Comparing the Efficacy of Electronically Delivered Cognitive Behavioral Therapy (e-CBT) to Weekly Online Mental Health Check-Ins for Generalized Anxiety Disorder-A Randomized Controlled Trial: Comparaison de l'efficacité de la thérapie cognitivo-comportementale délivrée par voie électronique (e-TCC) aux contrôles hebdomadaires en ligne de santé mentale pour le trouble d'anxiété généralisée - un essai randomisé contrôlé.

BACKGROUND: Generalized anxiety disorder (GAD) is a prevalent anxiety disorder characterized by uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is one of the first-line treatments that has demonstrated high efficacy in reducing symptoms of anxiety. Electronically delivered CBT (e-CBT) has been a promising adaptation of in-person treatment, showing comparable efficacy with increased accessibility and scalability. Finding further scalable interventions that can offer benefits to patients requiring less intensive interventions can allow for better resource allocation. Some studies have indicated that weekly check-ins can also lead to improvements in GAD symptoms. However, there is a lack of research exploring the potential benefits of online check-ins for patients with GAD. OBJECTIVE: This study aims to investigate the effects of weekly online asynchronous check-ins on patients diagnosed with GAD and compare it with a group receiving e-CBT. METHODS: Participants (n e-CBT = 45; n check-in = 51) with GAD were randomized into either an e-CBT or a mental health check-in program for 12 weeks. Participants in the e-CBT program completed pre-designed modules and homework assignments through a secure online delivery platform where they received personalized feedback from a trained care provider. Participants in the mental health check-in condition had weekly asynchronous messaging communication with a care provider where they were asked structured questions with a different weekly theme to encourage conversation. RESULTS: Both treatments demonstrated statistically significant reductions in GAD-7-item questionnaire (GAD-7) scores over time, but when comparing the groups there was no significant difference between the treatments. The number of participants who dropped out and baseline scores on all questionnaires were comparable for both groups. CONCLUSIONS: The findings support the effectiveness of e-CBT and mental health check-ins for the treatment of GAD. PLAIN LANGUAGE SUMMARY TITLE: Comparing the Effectiveness of Electronically Delivered Therapy (e-CBT) to Weekly Online Mental Health Check-ins for Generalized Anxiety Disorder-A Randomized Controlled Trial.

Generalized anxiety disorder (GAD) is a prevalent psychiatric condition that leads to symptoms like uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is a common psychotherapy used for GAD since it has been shown to reduce symptoms. However, traditional CBT that is in person can have barriers such as being inaccessible and costly, and therefore electronically delivered CBT (e-CBT) is a viable alternative since previous studies have shown its efficacy in reducing symptoms and being similar compared to face-to-face CBT. Previous studies have also shown reductions in GAD symptomology through the use of checking in on people and their mental health. Therefore, this study aimed to compare e-CBT to a check-in condition and had a total of 45 individuals in e-CBT and 51 participants in the check-in condition. Participants in the e-CBT condition completed 12 weeks of predesigned e-CBT modules, homework and received personalized feedback from a care provider. In contrast, individuals in the check-in condition completed 12 weeks of unstructured asynchronous messaging with a care provider. Results from the study showed that both the e-CBT and check-in condition demonstrated statistically significant improvements in GAD-7 across time, but when comparing the groups there was no significant difference. The results show the efficacy of e-CBT and checking in on people's mental health to reduce GAD and future research should examine the 2 conditions combined.

Redefining the relationship in digital care: A qualitative study of the Digital Therapeutic Alliance.

