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"Sharp Increases in Drug Overdose Deaths Among High-School-Age Adolescents During the US COVID-19 Epidemic and Illicit Fentanyl Crisis","Although overdose deaths in the US have increased exponentially for the past four decades, these shifts have historically affected adults, while pediatric overdose rates remained stable. However, this may be changing, given that the illicit drug supply has become increasingly hazardous in recent years, as illicitly-manufactured-fentanyls (IMFs) and other synthetic opioid and benzodiazepine analogues are increasingly sold as heroin and counterfeit prescription pills. We calculated drug overdose deaths per 100,000 population by 5-year age groups for the 2010-2021 period. For high-school-aged adolescents (age 14-18), we stratified rates by race/ethnicity, census region, associated substance, and ICD-10 cause-of-death intent categories. Adolescent overdose mortality saw a sharp increase between 2019 and 2020, from 2.35 per 100,000 to 4.58 per 100,000, representing a 94.3% increase, the largest percent increase of any 5-year age group. American Indian or Alaska Native (AIAN) adolescents, Latinx adolescents, and adolescents in the West census region were disproportionately affected, overdose death rates 2.15, 1.31, and 1.68 times the national average in 2021, respectively. Trends were driven by fatalities involving IMFs, which nearly tripled from 2019 to 2020, and represented 76.6% of adolescent overdose deaths in 2021. Sharp increases in adolescent drug overdose deaths, despite flat or declining drug use rates, and no increase in deaths from alcohol or most drugs, reinforce that rising fatalities are likely driven by an increasingly toxic, IMF-contaminated drug supply. Rising racial disparities in overdose require a prevention approach that ameliorates deep-seated social and economic inequalities as well as poor access to mental and physical healthcare and social services for AIAN and Latinx adolescents. Our results should also be understood in the context of rising rates of adolescent mental illness during the COVID-19 pandemic. These findings highlight the urgent need for accurate, harm-reduction-oriented education for early adolescents about the risks of an evolving drug supply, as well as greater access to naloxone and services that check drugs for the presence of IMFs.","Joseph Friedman; Morgan Godvin; Chelsea Shover; Joseph P. Gone; Helena Hansen; David Schriger","https://medrxiv.org/cgi/content/short/2021.12.23.21268284","20211224","","medRxiv","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-12-25","",24324,""
"Healthcare workers' COVID-19 Omicron variant uncertainty-related stress, resilience, and coping strategies during the first week of World Health Organization alert","Background: As the COVID-19 Omicron variant emerged and spread globally at an alarming speed, healthcare workers' (HCWs) uncertainties, worries, resilience, and coping strategies warrant assessment. The COVID-19 pandemic had a severe psychological impact on HCWs, including the development of Post-Traumatic Stress symptoms. Specific subgroups of HCWs, such as front-line and female workers, were more prone to poor mental health outcomes and difficulties facing stress. Methods: The responses to an online questionnaire among HCWs in Saudi Arabia (KSA) were collected December 1-5, 2021, aiming to assess their Omicron variant's uncertainties, worries, resilience, and coping strategies. Three validated instruments were used to achieve the study's goals: the Brief Resilient Coping Scale, the Standard Stress Scale (SSS), and the Intolerance of Uncertainty Scale (IUS) - Short Form. Results: The online survey was completed by 1285 HCWs. Females made up the majority (64%). The BRCS score of resilient coping was negatively and substantially linked with the SSS score of stress (r=-0.313, p = 0.010). Furthermore, the IUS had a positive and significant relationship with stress (r=0.326, p= 0.010). Increased stress levels were linked to a considerable drop in resilient coping scores. Furthermore, being a Saudi HCW or a nurse was linked to a significant reduction in resilient coping ratings. Coping by following healthcare authorities' preventative instructions and using the WHO website as a source of information was linked to a considerable rise in resilient coping. Conclusions: Following the emergence of the Omicron variant of SARS-CoV-2 in late 2021, a rapid investigation into the correlates of stress and resilient coping among the HCWs in KSA was conducted. The negative association between resilient coping and stress was clearly shown, as well as how underlying intolerance of uncertainty is linked to higher stress among HCWs quickly following the development of a new infectious threat. The study provides early insights to develop and promote coping strategies for emerging SARS-CoV-2 variants.","Mohamad-Hani Temsah; Shuliweeh Alenezi; Mohamad Al-Arabi; Fadi Aljamaan; Khalid Alhasan; Rasha Assiri; Rolan Bassrawi; Fatimah Alshahrani; Ali Alhaboob; Ali Alaraj; Naser S Alharbi; Rabih Halwani; Amr Jamal; Naif Abdulmajeed; Lina Alfarra; Wafa almashdali; Ayman Al-Eyadhy; Fahad AlZamil; Sarah Al-Subaie; Mazin Barry; Ziad A. Memish; Jaffar A. Al-Tawfiq","https://medrxiv.org/cgi/content/short/2021.12.24.21268377","20211224","","medRxiv","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-12-25","",24325,""
"Burnout, Discrimination, Abuse, and Mistreatment in Latin America Neurosurgical Training During the Coronavirus Disease 2019 Pandemic","Discrimination, abuse, and mistreatment are prevailing problems reported in neurosurgical training programs globally. Moreover, the current coronavirus disease 2019 (COVID-19) pandemic may also show a negative impact on burnout levels in neurosurgery residents. This study aims to evaluate burnout, discrimination, and mistreatment in neurosurgical residents training in Latin America during the severe acute respiratory syndrome coronavirus 2 era. A 33-item electronic survey was sent to neurosurgery residents from Latin America from May 10 to 25, 2021. Statistical analysis was performed using SPSS version 25. A total of 111 neurosurgery residents responded to the survey. Mean age was 29.39 ± 2.37 years; 22.5% were female and 36% were training in Mexico. Residents who reported experiencing discrimination for testing positive to COVID-19 had the highest levels of depersonalization (66.7%; P = 0.043) and emotional exhaustion (75%; P = 0.023). Female respondents reported higher rates of gender discrimination (80% vs. 1.2%; P = 0.001), abuse (84% vs. 58.1%; P < 0.005), and sexual harassment (24% vs. 0%; P < 0.001) than did male respondents. Residents training in Mexico reported lower rates of emotional or verbal abuse (59.2% vs. 32.5%; P = 0.007) and bullying (P < 0.005) than did those in other countries in Latin America. Older age was a protective factor for high depersonalization scores (odds ratio [OR], 0.133; 95% confidence interval [CI], 0.035-0.500). Experiencing discrimination represented a risk factor for presenting high emotional exhaustion scores (OR, 3.019; 95% CI, 1.057-8.629). High levels of depersonalization were associated with a 7-fold increased risk of suicidal ideation (OR, 7.869; 95% CI, 1.266-48.88). The COVID-19 pandemic has been a significant burden on several aspects of health care workers' lives. Our results provide a broad overview of its impact on burnout, discrimination, and mistreatment as experienced by neurosurgery residents training in Latin America, laying the groundwork for future studies and potential interventions.","De la Cerda-Vargas, Stienen, Campero, Pérez-Castell, Soriano-Sánchez, Nettel-Rueda, Borba, Castillo-Rangel, Navarro-DomÃÂnguez, Muñoz-Hernández, Segura-López, Guinto-Nishimura, Sandoval-Bonilla","https://doi.org/10.1016/j.wneu.2021.10.188","20211224","Burnout; Coronavirus; Latin America; Mistreatment; Neurosurgery","PubMed","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-12-25","",24326,""