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Article ; Online: Increasing paediatric emergency visits for suicide-related concerns during COVID-19.

Geoffroy, Marie-Claude / Chadi, Nicholas

The lancet. Psychiatry

2023 Volume 10, Issue 5, Page(s) 308–309

MeSH term(s)	Humans ; Child ; COVID-19 ; Suicide ; Suicide, Attempted ; Emergency Service, Hospital ; Retrospective Studies
Language	English
Publishing date	2023-03-09
Publishing country	England
Document type	Journal Article ; Comment
ISSN	2215-0374
ISSN (online)	2215-0374
DOI	10.1016/S2215-0366(23)00073-1
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Article ; Online: An innovative inpatient protocol for alcohol withdrawal prevention in a 16-year-old adolescent: a case report.

Moubayed, Dina / Chadi, Nicholas

Journal of medical case reports

2023 Volume 17, Issue 1, Page(s) 179

Abstract: Background: Alcohol cessation in youth with daily drinking poses a risk of severe and life-threatening alcohol withdrawal. If unsupervised, alcohol withdrawal in heavy users can cause severe complications, such as seizures, delirium tremens, and death. ... ...

Abstract	Background: Alcohol cessation in youth with daily drinking poses a risk of severe and life-threatening alcohol withdrawal. If unsupervised, alcohol withdrawal in heavy users can cause severe complications, such as seizures, delirium tremens, and death. We present the case of a teenager admitted at our pediatric center for the prevention of alcohol withdrawal using an innovative protocol, including a fixed-dosage benzodiazepine regimen. Case description: A 16-year-old Caucasian male, known to have anxiety and an attention deficit disorder, was electively admitted for medical stabilization and surveillance of alcohol withdrawal. He had been previously diagnosed with alcohol use disorder and had a past history of withdrawal symptoms. He was prescribed a course of thiamine, folic acid, as well as a fixed-dosage benzodiazepine taper over 5 days. His withdrawal symptoms were evaluated using a standardized Clinical Institute Withdrawal Assessment for Alcohol scale. During his stay, he reported minimal symptoms, as well as a score on the Clinical Institute Withdrawal Assessment for Alcohol scale consistently lower than 5. His mood, motivation, eating habits and sleeping patterns significantly improved during his stay. He developed no medical complications and demonstrated pride in his successes. He was successfully transferred to a long-term rehabilitation center. Conclusions: A withdrawal prevention protocol was developed on the basis of existing literature. It included a soothing environment, basic laboratory work evaluating the medical complications of alcohol use, as well as medication aiming to prevent and reduce potential withdrawal symptoms. The patient responded well to the fixed-dosage taper with minimal symptoms and discomfort. Although alcohol use in adolescents is frequent, alcohol withdrawal in this population is rarely seen in a pediatric hospital setting. Nonetheless, given the lack of existing guidelines regarding alcohol withdrawal in adolescents, standardized protocols could be greatly beneficial for the prevention of this condition in this population.
MeSH term(s)	Child ; Adolescent ; Male ; Humans ; Substance Withdrawal Syndrome/prevention & control ; Substance Withdrawal Syndrome/complications ; Substance Withdrawal Syndrome/diagnosis ; Alcoholism/complications ; Alcohol Withdrawal Delirium/drug therapy ; Alcohol Withdrawal Delirium/prevention & control ; Alcohol Withdrawal Delirium/complications ; Inpatients ; Benzodiazepines/therapeutic use ; Ethanol
Chemical Substances	Benzodiazepines (12794-10-4) ; Ethanol (3K9958V90M)
Language	English
Publishing date	2023-04-19
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-023-03863-8
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Article ; Online: Applied Mindfulness for Physician Wellbeing: A Prospective Qualitative Study Protocol.

Weisbaum, Elli / Chadi, Nicholas

Frontiers in public health

2022 Volume 10, Page(s) 807792

Abstract: Background: Physician burnout has significant adverse impacts on the wellbeing of individual physicians, and by extension the healthcare delivery systems of which they are part. Mindfulness is consistently cited as a pragmatic approach to effectively ... ...