Digital therapeutic programs are emerging almost daily, offering the potential to reduce healthcare access inequalities by providing more flexible and accessible care options. However, as with traditional healthcare, the issue of patient engagement is fundamental, and the latest research have reported that fewer than 30% of users complete these programs in their entirety. Hence, many authors emphasize the importance of studying the role of therapeutic alliances specifically adapted to digital care. The therapeutic alliance encompasses the collaborative aspects of the relationship between the therapist and the patient. In this context there is a need to reconceptualize the alliance within the context of digital healthcare as it can enhance engagement, adherence, and the effectiveness of such treatments. The objective of this qualitative study was to identify the components of the digital therapeutic alliance. A thematic analysis has identified three major themes that appear to constitute the digital therapeutic alliance among 44 users of an online program: trust in the program, perception of interactions, and feeling of consideration. These results prompted a discussion of the challenges of digital healthcare, including the terminology to use. The term "digital therapeutic adherence" is proposed, thereby opening up a field for research and clarification of this important concept distinct from traditional alliance.

A Randomized Evaluation of MoodFX, a Patient-Centred e-Health Tool to Support Outcome Measurement for Depression: Une évaluation randomisée de MoodFX, un outil de santé en ligne centré sur le patient pour soutenir la mesure du résultat dans la dépression.

BACKGROUND: e-Health tools using validated questionnaires to assess outcomes may facilitate measurement-based care for psychiatric disorders. MoodFX was created as a free online symptom tracker to support patients for outcome measurement in their depression treatment. We conducted a pilot randomized evaluation to examine its usability, and clinical utility. METHODS: Patients presenting with a major depressive episode (within a major depressive or bipolar disorder) were randomly assigned to receive either MoodFX or a health information website as the intervention and control condition, respectively, with follow-up assessment surveys conducted online at baseline, 8 weeks and 6 months. The primary usability outcomes included the percentage of patients with self-reported use of MoodFX 3 or more times during follow up (indicating minimally adequate usage) and usability measures based on the System Usability Scale (SUS). Secondary clinical outcomes included the Quick Inventory of Depressive Symptomatology, Self-Rated (QIDS-SR) and Patient Health Questionnaire (PHQ-9). RESULTS: Forty-nine participants were randomized (24 to MoodFX and 25 to the control condition). Of the 23 participants randomized to MoodFX who completed the user survey, 18 (78%) used MoodFX 3 or more times over the 6 months of the study. The mean SUS score of 72.7 (65th-69th percentile) represents good usability. Compared to the control group, the MoodFX group had significantly better improvement on QIDS-SR and PHQ-9 scores, with large effect sizes and higher response rates at 6 months. There were no differences between conditions on other secondary outcomes such as functioning and quality of life. CONCLUSION: MoodFX demonstrated good usability and was associated with reduction in depressive symptoms. This pilot study supports the use of digital tools in depression treatment.

E-health tools may be useful for measuring and tracking symptoms and other outcomes during treatment for depression. This study is a randomized evaluation of MoodFX, a free web-based app that helps patients track their symptoms using validated questionnaires, and also offers depression information and self-management tips. A total of 49 participants with clinical depression were randomized to using MoodFX or a health information website, for 6 months. In a survey, the participants that used MoodFX found it easy and useful to use. In addition, the participants that used MoodFX had greater improvement in depressive symptoms after 6 months, compared to those who used the health information website. These results suggest that MoodFX may be a useful tool to monitor outcomes and support depression treatment.

Investigating Alexithymia as a Moderator of Outcomes in a Randomized Controlled Trial of an Online Intervention for Co-Occurring Depression and Hazardous Alcohol Use: Enquête sur l'alexithymie en tant que modérateur des résultats dans un essai randomisé contrôlé d'une intervention en ligne pour la dépression concomitante et la consommation dangereuse d'alcool.

