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1.
Ir J Psychol Med ; 38(2): 93-98, 2021 06.
Article in English | MEDLINE | ID: covidwho-2096534

ABSTRACT

The medium- to long-term consequences of COVID-19 are not yet known, though an increase in mental health problems are predicted. Multidisciplinary strategies across socio-economic and psychological levels may be needed to mitigate the mental health burden of COVID-19. Preliminary evidence from the rapidly progressing field of psychedelic science shows that psilocybin therapy offers a promising transdiagnostic treatment strategy for a range of disorders with restricted and maladaptive habitual patterns of cognition and behaviour, notably depression, addiction and obsessive compulsive disorder. The COMPASS Pathways (COMPASS) phase 2b double-blind trial of psilocybin therapy in antidepressant-free, treatment-resistant depression (TRD) is underway to determine the safety, efficacy and optimal dose of psilocybin. Results from the Imperial College London Psilodep-RCT comparing the efficacy and mechanisms of action of psilocybin therapy to the selective serotonin reuptake inhibitor (SSRI) escitalopram will soon be published. However, the efficacy and safety of psilocybin therapy in conjunction with SSRIs in TRD is not yet known. An additional COMPASS study, with a centre in Dublin, will begin to address this question, with potential implications for the future delivery of psilocybin therapy. While at a relatively early stage of clinical development, and notwithstanding the immense challenges of COVID-19, psilocybin therapy has the potential to play an important therapeutic role for various psychiatric disorders in post-COVID-19 clinical psychiatry.


Subject(s)
COVID-19 , Hallucinogens , Psychiatry , Hallucinogens/therapeutic use , Humans , Psilocybin/therapeutic use , SARS-CoV-2
2.
Annals of Emergency Medicine ; 80(4, Supplement):S4-S5, 2022.
Article in English | ScienceDirect | ID: covidwho-2060341
3.
Journal of General Internal Medicine ; 37:S322, 2022.
Article in English | EMBASE | ID: covidwho-1995630

ABSTRACT

BACKGROUND: African-Americans (AA) are underrepresented in mobile health (mHealth) intervention research studies which can perpetuate health inequities and the digital divide. A community based, user-centered approach to designing mHealth interventions may increase their sociocultural relevance and effectiveness, especially with increased smartphone use during the COVID-19 pandemic. We aimed to refine an existing mHealth intervention via a virtual focus group series for use in a randomized controlled trial (RCT) aiming to improve cardiovascular health (CVH) in AAs. METHODS: AA community members (N=15) from churches in Minneapolis and Rochester, Minnesota were enrolled in a virtual, 3-session focus group series over 5 months to refine an existing CVH focused mHealth application (FAITH! App). Participants completed a baseline electronic survey capturing sociodemographics, mobile technology use, and electronic health information sources prior to start of focus groups. Participants accessed the FAITH! App via their smartphones and received a Fitbit synced to the app. Participants engaged with multimedia CVH focused education modules, a sharing board for social networking, and diet/PA self-monitoring. Participant feedback on app features prompted iterative revisions to yield a refined app. Primary outcomes were app usability (assessed via Health Information Technology Usability Evaluation Scale [Health-ITUES], range 0-5) and user satisfaction which were evaluated via electronic survey after the final focus group. A predetermined goal of mean overall Health-ITUES score of ≥4 was set for the app to advance for use in the RCT. RESULTS: Participants (mean age [SD] 56.9 [12.3] years, 13, 86.7% female) attended a mean 2.8 focus groups (80% attended all sessions). Participant feedback resulted in app refinements to increase visual appeal, increase diversity and gender balance in testimonial videos, further improve ease of diet/PA self-monitoring, and add fitness videos as well as a moderated sharing board. The revised FAITH! App achieved a mean overall Health-ITUES score of ≥4 (mean 4.39, range 3.20-4.95). Participants positively rated updated app content, visual appeal, and use of social incentives to maintain engagement. Increasing user control and further refinement of the moderated sharing board were identified as areas for future improvement. CONCLUSIONS: Virtual focus group data can improve usability and increase participant satisfaction in mHealth lifestyle interventions aiming to promote CVH in AAs.

