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Article: Emergency physician mental health during the subacute phase of the COVID-19 pandemic.

Lim, Rodrick / Ali, Huma / Gagnier, Rachel / Marlborough, Michelle / Northcott, Sandra

2020 Volume 22, Issue 6, Page(s) E13

MeSH term(s)	COVID-19/epidemiology ; COVID-19/therapy ; Emergency Service, Hospital/standards ; Humans ; Mental Health ; Occupational Health/standards ; Pandemics ; Physicians/psychology ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-07-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2059217-6
ISSN	1481-8035 ; 1481-8035 ; 1488-1543
ISSN (online)	1481-8035
ISSN	1481-8035 ; 1488-1543
DOI	10.1017/cem.2020.442
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Emergency physician mental health during the subacute phase of the COVID-19 pandemic

Lim, Rodrick / Ali, Huma / Gagnier, Rachel / Marlborough, Michelle / Northcott, Sandra

CJEM

2020 , Page(s) 1–2

Keywords	Emergency Medicine ; covid19
Language	English
Publisher	Cambridge University Press (CUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	2059217-6
ISSN	1481-8035 ; 1488-1543
ISSN (online)	1481-8035
ISSN	1488-1543
DOI	10.1017/cem.2020.442
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Emergency physician mental health during the subacute phase of the COVID-19 pandemic

Lim, Rodrick / Ali, Huma / Gagnier, Rachel / Marlborough, Michelle / Northcott, Sandra

CJEM

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #630407
Database	COVID19

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Article ; Online: Factor structure of deployment experiences and relations to mental health disorders among treatment-seeking Canadian armed forces personnel and veterans.

King, Lisa / Ketcheson, Felicia / St Cyr, Kate / Marlborough, Michelle / Richardson, J Don

Psychological trauma : theory, research, practice and policy

2019 Volume 12, Issue 4, Page(s) 413–421

Abstract: Objective: Among a sample of 341 treatment-seeking veterans and currently serving Canadian Forces members, our objectives were to identify factors of deployment experiences and determine whether they were related to the severity of posttraumatic stress ... ...

Abstract	Objective: Among a sample of 341 treatment-seeking veterans and currently serving Canadian Forces members, our objectives were to identify factors of deployment experiences and determine whether they were related to the severity of posttraumatic stress disorder (PTSD) symptom clusters and depressive, anxiety, and alcohol use symptom severity. Method: Participants completed questionnaires during intake to an outpatient mental health clinic. Factor analysis was used to determine factors of deployment experiences and which mental health conditions were associated with the factors. Results: Exploratory factor analysis grouped experiences into 3 factors: (a) combat, (b) exposure to injury or death, and (c) potential moral injury and atrocity. Potential moral injury and atrocity was significantly associated with all outcomes except for alcohol use disorder, and combat was significantly associated with the arousal PTSD symptom cluster and depressive symptom severity. Conclusions: Our study demonstrates the association between combat experiences and PTSD symptom, depression, and anxiety severity. Clinically, it stresses the importance of evaluating specific traumatic events to improve treatment outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
MeSH term(s)	Adult ; Anxiety ; Anxiety Disorders ; Canada/epidemiology ; Depression ; Female ; Humans ; Male ; Mental Disorders/epidemiology ; Mental Health ; Middle Aged ; Military Personnel/psychology ; Military Personnel/statistics & numerical data ; Stress Disorders, Post-Traumatic ; Veterans/psychology
Language	English
Publishing date	2019-07-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0000493
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Article ; Online: Randomized Controlled Trial of Automated Directly Observed Therapy for Measurement and Support of PrEP Adherence Among Young Men Who have Sex with Men.

Buchbinder, Susan P / Siegler, Aaron J / Coleman, Kenneth / Vittinghoff, Eric / Wilde, Gretchen / Lockard, Annie / Scott, Hyman / Anderson, Peter L / Laborde, Nicole / van der Straten, Ariane / Christie, Richard H / Marlborough, Michelle / Liu, Albert Y

AIDS and behavior

2022 Volume 27, Issue 2, Page(s) 719–732

Abstract: Measurement of adherence to oral pre-exposure prophylaxis (PrEP) in real-time has been challenging. We developed DOT Diary, a smartphone application that combines automated directly observed therapy with a PrEP adherence visualization toolkit, and tested ...