OBJECTIVE: Alexithymia is characterized by difficulty identifying and/or describing emotions, reduced imaginal processes, and externally oriented thinking. High levels of alexithymia may increase the challenge of supporting individuals with co-occurring depression and hazardous alcohol use. This secondary analysis sought to investigate whether or not alexithymia moderated the outcomes of an online intervention for depression and alcohol use. METHOD: As part of a randomized controlled trial, 988 participants were randomly assigned to receive an intervention dually focused on depression and alcohol use, or an intervention only focused on depression. The pre-specified mediation hypothesis was that changes in drinking at 3 months follow-up would effect the association between the intervention and change in depression at 6 months. This secondary analysis extends the investigation by adding alexithymia as a moderator. RESULTS: The current analysis demonstrated that including alexithymia as a moderator resulted in a conditional direct effect. Specifically, there was an intervention effect where participants who received the combined depression and alcohol intervention had larger improvements in their depression scores at 6 months, but this was only when their alexithymia score at baseline was also high (60.5 or higher). CONCLUSION: These results suggest that treatment planning and intervention effectiveness could be informed and optimized by taking alexithymia severity into consideration. This is especially merited as alexithymia can contribute to the weaker therapeutic alliance, more distress and dysphoria, shorter periods of abstinence, and more severe depression, compounding the complexity of supporting individuals with comorbid conditions. More research is needed to systematically investigate these possible modifying effects. PLAIN LANGUAGE TITLE: Does difficulty identifying/describing emotions or externally-oriented thinking influence the effectiveness of an intervention among people with both depression and hazardous alcohol use?

In a recent study we recruited participants who were concerned with both their alcohol use and low mood. We provided two different online interventions. Half of the participants received an intervention designed for both concerns and half received an intervention that addressed only depression. We hypothesized that receiving the combined intervention for both concerns would result in greater benefits, however, our results indicated no apparent difference. This analysis uses the same data, but investigated the influences of alexithymia on the effectiveness of the interventions. Alexithymia is defined as having difficulty identifying/describing emotions and/or thinking more about external events than internal feelings. It commonly co-occurs with depression and with hazardous alcohol use and can increase the challenge of supporting individuals with these co-occurring concerns. The results of this analysis showed support for our original hypothesis that participants who received the intervention that addressed both their mood and alcohol concerns had lower depression scores 6-months later, but only among individuals who also had alexithymia scores above 60.5. Taking alexithymia severity into consideration during treatment planning may help optimize the effectiveness of interventions. These results show merit for future research to consider alexithymia as a variable that could potentially impact outcomes among individuals with co-occurring depression and hazardous alcohol use.

Sociotropy and video game playing: Massively multiplayer online role-playing games versus other games.

INTRODUCTION: Internet Gaming Disorder (IGD) is associated with several psychiatric disorders. Previous research on IGD has predominantly focused on Massively Multiplayer Online Role-playing Games (MMORPGs), considered to be pro-social games as they foster interpersonal relationships necessary for in-game progress. Sociotropy is a personality trait characterized by a cognitive approach to dealing with interpersonal relationships. Individuals with high sociotropy have a strong desire for approval from others. Beck's cognitive theory of depression posits that high sociotropy can lead to depressive symptoms when faced with interpersonal stress. We used the I-PACE model to account for the consequences of distal factors such as sociotropy on the development and maintenance of IGD. The aim of this study was therefore to compare MMORPG players with players of other game genres in terms of sociotropy, social anxiety and depression. We hypothesized that sociotropy could serve as a predictor of IGD, particularly among MMORPG players. METHODS: A total of 233 French videogame players recruited from specialized internet gaming forums participated in the study via questionnaires. Different scales were used to assess depression and social anxiety symptoms, IGD intensity, and sociotropy and autonomy. RESULTS & DISCUSSION: MMORPG players reported higher psychological distress than players of other game genres. For all players, sociotropy, rather than autonomy, was found to be a predictor of social anxiety symptoms and IGD intensity. Sociotropy and depression explained IGD intensity only for MMORPG players and not for players of other game genres. The social dimension appears to be more prominent among MMORPG players and could be one of the main personality traits predicting this specific internet gaming disorder. The treatment implications for internet gaming disorder are discussed.

Perception and expectation of Moroccan pharmacy students regarding e-learning in the context of COVID-19 pandemic lockdown.