Abstract	Background: Physician burnout has significant adverse impacts on the wellbeing of individual physicians, and by extension the healthcare delivery systems of which they are part. Mindfulness is consistently cited as a pragmatic approach to effectively address burnout and enhance physician wellbeing. However, very few empirical studies have been published on Mindfulness Based Interventions (MBIs) for physicians. Moreover, the majority of these studies have been quantitative, leaving a gap in understanding the practical application of mindfulness in the context of physicians' daily lives. Objectives: This paper outlines the rationale, development and design of a novel prospective qualitative study examining the acceptability, feasibility, and pragmatic application of a mindfulness intervention for physician wellness. Methods: The study will be conducted in three groups of at least 8 practicing physicians from a broad range of medical specialties at a tertiary care hospital in a large urban center in Eastern Canada. The intervention will consist of an innovative program based on the teachings of internationally renowned scholar and Zen Master Thích Nhãt Hạnh. It will include 5 weekly 2-h mindfulness sessions delivered by two health providers trained in mindfulness and in the teachings of Thich Nhat Hanh. The primary outcome measure will be an in-depth Thematic Analysis of post-program semi-structured interviews. Field data will also be collected through participant observation. The study will be theoretically grounded within the interpretive paradigm utilizing "the Mechanisms of Mindfulness Theory". An external advisory committee formed by four senior members of Thích Nhãt Hạnh's community will provide guidance across all phases of the study. Discussion: Our innovative approach provides a new framework to further understand the mechanisms by which mindfulness interventions can impact physician wellbeing, and by extension their patients, colleagues, and broader healthcare systems. Through a clear articulation of the rigorous application of accepted procedures and standards used in our protocol, this paper seeks to provide a roadmap for other researchers who wish to develop further studies in this area. Lessons learned in the preparation and conduction of this study can be applied to other healthcare contexts including non-physician health provider wellbeing, clinical care, and population-level mental health.
MeSH term(s)	Burnout, Professional/psychology ; Humans ; Mindfulness/methods ; Physicians/psychology ; Prospective Studies ; Surveys and Questionnaires
Language	English
Publishing date	2022-02-11
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.807792
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Article: The tobacco-free fallacy: What paediatricians should know about herbal smoking products.

Khorasani, Arianne / Chadi, Nicholas

Paediatrics & child health

2022 Volume 28, Issue 3, Page(s) 141–144

Abstract: While e-cigarette and combustible cigarette use remains more common among youth, herbal smoking products are gaining interest and popularity among children and adolescents. Herbal smoking products are often touted as a safer alternative to tobacco ... ...

Abstract	While e-cigarette and combustible cigarette use remains more common among youth, herbal smoking products are gaining interest and popularity among children and adolescents. Herbal smoking products are often touted as a safer alternative to tobacco smoking or nicotine vaping; however, research suggests that they emit significant levels of toxicants and carcinogens posing risks to child and adolescent health. The low perceived risk coupled with youth-friendly flavours and easy access may entice youth to use herbal smoking products and increase the risk of subsequent tobacco and substance use. We discuss what is known about the use, health effects, and regulations of herbal smoking products and present strategies for policymakers and paediatric providers to reduce the risks associated with these products for Canadian youth.
Language	English
Publishing date	2022-09-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2106767-3
ISSN	1918-1485 ; 1205-7088
ISSN (online)	1918-1485
ISSN	1205-7088
DOI	10.1093/pch/pxac096
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Zs.A 5774: Show issues

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Article ; Online: Improving physician wellness through the Applied Mindfulness Program for Medical Personnel: findings from a prospective qualitative study.

Weisbaum, Elli / Chadi, Nicholas / Young, L Trevor

CMAJ open

2023 Volume 11, Issue 6, Page(s) E1083–E1092

Abstract: Background: Physicians play a critical role across health care delivery systems, yet their own well-being is often overlooked; mindfulness has been widely recommended as a promising modality to support physician wellness. We sought to explore how ... ...

Abstract	Background: Physicians play a critical role across health care delivery systems, yet their own well-being is often overlooked; mindfulness has been widely recommended as a promising modality to support physician wellness. We sought to explore how physicians experience and engage with a 5-week applied mindfulness program and how they perceive its impact on their personal well-being in the context of their daily lives. Method: We delivered the Applied Mindfulness Program for Medical Personnel (AMP-MP) at a tertiary care hospital in downtown Toronto, Canada. This prospective qualitative study consists of a thematic analysis of post-program interviews with physicians, from across different specialties, who participated in the AMP-MP. The program includes 2-hour sessions, delivered once a week over 5 weeks, and is based on the teachings of Thích Nhất Hạnh. Results: We interviewed 28 physicians after they completed the AMP-MP. Our data show that a 5-week training was sufficient for physicians to develop a foundational level of mindfulness that integrated into their daily life. Two themes were identified: mindfulness encourages behavioural and cognitive changes that facilitate well-being, and mindfulness improves communication with patients and colleagues. Interpretation: Our results show applied mindfulness to be well received by physicians as an effective modality to increase their perceived sense of wellness and enhance communication with their patients and colleagues. Further research is necessary to better understand the individual and systemic implications of mindfulness training, and how this modality can complement other efforts being made to address and maintain physician wellness.
Language	English
Publishing date	2023-11-21
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2701622-5
ISSN	2291-0026 ; 2291-0026
ISSN (online)	2291-0026
ISSN	2291-0026
DOI	10.9778/cmajo.20220252
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Article ; Online: E-cigarettes and Vaping: A Global Risk for Adolescents.