Abstract	Measurement of adherence to oral pre-exposure prophylaxis (PrEP) in real-time has been challenging. We developed DOT Diary, a smartphone application that combines automated directly observed therapy with a PrEP adherence visualization toolkit, and tested its ability to measure PrEP adherence and to increase adherence among a diverse cohort of young men who have sex with men (MSM). We enrolled 100 MSM in San Francisco and Atlanta and randomly assigned them 2:1 to DOT Diary versus standard of care. Concordance between DOT Diary measurement and drug levels in dried blood spots was substantial, with 91.0% and 85.3% concordance between DOT Diary and emtricitabine-triphosphate and tenofovir-diphosphate, respectively. There was no significant difference in the proportion of participants with detectable PrEP drug levels at 24 weeks between study arms. These results suggest DOT Diary is substantially better than self-reported measures of adherence, but additional interventions are needed to improve PrEP adherence over time.
MeSH term(s)	Male ; Humans ; Homosexuality, Male ; HIV Infections/drug therapy ; HIV Infections/prevention & control ; Tenofovir/therapeutic use ; Directly Observed Therapy ; Anti-HIV Agents/therapeutic use ; Sexual and Gender Minorities ; Medication Adherence ; Pre-Exposure Prophylaxis/methods
Chemical Substances	Tenofovir (99YXE507IL) ; Anti-HIV Agents
Language	English
Publishing date	2022-08-19
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1339885-4
ISSN	1573-3254 ; 1090-7165
ISSN (online)	1573-3254
ISSN	1090-7165
DOI	10.1007/s10461-022-03805-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Well-being of Canadian Veterans during the COVID-19 pandemic: cross-sectional results from the COVID-19 Veteran well-being study.

Richardson, J Don / St Cyr, Kate / Forchuk, Callista / Liu, Jenny J W / Plouffe, Rachel A / Le, Tri / Gargala, Dominic / Deda, Erisa / Soares, Vanessa / Hosseiny, Fardous / Smith, Patrick / Dupuis, Gabrielle / Roth, Maya / Bridgen, Andrew / Marlborough, Michelle / Jetly, Rakesh / Heber, Alexandra / Lanius, Ruth / Nazarov, Anthony

European journal of psychotraumatology

2022 Volume 13, Issue 1, Page(s) 2012374

Abstract: Background: The impacts of the COVID-19 pandemic have disproportionally affected different population groups. Veterans are more likely to have pre-existing mental health conditions compared to the general Canadian population, experience compounded ... ...