PURPOSE: Online learning, or e-learning, has grown exponentially in recent years, not least because the COVID-19 pandemic has forced many educational establishments to adopt distance learning modalities. In the field of pharmacy, where the acquisition of theoretical and practical knowledge is essential, the adoption of e-learning has attracted particular interest. The aim of this study is to analyze the feedback received by pharmacy students from different faculties in the country following the introduction of new learning methods during the Covid pandemic. METHODS: The study was carried out using a "Google forms" questionnaire, which was sent to students at the country's faculties of pharmacy. The questionnaire included various points, such as a description of the population, preferred mode of distance learning of lectures among students and satisfaction with e-learning. RESULTS: The study involved 176 respondents, 65.9% of whom were women. Around 50% of respondents use e-learning tools more than 6 times a week for educational purposes. Seventy per cent of respondents are satisfied with their e-learning experience, but only 43.2 believe that e-learning has a positive effect on their academic results. Forty-seven per cent of respondents considered the quality of teaching to be the major shortcoming of e-learning, followed by distraction (32%) and the questionable credibility of the diploma (20%). CONCLUSION: E-learning has significant potential to transform teaching and learning in pharmacy, and its thoughtful integration can bring lasting benefits to students.

Online Educational Resources for Youth Living With Type 1 Diabetes Transitioning to Adult Care: An Environmental Scan of Canadian Content.

OBJECTIVES: There are many educational resources for adolescents and young adults living with type 1 diabetes; however, it is unknown whether they address the breadth of topics related to transition to adult care. Our aim in this study was to collect educational resources relevant to Canadian youth and assess their quality and comprehensiveness in addressing the knowledge necessary for youth to prepare for interdependent management of their diabetes. METHODS: We conducted an environmental scan, a systematic assessment and analysis, of online education resources in English and French relevant to Canadian youth living with type 1 diabetes. Resources were screened using an open education resource evaluation grid and relevant resources were mapped to the Readiness for Emerging Adults with Diabetes Diagnosed in Youth, a validated diabetes transition readiness assessment tool. RESULTS: From 44 different sources, 1,245 resources were identified and, of these, 760 were retained for analysis. The majority were webpages (50.1%) and downloadable PDFs (42.4%), and 12.1% were interactive. Most resources covered Diabetes Knowledge (46.0%), Health Behaviour (23.8%), Insulin and Insulin Pump Management (11.8% and 8.6%, respectively), and Health-care System Navigation (9.7%). Topic areas with the fewest resources were disability accommodations (n=5), sexual health/function (n=4), and locating trustworthy diabetes resources (n=3). CONCLUSIONS: There are many resources available for those living with type 1 diabetes preparing to transition to adult care, with the majority pertaining to diabetes knowledge and the least for navigation of the health system. Few resources were available on the topics of substance use, sexual health, and reproductive health. An interactive presentation of these resources, as well as a central repository to house these resources, would improve access for youth and diabetes care providers during transition preparation.

You've Got E-Mail: A Pilot Study Examining the Feasibility and Impact of a Group-Based Technology-Training Intervention Among Older Adults Living in Residential Care.

Older adults living in residential care often experience challenges in sustaining meaningful social relationships, which can result in compromised health and well-being. Online social networking has the potential to mitigate this problem, but few studies have investigated its implementation and its effectiveness in maintaining or enhancing well-being. This pilot study used a cluster-randomized pre-post design to examine the feasibility of implementing a 12-week group-based technology-training intervention for older adults (n = 48) living in residential care by exploring how cognitive health, mental health, and confidence in technology were impacted. Analysis of variance revealed significant increases in life satisfaction, positive attitudes toward computer use, and self-perceived competence among participants who received the intervention, but increased depressive symptoms for the control group. These findings suggest that, despite challenges in implementing the intervention in residential care, group-based technology training may enhance confidence among older adults while maintaining or enhancing mental health.