Bhave, Swati Y / Chadi, Nicholas

Indian pediatrics

2021 Volume 58, Issue 4, Page(s) 315–319

Abstract: While the marketing and sale of electronic cigarettes (e-cigarettes) in India is forbidden since September, 2019, vaping represents a significant risk to the health and safety of Indian adolescents. Though the prevalence of youth e-cigarette use in India ...

Abstract	While the marketing and sale of electronic cigarettes (e-cigarettes) in India is forbidden since September, 2019, vaping represents a significant risk to the health and safety of Indian adolescents. Though the prevalence of youth e-cigarette use in India remains unknown, pediatricians are often brought to provide care to youth who vape. In this commentary, background information on e-cigarettes including a review of the different types of vaping devices and of the substances contained in e-cigarette liquids is provided. The short- and long-term health risks associated with vaping, including risks for the developing brain, acute lung injuries and long-term mental health effects, and a practical approach for clinical management of e-cigarette use for Indian pediatricians is presented. Public health measures to prevent and reduce youth vaping and a review of current Indian laws and policies around e-cigarette use are also mentioned.
MeSH term(s)	Adolescent ; Electronic Nicotine Delivery Systems ; Humans ; Marketing ; Prevalence ; Public Health ; Vaping/adverse effects
Language	English
Publishing date	2021-04-21
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
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Zs.A 859: Show issues

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Article ; Online: Expected vs. perceived effects of gender-affirming hormone therapy among transmasculine adolescents.

Taillefer, Valerie / Kelley, Janie / Marsolais, Sophie / Chiniara, Lyne / Chadi, Nicholas

Journal of pediatric endocrinology & metabolism : JPEM

2023 Volume 36, Issue 11, Page(s) 1072–1078

Abstract: Objectives: Gender-affirming testosterone therapy is increasingly prescribed among transmasculine adolescents and has been associated with improved mental health outcomes. However, expected and perceived effects of testosterone have not previously been ... ...

Abstract	Objectives: Gender-affirming testosterone therapy is increasingly prescribed among transmasculine adolescents and has been associated with improved mental health outcomes. However, expected and perceived effects of testosterone have not previously been compared in this population. Methods: We compared desired and reported effects of testosterone in all consecutive transmasculine adolescents followed at a large interdisciplinary gender diversity clinic in North America. Participants received a prescription for testosterone and were first seen between November 2016 and May 2021. Our study was a retrospective audit of case notes. We collected self-reported desired effects prior to initiation of testosterone and self-reported perceived effects from participants' medical records up to 24 months after initiation. The masculinizing effects of testosterone considered in our study were increased body/facial hair, voice deepening/Adam's apple growth, increased muscle mass, clitoromegaly, and body fat redistribution. Results: There were 76 participants included in this study. Mean age at prescription of testosterone was 16.31 years (standard deviation: 0.99 years). The effects desired by the greatest proportion of participants prior to initiation were increased body/facial hair (69 %) and voice deepening/Adam's apple growth (52 %). These same two effects were the most reported by participants, reaching 80 % report rates at 12 months, and increasing steadily across the 24-month follow-up period. Conclusions: Our study shows that for most, but not all gender diverse adolescents undergoing testosterone therapy, the most expected physical changes were seen in the first year of gender-affirming treatment. More research and provider education are needed to offer optimal counseling for adolescents undergoing gender-affirming hormone therapy.
MeSH term(s)	Humans ; Adolescent ; Transgender Persons/psychology ; Retrospective Studies ; Gender Identity ; Testosterone/therapeutic use ; Physical Examination
Chemical Substances	Testosterone (3XMK78S47O)
Language	English
Publishing date	2023-09-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1231070-0
ISSN	2191-0251 ; 0334-018X
ISSN (online)	2191-0251
ISSN	0334-018X
DOI	10.1515/jpem-2023-0119
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Zs.A 2258: Show issues

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Article ; Online: COVID-19 and the impacts on youth mental health: emerging evidence from longitudinal studies.

Chadi, Nicholas / Ryan, Natalie Castellanos / Geoffroy, Marie-Claude

Canadian journal of public health = Revue canadienne de sante publique

2022 Volume 113, Issue 1, Page(s) 44–52

Abstract: Several experts have warned that the current coronavirus disease 2019 (COVID-19) pandemic and associated confinement measures may have taken a devastating toll on youth mental health. While the COVID-19 pandemic has certainly created important challenges ...