Abstract	Background: The impacts of the COVID-19 pandemic have disproportionally affected different population groups. Veterans are more likely to have pre-existing mental health conditions compared to the general Canadian population, experience compounded stressors resulting from disruptions to familial, social, and occupational domains, and were faced with changes in health-care delivery (e.g. telehealth). The objectives of this study are to assess (a) the mental health impact of COVID-19 and related life changes on the well-being of Veterans and (b) perceptions of and satisfaction with changes in health-care treatments and delivery during the pandemic. Methods: A total of 1136 Canadian Veterans participated in an online survey. Participants completed questions pertaining to their mental health and well-being, lifestyle changes, and concerns relating to the COVID-19 pandemic, as well as experiences and satisfaction with health-care treatments during the pandemic. Results: Results showed that 55.9% of respondents reported worse mental health functioning compared to before the pandemic. The frequency of probable posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder, alcohol use disorder, and suicidal ideation were 34.2%, 35.3%, 26.8%, 13.0%, and 22.0%, respectively. Between 38.6% and 53.1% of respondents attributed their symptoms as either directly related to or exacerbated by the pandemic. Approximately 18% of respondents reported using telehealth for mental health services during the pandemic, and among those, 72.8% indicated a choice to use telehealth even after the pandemic. Conclusions: This study found that Veterans experienced worsening mental health as a result of the COVID-19 pandemic. The use of telehealth services was widely endorsed by mental health treatment-seeking Veterans who transitioned to virtual care during the pandemic. Our findings have important clinical and programmeadministrator implications, emphasizing the need to reach out to support veterans, especially those with pre-existing mental health conditions and to enhance and maintain virtual care even post-pandemic.
MeSH term(s)	Adult ; Aged ; COVID-19/epidemiology ; COVID-19/psychology ; Canada ; Cross-Sectional Studies ; Female ; Humans ; Male ; Mental Disorders/epidemiology ; Mental Health/statistics & numerical data ; Middle Aged ; Pandemics ; Psychiatric Status Rating Scales ; Surveys and Questionnaires ; Telemedicine/statistics & numerical data ; Veterans/psychology ; Veterans/statistics & numerical data
Language	English
Publishing date	2022-01-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2586642-4
ISSN	2000-8066 ; 2000-8066
ISSN (online)	2000-8066
ISSN	2000-8066
DOI	10.1080/20008198.2021.2012374
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Article ; Online: Psilocybin-assisted psychotherapy for treatment resistant depression: A randomized clinical trial evaluating repeated doses of psilocybin.

Rosenblat, Joshua D / Meshkat, Shakila / Doyle, Zoe / Kaczmarek, Erica / Brudner, Ryan M / Kratiuk, Kevin / Mansur, Rodrigo B / Schulz-Quach, Christian / Sethi, Rickinder / Abate, Amanda / Ali, Shaun / Bawks, Jordan / Blainey, Marc G / Brietzke, Elisa / Cronin, Victoria / Danilewitz, Jessica / Dhawan, Shalini / Di Fonzo, Anthony / Di Fonzo, Melissa /

Drzadzewski, Pawel / Dunlop, William / Fiszter, Hajnalka / Gomes, Fabiano A / Grewal, Smrita / Leon-Carlyle, Marisa / McCallum, Marilyn / Mofidi, Niki / Offman, Hilary / Riva-Cambrin, Jeremy / Schmidt, Joel / Smolkin, Mark / Quinn, Joan M / Zumrova, Andrea / Marlborough, Michelle / McIntyre, Roger S

Med (New York, N.Y.)

2024 Volume 5, Issue 3, Page(s) 190–200.e5

Abstract: Background: Psilocybin-assisted psychotherapy (PAP) has been associated with antidepressant effects. Trials to date have typically excluded participants with complex presentations. Our aim was to determine the feasibility of PAP in a complex population, ...

Abstract	Background: Psilocybin-assisted psychotherapy (PAP) has been associated with antidepressant effects. Trials to date have typically excluded participants with complex presentations. Our aim was to determine the feasibility of PAP in a complex population, including high levels of treatment resistance in major depressive and bipolar disorder and patients with baseline suicidality and significant comorbidity. We also evaluated flexible repeated doses over a 6-month period. Methods: Adults with treatment-resistant depression as part of major depressive or bipolar II disorder without psychosis or a substance use disorder were eligible to participate. Subjects were randomized to immediate treatment or waitlist control, with all eventually receiving PAP. Participants had one, two, or three psilocybin sessions with a fixed dose of 25 mg. Each dose was accompanied by preparation and integration psychotherapy sessions. Acceptability, safety, tolerability, and efficacy were evaluated (this study was registered at ClinicalTrials.gov: NCT05029466). Findings: Participants were randomized to immediate treatment (n = 16) or delayed treatment (n = 14). 29/30 were retained to the week-2 primary endpoint. Adverse events were transient, with no serious adverse events. Greater reductions in depression severity as measured by the Montgomery-Åsberg Depression Rating Scale (MADRS) were observed in the immediate treatment arm compared to the waitlist period arm with a large hedge's g effect size of 1.07 (p < 0.01). Repeated doses were associated with further reductions in MADRS scores compared to baseline. Conclusions: PAP was feasible in complex patients with preliminary antidepressant efficacy and adequate safety and tolerability. Repeated doses were associated with greater reductions in depression severity. Funding: This work was funded by Brain and Cognition Discovery Foundation (BCDF), Usona, and Braxia Scientific.
MeSH term(s)	Adult ; Humans ; Psilocybin/adverse effects ; Depressive Disorder, Major/drug therapy ; Depressive Disorder, Major/chemically induced ; Depressive Disorder, Treatment-Resistant/drug therapy ; Antidepressive Agents/adverse effects ; Psychotherapy
Chemical Substances	Psilocybin (2RV7212BP0) ; Antidepressive Agents
Language	English
Publishing date	2024-02-14
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ISSN	2666-6340
ISSN (online)	2666-6340
DOI	10.1016/j.medj.2024.01.005
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Well-being of Canadian Armed Forces Veterans and Spouses of Veterans During the COVID-19 Pandemic: Protocol for a Prospective Longitudinal Survey.