Psicoterapia infantil on-line: experiências de psicólogas de orientação psicanalítica durante a pandemia de COVID-19 / Psicoterapia infantil en línea: experiencias de psicólogos de orientación psicoanalítica durante la pandemia de COVID-19 / Online child psychotherapy: experiences of psychoanalytically psychologists during the COVID-19 pandemic / Psychothérapie en ligne pour enfants: expériences de psychologues d'orientation psychanalytique pendant la pandémie de COVID-19

Este artigo é um estudo qualitativo exploratório para compreender como as Tecnologia da Informação e da Comunicação foram empregadas por psicólogos brasileiros de orientação psicanalítica durante a pandemia de COVID-19, investigando as adaptações do setting no modo virtual, além da utilização do contrato, do brincar e dos recursos lúdicos via plataformas digitais. Por meio de dez entrevistas realizadas com psicólogas, pelo Google Meet, peculiaridades com relação à condução do atendimento on-line foram observadas, além dos alcances e limites dessa modalidade dentro de um setting distante dos moldes clássicos. Esses serviços se tornaram essenciais durante a pandemia, com a saúde mental das crianças desencadeando consequências físicas e psicológicas. Mesmo com as adversidades, o trabalho virtualizado se mostrou como um recurso possível dentro do cenário pandêmico

Este artículo es un estudio cualitativo exploratorio para comprender cómo las Tecnologías de la Información y la Comunicación fueron empleadas por psicólogos brasileños de orientación psicoanalítica durante la pandemia de COVID-19, investigando las adaptaciones del setting en el modo virtual, así como el uso del contrato, el juego y los recursos lúdicos a través de plataformas digitales. A través de diez entrevistas realizadas a psicólogos a través de Google Meet, fue posible observar las peculiaridades relacionadas con el manejo en la atención en línea, así como los alcances y limitaciones de esta modalidad en un setting alejado de los moldes clásicos. Estos servicios se volvieron esenciales durante la pandemia, con la salud mental de los niños desencadenando consecuencias físicas y psicológicas. A pesar de las adversidades, lo trabajo virtualizado se mostró como un recurso posible dentro del escenario pandémico

This article is an exploratory qualitative study aimed at understanding how Information and Communication Technologies were utilized by psychoanalytically oriented Brazilian psychologists during the COVID-19 pandemic. It investigates the adaptations of the therapeutic setting in a virtual mode, as well as the use of the therapeutic contract, play, and playful resources through digital platforms. Through ten interviews conducted with psychologists via Google Meet, it was possible to observe the peculiarities related to managing online therapy, as well as the scope and limitations of this modality within a context that is far from the classical framework. These services became essential during the pandemic, as children's mental health triggered physical and psychological consequences. Despite the adversities, the virtual setting proved to be a viable resource within the pandemic scenario

Cet article est une étude qualitative exploratoire visant à comprendre comment les Technologies de l'Information et de la Communication ont été utilisées par Les psychologues brésiliens d'orientation psychanalytique pendant la pandémie de COVID-19, en examinant les adaptations du cadre en mode virtuel, ainsi que l'utilisation du contrat, du jeu et des ressources ludiques via les plateformes numériques. A travers dix entretiens réalisés avec des psychologues via Google Meet, il a été possible d'observer les particularités de la prise en charge en ligne, ainsi que les avantages et les limites de cette modalité dans un setting éloigné des modèles classiques. Ces services sont devenus essentiels pendant la pandémie, avec des conséquences physiques et psychologiques sur la santé mentale des enfants. Malgré les difficultés, le travail virtualisé s'est avéré être une ressource viable dans le contexte de la pandémie

Psicoterapia online durante a fase inicial da pandemia de COVID-19: desafios e benefícios percebidos / Online psychotherapy during the early phase of the COVID-19 pandemic: perceived challenges and benefits / Psychothérapie en ligne pendant la phase initiale de la pandémie de COVID-19: défis et avantages perçus / Psicoterapia en línea durante la fase inicial de la pandemia de COVID-19: retos y beneficios percibidos

