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.

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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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This study highlights (a) the value of the clinicians' survey to identify gaps in clinical services and (b) the necessity of improvements in suicide risk assessment/management and restriction of prescription medications.

Objective Only a minority of suicide decedents leave a suicide note. Typically, the notes are handwritten on paper; however, electronic suicide notes have been reported with increasing frequency. This emerging phenomenon remains generally under‐researched. The aim of this study was to compare the psychosocial and clinical antecedents of suicide decedents who left E‐notes with those who left paper notes or no notes. Method The study was embedded in the Southwestern Ontario Suicide Study (SOSS). The SOSS was a three‐year case series of consecutive deaths by suicide that occurred in the region between 2012 and 2014. Data on psychosocial and clinical antecedents were collected with a modified version of the Manchester questionnaire used in the UK. Results Of the 476 suicides files reviewed, 45.8% contained a suicide note. A total of 383 separate suicide notes were left: 74.3% were paper notes and 25.7% were E‐notes. The results of the multivariate regression analyses indicate that the likelihood of leaving a suicide note was negatively associated with a history of admissions to a mental health unit, while the likelihood of leaving an E‐note was negatively associated with age, positively associated with presence of a mental disorder, and negatively associated with history of hospital admissions. Conclusions Future studies with larger samples need to consider the timing of the text messages, and appraise whether there was the intent of seeking help or rescue in the text messages.

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