JMIR research protocols

2022 Volume 11, Issue 1, Page(s) e34984

Abstract: Background: The COVID-19 pandemic has resulted in significant changes to everyday life, including social distancing mandates, changes to health care, and a heightened risk of infection. Previous research has shown that Canadian Armed Forces (CAF) ... ...

Abstract	Background: The COVID-19 pandemic has resulted in significant changes to everyday life, including social distancing mandates, changes to health care, and a heightened risk of infection. Previous research has shown that Canadian Armed Forces (CAF) veterans are at higher risk of developing mental and physical health conditions. Veterans and their families may face unique social challenges that can compound with pandemic-related disruptions to negatively impact well-being. Objective: This study aims to longitudinally characterize the mental health of CAF veterans and spouses of CAF veterans throughout the pandemic and to understand the dynamic influences of pandemic-related stressors on psychological health over time. Methods: We employed a prospective longitudinal panel design using an online data collection platform. Study participation was open to all CAF veterans and spouses of CAF veterans residing in Canada. Participants were asked to complete a comprehensive battery of assessments representing psychological well-being, chronic pain, health care access patterns, physical environment, employment, social integration, and adjustment to pandemic-related lifestyle changes. Follow-up assessments were conducted every 3 months over an 18-month period. This study was approved by the Western University Health Sciences and Lawson Health Research Institute Research Ethics Boards. Results: Baseline data were collected between July 2020 and February 2021. There were 3 population segments that participated in the study: 1047 veterans, 366 spouses of veterans, and 125 veterans who are also spouses of veterans completed baseline data collection. As of November 2021, data collection is ongoing, with participants completing the 9- or 12-month follow-up surveys depending on their date of self-enrollment. Data collection across all time points will be complete in September 2022. Conclusions: This longitudinal survey is unique in its comprehensive assessment of domains relevant to veterans and spouses of veterans during the COVID-19 pandemic, ranging from occupational, demographic, social, mental, and physical domains, to perceptions and experiences with health care treatments and access. The results of this study will be used to inform policy for veteran and veteran family support, and to best prepare for similar emergencies should they occur in the future. International registered report identifier (irrid): DERR1-10.2196/34984.
Language	English
Publishing date	2022-01-11
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2719222-2
ISSN	1929-0748
ISSN	1929-0748
DOI	10.2196/34984
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Article ; Online: Quantifying the magnitude and cost of collecting extraneous protocol data.

Getz, Kenneth A / Stergiopoulos, Stella / Marlborough, Michelle / Whitehill, Jane / Curran, Marla / Kaitin, Kenneth I

American journal of therapeutics

2015 Volume 22, Issue 2, Page(s) 117–124

Abstract: Although most research professionals believe that protocol designs contain a growing number of unnecessary and redundant procedures generating unused data, incurring high cost, and jeopardizing study success, there are no published studies systematically ...