Resumo: Este estudo tem como objetivo identificar os desafios e benefícios percebidos da psicoterapia online durante a fase inicial da pandemia de COVID-19. Trata-se de pesquisa exploratória e descritiva, com abordagem quanti-qualitativa. A amostra foi composta por 385 psicólogas(os) que preencheram um formulário online. Os dados quantitativos foram submetidos à análise estatística descritiva e as questões abertas à análise temática reflexiva. As categorias elencadas foram: (1) Aprendendo a lidar com a crise, que abarca os desafios identificados no ambiente online, com destaque para a insegurança dos profissionais devido à falta de domínio de aspectos técnicos, preocupações com questões éticas e resistência dos pacientes ao atendimento remoto; e (2) Expandindo as fronteiras da atuação, que concerne aos benefícios percebidos com o uso das plataformas digitais, como ampliação da oferta de atendimento psicológico e vantagens financeiras. A passagem da modalidade presencial para a psicoterapia online nos primeiros meses da pandemia de COVID-19 evidenciou tanto limites como possibilidades, além da necessidade de desenvolver competências específicas para a oferta de cuidado psicoterapêutico mediado por tecnologia digital.

Abstract: This study aims to identify the perceived challenges and benefits of online psychotherapy during the early phase of the COVID-19 pandemic. This is an exploratory and descriptive research with a quali-quantitative approach. The sample consisted of 385 psychologists who completed an online form. The data were subjected to descriptive statistical analysis and the open questions to reflective thematic analysis. The categories listed were: (1) Learning to deal with the crisis , which encompasses the challenges identified in the online setting, with emphasis on professionals' insecurity due to lack of mastery of technical aspects, concerns about ethical issues, and patients' resistance to remote care; and (2) Expanding the frontiers of practice , which refers to the benefits perceived with the use of digital platforms, such as expanding the offer of psychological care and financial advantages. The shift from face-to-face to online psychotherapy in the first months of the COVID-19 pandemic has highlighted both limits and possibilities, as well as the need to develop specific skills to offer technology-mediated psychotherapeutic care.

Résumé : Cette étude vise à identifier les défis et les avantages perçus de la psychothérapie en ligne pendant la phase initiale de la pandémie de COVID-19. Il s'agit d'une recherche exploratoire et descriptive, avec une approche quanti-qualitative. L'échantillon était composé de 385 psychologues qui ont répondu à un formulaire en ligne. Les données numériques ont été soumises à une analyse statistique descriptive et les questions ouvertes à une analyse réflexive thématique. Les catégories énumérées étaient les suivantes: (1) Apprendre à faire face à la crise , qui englobe les défis identifiés dans la thérapie en ligne, notamment l'insécurité des professionnels due au manque de maîtrise des aspects techniques, les préoccupations liées aux questions éthiques et la résistance des patients aux soins à distance; et (2) Élargir les frontières de l'action, qui renvoie aux avantages perçus de la psychothérapie en ligne, tels que l'élargissement de l'offre de services de soins psychologiques et les avantages financiers. La transition de la psychothérapie présentielle vers la psychothérapie en ligne au cours des premiers mois de la pandémie de COVID-19 a mis en évidence les limites et les possibilités, ainsi que la nécessité de développer des compétences spécifiques pour l'offre de psychothérapie médiatisée par les technologies de la communication.

Resumen: Este estudio tiene como objetivo identificar los retos y beneficios percibidos de la psicoterapia en línea durante la fase inicial ola de la pandemia de COVID-19. Se trata de una investigación exploratoria y descriptiva, con enfoque cuanticualitativo. La muestra estaba compuesta por 385 psicólogos(as) que respondieron a un formulario en línea. Los datos numéricos se sometieron a un análisis estadístico descriptivo, y las preguntas abiertas, a un análisis temático reflexivo. Las categorías enumeradas fueron las siguientes: (1) Aprender a hacer frente a la crisis , que abarca los retos detectados en la terapia en línea, especialmente la inseguridad de los profesionales debido a la falta de dominio de los aspectos técnicos, las preocupaciones por las cuestiones éticas y la resistencia de los pacientes a la atención a distancia; y (2) Ampliar las fronteras de actuación , que se refiere a los beneficios percibidos con el uso de las plataformas digitales, como la ampliación de la oferta de atención psicológica y las ventajas financieras. La transición a la psicoterapia en línea en los primeros meses de la pandemia de la COVID-19 puso de relieve tanto los límites como las posibilidades, así como la necesidad de desarrollar habilidades específicas para la prestación de atención psicoterapéutica mediada por las tecnologías de la información y comunicación.

