Background: A measles outbreak associated with a migrant shelter occurred in Chicago in early 2024. Given the high transmissibility of measles in combination with the congregate nature of the shelter, health care facilities were tasked with hospitalizing patients with confirmed measles throughout the duration of their contagious period. Comer Children’s Hospital at the University of Chicago was able to hospitalize many of these patients, but numerous challenges were encountered in the initial response. Method: Communications were sent out to all providers to educate and increase awareness of measles presentations. Our infection prevention team helped coordinate timely collection of appropriate measles testing with the clinical team and helped facilitate timely processing with our microbiology lab for the test to be run by our state reference lab. Constant communication between the area hospitals and the city were instrumental in weathering the challenges our center faced in responding to the local outbreak. Result: Collaboration with the public health department allowed for optimizing turnaround times for diagnostic results, forecasting future patient volume, increasing advanced notice for patient arrival to the ED from the local shelter. Our hospital was faced with an inability to safely accommodate the influx of patients with airborne infection isolation rooms (AIIRs), and discussions with our facilities group led to the construction of multiple makeshift anterooms both in the ED and on the pediatric floors with the necessary amount of air exchanges to safely isolate these patients. A total of 18 patients were tested for measles at Comer Children’s Hospital in March 2024, including those from the community who did not reside in a shelter. Ten patients tested positive for measles, all of whom lived in the nearby shelter. Ages ranged from 2 months old to 9 years old. Patients returned back to the shelter after their infectious window was over. One patient suffered a complication of bacterial empyema requiring readmission. No exposures to patients or staff members occurred. Conclusion: Strong, efficient communication amongst hospital leaders allowed us to safely accommodate all the patients who presented with suspicion of measles. Working closely with the local public health department ensured optimal turnaround times of diagnostic results and increased our hospital’s level of preparedness.

Patients with social anxiety disorder (SAD) have a range of negative thoughts and beliefs about how they think they come across to others. These include specific fears about doing or saying something that will be judged negatively (e.g. ‘I’ll babble’, ‘I’ll have nothing to say’, ‘I’ll blush’, ‘I’ll sweat’, ‘I’ll shake’, etc.) and more persistent negative self-evaluative beliefs such as ‘I am unlikeable’, ‘I am foolish’, ‘I am inadequate’, ‘I am inferior’, ‘I am weird/different’ and ‘I am boring’. Some therapists may take the presence of such persistent negative self-evaluations as being a separate problem of ‘low self-esteem’, rather than seeing them as a core feature of SAD. This may lead to a delay in addressing the persistent negative self-evaluations until the last stages of treatment, as might be typically done in cognitive therapy for depression. It might also prompt therapist drift from the core interventions of NICE recommended cognitive therapy for social anxiety disorder (CT-SAD). Therapists may be tempted to devote considerable time to interventions for ‘low self-esteem’. Our experience from almost 30 years of treating SAD within the framework of the Clark and Wells (1995) model is that when these digressions are at the cost of core CT-SAD techniques, they have limited value. This article clarifies the role of persistent negative self-evaluations in SAD and shows how these beliefs can be more helpfully addressed from the start, and throughout the course of CT-SAD, using a range of experiential techniques.

Online peer support platforms have been shown to provide a supportive space that can enhance social connectedness and personal empowerment. Some studies have analysed forum messages, showing that users describe a range of advantages, and some disadvantages to their use. However, the direct examination of users’ experiences of such platforms is rare and may be particularly informative for enhancing their helpfulness. This study aimed to understand users’ experiences of the Support, Hope and Recovery Online Network (SHaRON), an online cognitive behavioural therapy-based peer support platform for adults with mild to moderate anxiety or depression. Platform users (n = 88) completed a survey on their use of different platform features, feelings about using the platform, and overall experience. Responses were analysed descriptively and using thematic analysis. Results indicated that most features were generally well used, with the exception of private messaging. Many participants described feeling well supported and finding the information and resources helpful; the majority of recent users (81%) rated it as helpful overall. However, some participants described feeling uncomfortable about posting messages, and others did not find the platform helpful and gave suggestions for improvements. Around half had not used the platform in the past 3 months, for different reasons including feeling better or forgetting about it. Some described that simply knowing it was there was helpful, even without regular use. The findings highlight what is arguably a broader range of user experiences than observed in previous studies, which may have important implications for the enhancement of SHaRON and other platforms.