Abstract	Although most research professionals believe that protocol designs contain a growing number of unnecessary and redundant procedures generating unused data, incurring high cost, and jeopardizing study success, there are no published studies systematically examining this issue. Between November 2011 and May 2012, Tufts Center for the Study of Drug Development conducted a study among a working group of 15 pharmaceutical companies in which a total of 25,103 individual protocol procedures were evaluated and classified using clinical study reports and analysis plans. The results show that the typical later-stage protocol had an average of 7 objectives and 13 end points of which 53.8% are supplementary. One (24.7%) of every 4 procedures performed per phase-III protocol and 17.7% of all phase-II procedures per protocol were classified as "Noncore" in that they supported supplemental secondary, tertiary, and exploratory end points. For phase-III protocols, 23.6% of all procedures supported regulatory compliance requirements and 15.9% supported those for phase-II protocols. The study also found that on average, $1.7 million (18.5% of the total) is spent in direct costs to administer Noncore procedures per phase-III protocol and $0.3 million (13.1% of the total) in direct costs are spent on Noncore procedures for each phase-II protocol. Based on the results of this study, the total direct cost to perform Noncore procedures for all active annual phase-II and phase-III protocols is conservatively estimated at $3.7 billion annually, not including the indirect costs associated with collecting and managing Noncore procedure data and the ethical costs of exposing study volunteers to unnecessary risks associated with conducting extraneous procedures.
MeSH term(s)	Clinical Trials, Phase II as Topic/economics ; Clinical Trials, Phase II as Topic/methods ; Clinical Trials, Phase III as Topic/economics ; Clinical Trials, Phase III as Topic/methods ; Data Collection/economics ; Data Collection/methods ; Drug Industry/economics ; Drug Industry/methods ; Humans ; Research Design
Language	English
Publishing date	2015-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0b013e31826fc4aa
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Article ; Online: Impacts of morally distressing experiences on the mental health of Canadian health care workers during the COVID-19 pandemic.

European journal of psychotraumatology

2021 Volume 12, Issue 1, Page(s) 1984667

Abstract: Background: Research is urgently needed to understand health care workers' (HCWs') experiences of moral-ethical dilemmas encountered throughout the COVID-19 pandemic, and their associations with organizational perceptions and personal well-being. This ... ...

Abstract	Background: Research is urgently needed to understand health care workers' (HCWs') experiences of moral-ethical dilemmas encountered throughout the COVID-19 pandemic, and their associations with organizational perceptions and personal well-being. This research is important to prevent long-term moral and psychological distress and to ensure that workers can optimally provide health services. Objective: Evaluate associations between workplace experiences during COVID-19, moral distress, and the psychological well-being of Canadian HCWs. Method: A total of 1362 French- and English-speaking Canadian HCWs employed during the COVID-19 pandemic were recruited to participate in an online survey. Participants completed measures reflecting moral distress, perceptions of organizational response to the pandemic, burnout, and symptoms of psychological disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD). Results: Structural equation modelling showed that when organizational predictors were considered together, resource adequacy, positive work life impact, and ethical work environment negatively predicted severity of moral distress, whereas COVID-19 risk perception positively predicted severity of moral distress. Moral distress also significantly and positively predicted symptoms of depression, anxiety, PTSD, and burnout. Conclusions: Our findings highlight an urgent need for HCW organizations to implement strategies designed to prevent long-term moral and psychological distress within the workplace. Ensuring availability of adequate resources, reducing HCW risk of contracting COVID-19, providing organizational support regarding individual priorities, and upholding ethical considerations are crucial to reducing severity of moral distress in HCWs.
MeSH term(s)	Adult ; Anxiety/psychology ; Burnout, Professional/psychology ; COVID-19 ; Canada ; Depression/psychology ; Female ; Health Personnel/ethics ; Health Personnel/psychology ; Humans ; Internet ; Male ; Mental Health/trends ; Middle Aged ; Morals ; Organizational Culture ; Psychological Distress ; Surveys and Questionnaires ; Workplace/psychology
Language	English
Publishing date	2021-11-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2586642-4
ISSN	2000-8066 ; 2000-8066
ISSN (online)	2000-8066
ISSN	2000-8066
DOI	10.1080/20008198.2021.1984667
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