[An online tool to personalize the drug-doses for obese adults]. / Un outil d'adaptation individualisée des posologies de médicaments chez le patient adulte obèse.

BACKGROUND: Between 1975 and 2014, the number of people suffering from obesity tripled, reaching 17% of the adult population in France and more than 35% in the United States. Obesity is defined by a Body Mass Index (BMI)>30kg/m2 and characterized by a significant accumulation of adipose tissue responsible for the increase in weight. This accumulation leads to physiological changes capable of modifying the pharmacokinetics of drugs, which can lead to the administration of inappropriate doses. For this reason, some significant dosage adjustments are necessary for obese patients. However, data on these adaptations are not easily accessible and sometimes complex to implement in practice. AIM: To perform a new online tool allowing to calculate and propose an adjusted dose of a drug that should be administered to an obese patient. METHOD: (i) carrying out an extensive bibliographic research according to the PRISMA methodology; and (ii) the development of a new website site proposing an adjusted dose for obese patients. RESULTS: Firstly, 49 reviews concerning the dose adaptation have been evaluated and, secondly, 319 articles have been selected. Among them, 204 articles have been included in the database to justify the adjusted dose of 84 drugs and administration methods including antibiotics, antifungals, anticoagulants or even cancer drugs. This database is available online through a calculator on the website named Adapt'Obese. Thus, with the sex, height and weight of an obese patient, Adapt'Obese proposes a personalized and adjusted dose of the drug to administer. PERSPECTIVES: Other drugs will be added soon, and functional improvements are planned, with the aim of adapting the dosages in obese patients, as for patients with renal insufficiency.

Perceived Quality of Online Music Therapy Sessions by Older Adults Aging at Home.

Online delivery is new to the field of music therapy (MT). This research investigated older adults' perceived quality of MT online by certified music therapists. In this feasibility study, applying both process and outcome assessments, nine older adults volunteered to participate. Zoom was used, and a virtual music therapy (VMT) kit was developed as a resource. Surveys and observed technical difficulties revealed that perceived quality varied slightly by level of technical difficulty experienced; however, overall mean perceived quality was 7.2 out of 9. Post-study interviews revealed three main themes: (a) individual experiences with VMT, (b) individuals' suggestions for further development of VMT sessions, and (c) individuals' personal outcomes from VMT sessions. Participants reported overall positive experiences with VMT. Despite a slight decline in perceived quality when more technical difficulties were present, each participant reported a desire for more sessions, and they would recommend it to others.

Apprendre l'anatomie radiographique en présentiel ou en ligne ? Une étude randomisée contrôlée.

Résumé L'enseignement de l'anatomie repose sur diverses techniques: les cours, les dissections, les modèles 3D ou encore les supports en ligne. Ces derniers sont généralement considérés comme des moyens d'apprentissage complémentaires. Cette étude vise à comparer les performances des étudiants vétérinaires (N=83) en anatomie radiographique (radioanatomie) après un apprentissage en ligne ou conventionnel, et de voir dans quelle mesure ces méthodes sont interchangeables. Trois stratégies sont comparées : apprentissage en ligne exclusif, apprentissage en ligne avec des os de chevaux, apprentissage sur radiographies conventionnelles avec des os de chevaux. Les performances au test de rotation mentale et au test de connaissance en radioanatomie sont similaires entre les 3 groupes à la base, lors du test préliminaire. Après l'apprentissage (test final), les scores de rotation mentale et de radioanatomie augment significativement de 6.7/40 points (CI : 5.2­8.2; p < .001) et de 5.1/20 points (CI: 4.3­5.9; p< .001). Il n'y a pas de différence entre les groupes pour les scores de rotation mentale et de radioanatomie après l'apprentissage. Le score de rotation mentale est influencé par le genre, et significativement plus élevé chez les hommes que chez les femmes au test préliminaire (M= 23.0, SD = 8.8 vs. M= 16.5, SD= 6.9; p= .001) et au test final (M= 32.1, SD= 5.5 vs. M= 22.7, SD= 8.6; p< .001). Les performances en radioanatomie ne sont pas influencées par le genre. Ces résultats suggèrent que l'enseignement de la radioanatomie peut être réalisé en présentiel avec des radiographies conventionnelles ou en ligne. Cette interchangeabilité entre apprentissage en présentiel et en distanciel est intéressante au regard des impératifs liés aux crises sanitaires, et des besoins d'adaptation rapide en distanciel. This translation was provided by the authors. To view the original article visit: https://doi.org/10.3138/jvme-2021-0153.

