stages of development or evaluation. We included 31 studies in our review that reported on newly designed psychological support interventions for healthcare workers (HCW) during the COVID-19 pandemic. We found that most programs commonly supported HCW mental health through offering one or more of the following initiatives: expanded basic need resources/services, additional workplace training programs that bolstered professional preparedness while also indirectly boosting HCW emotional health, and/or expanded psychological support programs, such as peer support programs, psychoeducational or counseling services. Most programs, however, did not consider methods to ensure program longevity or sustainability. The COVID-19 pandemic has underscored the acuity of HCW mental health issues and is likely to leave long lasting mental health strains among HCW. This pandemic is a critical point in time to catalyze much needed progress in reducing stigma and expanding HCW mental health care access.
Atopic dermatitis (AD) is one of the most common, chronic inflammatory skin diseases. The Global Burden of Disease study showed that approximately 15%-20% of children and up to 10% of adults suffer from AD with prevalence also varying among races and ethnicities. [1][2][3][4] AD belongs to a family of atopic disorders, including food allergy, asthma and allergic rhino-conjunctivitis, which are often comorbid. 5,6 The clinical presentation of AD is highly heterogeneous, influenced by age of onset, disease stage, chronicity, severity, ethnicity and geographical location, with pruritus and eczematous lesions common to all subtypes. 7-9 AD is characterized as an immune-mediated disorder, with corresponding impaired skin barrier function. [10][11][12][13][14][15][16] Th2 immune axis dysregulation is considered central to AD pathogenesis. 17,18 More recently, the understanding of the complex inflammatory processes underlying disease pathogenesis has significantly expanded, challenging the monolithic disease model of AD. Phenotypic differences across patient types have been better elucidated by unique biomarker findings. 19 Comparisons based on age show differing contributions from Th2/Th22 and Th1/Th17 biomarkers, [20][21][22] with differing immune phenotypes also among Asians and African Americans with AD. [23][24][25][26][27] The continuously expanding understanding of AD pathogenesis underlies the rapidly evolving landscape of new therapeutic approaches, among which are biologic therapies (Figure 1). Through
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