Title translation	Les impacts de la pandémie de la COVID-19 sur la santé mentale des jeunes : données émergeantes des études longitudinales.
Abstract	Several experts have warned that the current coronavirus disease 2019 (COVID-19) pandemic and associated confinement measures may have taken a devastating toll on youth mental health. While the COVID-19 pandemic has certainly created important challenges for children and youth, these claims vastly rely on cross-sectional data collected during the pandemic, from which it is difficult to draw firm conclusions. In this commentary, we offer a critical appraisal of the evidence from emerging longitudinal studies spanning the pre- and intra-pandemic period with a focus on internalizing and externalizing disorders, suicidality, eating disorders and substance use. We also discuss important research considerations in the monitoring of the long-term impacts of the COVID-19 pandemic on youth mental health as well as promising interventions to help mitigate potential long-lasting consequences of this unprecedented public health crisis.
MeSH term(s)	Adolescent ; COVID-19 ; Child ; Cross-Sectional Studies ; Humans ; Longitudinal Studies ; Mental Health ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2022-01-28
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	417262-0
ISSN	1920-7476 ; 0008-4263
ISSN (online)	1920-7476
ISSN	0008-4263
DOI	10.17269/s41997-021-00567-8
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Article ; Online: Underexplored Heterogeneity and Publication Bias for the Electronic Cigarette and Marijuana Use Association-Reply.

Chadi, Nicholas / Levy, Sharon

JAMA pediatrics

2020 Volume 174, Issue 5, Page(s) 505–506

MeSH term(s)	Adolescent ; Electronic Nicotine Delivery Systems ; Humans ; Marijuana Smoking ; Marijuana Use/epidemiology ; Publication Bias ; Vaping ; Young Adult
Language	English
Publishing date	2020-02-17
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2701223-2
ISSN	2168-6211 ; 2168-6203
ISSN (online)	2168-6211
ISSN	2168-6203
DOI	10.1001/jamapediatrics.2019.6093
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Article: An Intensive Ambulatory Care Program for Adolescents With Eating Disorders Combining In-Person and Web-Based Care: Protocol for a Single-Site Naturalistic Trial.

Novack, Kaylee / Dufour, Rachel / Picard, Louis / Booij, Linda / Chadi, Nicholas

JMIR research protocols

2022 Volume 11, Issue 11, Page(s) e37420

Abstract: Background: The incidence of eating disorders (EDs) among adolescents has significantly increased since the beginning of the COVID-19 pandemic. Hybrid care, which combines web-based and in-person modalities, is a promising approach for adolescents with ... ...

Abstract	Background: The incidence of eating disorders (EDs) among adolescents has significantly increased since the beginning of the COVID-19 pandemic. Hybrid care, which combines web-based and in-person modalities, is a promising approach for adolescents with EDs but remains understudied in this population. Objective: We aimed to implement a novel hybrid (web-based and in-person) intensive ambulatory care program for youth and evaluate its feasibility, acceptability, and preliminary effectiveness. Methods: We will use a naturalistic pretest-posttest design to evaluate our proposed pilot Intensive Ambulatory Care Program (IACP). This novel type of day hospital care follows evidence-based principles and uses a family-centered, educational, and motivational approach. It will be tailored to the psychological needs of each participant and will be delivered in a hybrid format. A total of 100 participants meeting the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria for EDs, aged 12-18 years, will be recruited over the 2-year trial period. We will examine recruitment, retention, and adhesion-to-protocol rates; participant and family satisfaction; and preliminary effectiveness using quantitative self-report questionnaires. Results: Rolling recruitment will take place from winter 2022 to fall 2023, during which time we expect to recruit approximately 80% (100/120) of eligible participants, retain at least 75% (75/100) of enrolled participants and have at least 70% (70/100) of enrolled participants complete at least one therapeutic session per week and all pre- and postintervention questionnaires. Data collection will occur concurrently. We base our recruitment and retention estimates on previous literature and consider that the highly flexible design of the IACP and the fact that no extra work will be required of individuals in the program to participate in the study, will lead to high levels of feasibility. We anticipate that participants and their families will be satisfied with both the program and hybrid delivery format. We expect that participation in the IACP will be associated with a medium effect size reduction in ED psychopathology from baseline to end of treatment. The data analysis and manuscript writing are expected to be completed by the summer of 2024. Conclusions: Given the high clinical burden associated with EDs, this study has the potential to fill an important research gap by testing the implementation of a novel hybrid mode of intervention. If feasible, acceptable, and effective, the IACP could lead to important improvements in health care services for adolescents with EDs. International registered report identifier (irrid): PRR1-10.2196/37420.
Language	English
Publishing date	2022-11-02
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2719222-2
ISSN	1929-0748
ISSN	1929-0748
DOI	10.2196/37420
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