4.
Gut ; 70(Suppl 4):A108, 2021.
Article in English | ProQuest Central | ID: covidwho-1504143

ABSTRACT

IntroductionDistance from a transplant centre may present a barrier to liver transplant referrals and transplant recipients report disliking travel for long-term follow-up. A liver transplant outreach service based at Manchester Royal Infirmary (MRI) was established collaboratively between the MRI and a transplant centre in Sept 2019. We report the outcomes from this service.MethodsThe service runs one day/month and includes post-transplant reviews, transplant assessment triage clinic and a ‘working lunch’ complex case meeting. Baseline transplant assessment + listing data between April 2017- March 2019 for chronic liver disease indications were collected and compared with those between Sept 2019-Dec 2020, in addition to other service activity data.ResultsIn the 24 month period in 2017-19 there were 11 chronic liver disease (CLD), excluding HCC, transplant assessments from the MRI. Only 8 were assessed as outpatients. Median referral UKELD was 56. 7/11 were listed with an assessment:listing conversion of 63%.In the 15 month period Sept 2019-Dec 20 there were 27 pre-transplant reviews with 20 new patients, 4 with HCC and 16 with CLD. One CLD patient had associated HCC. The commonest liver disease indication for review was alcohol related in 8 patients. Nineteen (90%) patients were reviewed for transplant assessment suitability. 12 (63%) were referred for assessment with investigations done locally. 9 (75%) were for chronic liver disease indications and 3 (25%) were for HCC. Median UKELD was 53.5.9 assessments have been completed, with 8 wait-listed. None were converted to inpatient assessments. Overall assessment:listing conversion is high: 8/9(88.8%) overall. 3 transplanted to date. 2 HCC patients had bridging therapies locally.Of 7 not referred for assessment, 1 was suitable for a TIPSS locally, 1 needed pre-habilitation and is under follow-up, 1 was out-with HCC criteria + is managed locally (still alive). 3 were too advanced/frail + all have since died. 1 was initially thought suitable for assessment but did not progress due to alcohol relapse. During the period April 20-Aug 20 only 1 pre-transplant patient was referred as NHS services were curtailed due to the Covid-19 pandemic.112 post-transplant reviews have been delivered, in 82 recipients. 98% gave positive feedback. Post-transplant interventions delivered locally include 2 liver biopsies, 1venogram + the management of 1patient with acute rejection.ConclusionDespite the pandemic this service provided improved pre-transplant outcomes in a shorter time frame cf. the preceding 2 years and saved 139 appointments in the transplant centre. The service is efficient, popular with patients, and adds to the case for the widespread adoption of similar partnerships within liver transplant networks.

5.
Critical Care Medicine ; 49(1):92-92, 2021.
Article in English | Web of Science | ID: covidwho-1326341
6.
Critical Care Medicine ; 49(1 SUPPL 1):92, 2021.
Article in English | EMBASE | ID: covidwho-1193900

ABSTRACT

INTRODUCTION: Since the beginning of this year, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic which has affected the entire world. Researchers are still trying to understand the characteristics and treatment options. Clinical manifestations may differ between children and adults. In rare cases, however, pediatric patients can present with a severe life-threatening complication called Multisystem Inflammatory Syndrome in Children (MIS-C), a term recognized by the CDC on May 14. (2) METHODS: A 25-year-old Hispanic male who previously tested positive for SARS-CoV-2 presents to the ICU with 1 week of sore throat, dysphagia, fever, non-bloody diarrhea, conjunctivitis, and mild confusion. He also reported he had a positive SARS-CoV-2 test 6 weeks prior to admission. On physical examination, the patient was febrile and found to have tender submandibular lymph nodes, redness on the oropharynx. The laboratory at admission shows an increase in inflammatory markers. The COVID-19 RT-PCR test was negative, coronavirus IgG was positive, and a normal chest radiograph. On the third day of admission, the patient's clinical status required ICU admission due to increased lethargy, shortness of breath, hypotension, and hypoxemia requiring vasopressor support. Additional tests including toxicology screen, blood culture, urinalysis, Histoplasma antigen, cryptococcal, coccidioidomycosis IgM and IgG, Clostridium Difficile PCR were all negative. An echocardiogram showed left ventricular ejection fraction (EF) of 35% with some hypokinesia. CT scan of the chest with contrast showed no pulmonary embolism but mild pleural effusions with atelectasis. Due to lack of improvement, we decided to start him on methylprednisolone at 1.5 mg/kg daily. After 24 hours of starting steroids, the clinical status and inflammatory markers improved significantly. RESULTS: This is the first case report of Multisystem Inflammatory Syndrome (MIS) in a young adult with clear documentation of increase inflammatory markers. MISChildren can present at any time but often occurs 6- 51 days following infection. Until now, it was unknown if this syndrome was specific to children or if it also occurs in adults with COVID-19. We treated our patient with steroids, resulting in improvement on his clinical status.

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