The covid19 crisis has rapidly become the most significant public health crisis of our times. It has particularly impacted healthcare workers (HCW) due to overwhelming of healthcare resources, as well as a critical absence of protective equipment and risk to their own health as well as risk of exposure to their family. All these factors have likely resulted in significant levels of stress and anxiety. The purpose of this study was to study the prevalence and severity of covid19 associated anxiety and stress in healthcare workers in the US during the period of the Covid19 pandemic METHODS: We created a covid19 anxiety and stress survey (CASS) by combining 2 abbreviated instrumentsthe Perceived Stress Scale (PSS-4) and the Patient Health Questionnaire for Depression and Anxiety PHQ-4. We distributed the CASS survery in electronic format during the month of March/April at the peak of the covid19 pandemic, both directly, as well as through use of social media. We invited all HCW including nurses (RN) physicians (MD) medical and nursing assistants (MA, CNA) and respiratory therapists (RT). We also collected limited information about age, gender, ethnicity and location. RESULTS: A total of 313 (53Male; 260 Female) HCW completed the questionnaire-166 RNs, 95 MDs, 15 CNA/MA, & 16 RTs. Age distribution-130 between 20-40, & 166 41-60. 151 (48.2%) had an elevated stress level (PSS-4 of >8). Both MD and RN had similar levels of high stress. 175 HCW (55.9%) screened positive for a mood disorder depression/anxiety based on PSQ4 of >4. When we examined the subscales we found 133(42.4%) had anxiety (PSQ-2 for anxiety of >3) whereas only 89 (28.4%) had depression (PSQ-2 for depression >3). Both MD and RN had similar levels of high stress. Age did not have a influence but a significance gender influence in both PSS and PSQ was seenmale gender representation was 10% of HCW for high stress vs 24% in normal stress and 9% for anxiety/depression vs 20.8% respectively (p <0.05). There was a strong correlation between PSS and PSQ scores (r ¼ 0.70) There was no significant differences between MD and RN in stress or anxiety scales. CONCLUSIONS: The Covid19 pandemic has resulted in an extremely high level of stress and mental health morbidity. Over half of healthcare workers had significant anxiety and depression and nearly 50% had high levels of perception of stress, regardless of age. This was especially more pronounced in female gender for both stress as well as anxiety. CLINICAL IMPLICATIONS: Specific screening measures and interventions to improve mental health of HCW is urgently warranted with a particular focus on womens health due to the covid19 pandemic.
The covid19 crisis has rapidly become the most significant public health crisis of our times. It has particularly impacted students due to cancellation of school and having to adjust to online learning and anxiety about their future, as well as prolonged social isolation. All these factors has likely led to significant stress and anxiety. The purpose of this study was to study the prevalence and severity of covid19 associated anxiety and stress in high school (HS) students and undergraduate (UG) college students in the US during the period of the Covid19 pandemic
Diabetes has been classified mainly into types 1 and 2. Some type 2 diabetes patients, when developing ketosis, have been labeled as having atypical diabetes. Lately, syndromes of ketosis-prone diabetes, primarily in patients who we previously classified as type 2 diabetics, have emerged, and calls are being made to even reclassify diabetes. This mini-review will extensively deal with the historical, molecular, phenotypical, and clinical basis of why ketosis-prone diabetes is different than the traditional principles of type 1 and 2 diabetes and should be classified as such. Clinicians, especially those who are not diabetologists or endocrinologists, as well as hospitalists, intensivists, and primary care providers, will greatly benefit from this review.
Background SARS-CoV-2 variants with different infectivity, transmission potential and morbidity change the characteristics of local epidemics and affect vaccine effectiveness. As part of the University of Southern California COVID-19 Pandemic Research Center’s efforts to understand, control and inform local community on COVID-19, we implemented a SARS-CoV-2 surveillance program among students, employees, and USC Keck Medical Center patients. We present the epidemiology and distribution of SARS-CoV-2 and its variants among the population. Methods We used droplet digital reverse transcriptase PCR to analyze remnant SARS-CoV-2 PCR positive saliva specimens stored at the USC Keck Medicine laboratory between September 2020 and April 2022. Samples were tested for the original strain (A20) and 9 SARS-CoV-2 variants: α(B.1.1.7, Q.1-Q.8), β(B.1.351, B.1.351.2, B.1.351.3), γ(P.1, P.1.1, P.1.2), δ(B.1.617.2), δ+(or δ417N), ε(B.1.427 and B.1.429), η(B.1.525), λ(C.37) and ο(B.1.1.529, ΒΑ.1, BA.2). We reviewed de-identified health information from positive cases including demographics, history of COVID-19 (e.g., symptoms, hospitalizations, and repeat infections) and COVID-19 vaccination status. Results We reviewed 1169 cases and determined the variant type of 482 specimens: 77 as original strain, 119 as ‘Delta’, 165 as ‘Omicron’. The original strain was detected during the third and fourth quarters of 2020. The ‘Delta’ variant appeared during the second quarter of 2021, while ‘Omicron’ appeared in the fourth quarter of 2021. Conclusions Tracking SARS-coV-2 variants in a university population and a hospital system, utilizing a low cost, high-throughput PCR assay was feasible. Local variant monitoring remains important to inform prevention and control efforts among university and clinical settings.
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