Some Questions Raised by the Practice of Online Analysis.

In this paper the author explores some of the issues raised by the practice of online analysis. In particular, he emphasizes the difference between the setting and the frame and proposes a theoretical approach of the latter as emerging within the transferential dynamic.

Dans cet article, l'auteur explore certaines des questions soulevées par la pratique de l'analyse en ligne. En particulier, il souligne la différence entre le dispositif et le cadre et propose une approche théorique de ce dernier comme émergeant au sein de la dynamique transférentielle.

En este artículo, el autor explora algunas de las cuestiones que plantea la práctica del análisis virtual. En particular, hace hincapié en la diferencia entre el encuadre y el marco y propone un enfoque teórico de este último como emergente dentro de la dinámica transferencial.

Working Online During the Contemporary COVID-19 Pandemic.

Within the psychoanalytic school there has been substantial and ongoing debate about the efficacy of teleanalysis. However, as a result of the current COVID-19 pandemic and the online work with which the Jungian analytic community has now had to engage, this paper initially focuses on analysts' actual experiences of working by teleanalysis. These experiences highlight a range of issues like "Zoom fatigue", "online disinhibition", dissonance, confidentiality, the frame and working with new patients. Alongside these issues, there were ample experiences by analysts of both productive psychotherapy apace with analytic work involving transference and countertransference phenomena, all indicating that a genuine and good enough analytic process can occur with teleanalysis. An overview of the research and literature both prior to the pandemic and as a result of it, confirms the validity of these experiences so long as analysts are cognizant of the specifics of such an online modality. Conclusions to do with the question, "what have we learned?", alongside training, ethics and supervision issues are subsequently discussed.

Au sein de l'école psychanalytique il y a encore un grand débat sur l'efficacité de la télé-analyse. Toutefois, du fait de la pandémie actuelle de COVID-19 et du travail en ligne que la communauté analytique Jungienne a dû entreprendre, cet article se concentre initialement sur les expériences actuelles de l'analyste dans l'analyse en ligne. Ces expériences soulignent une variété de problèmes tels la « fatigue Zoom ¼, la « désinhibition en ligne ¼, la dissonance, la confidentialité, le cadre, et commencer avec de nouveaux patients. Aux côtés de ces questions il y a eu pour les analystes nombre d'expériences à la fois de psychothérapie productive et de travail analytique, contenant des phénomènes de transfert-contretransfert. Cela indique qu'un processus authentique et convenable du point de vue analytique peut avoir lieu dans la télé-analyse. Un repérage des recherches et de la documentation effectuées à la fois avant la pandémie et suite à celle-ci confirme la validité de ces expériences, du moment que les analystes sont conscients de ce qui est spécifique à une telle modalité. L'article aborde ensuite des conclusions sur la question de ce que l'on a appris, sur la formation, l'éthique et la supervision.

Dentro de la escuela psicoanalítica ha habido un debate sustancial y continuo sobre la eficacia del teleanálisis. Sin embargo, como resultado de la actual pandemia de COVID-19 y el trabajo en línea con el que la comunidad analítica junguiana ha tenido que comprometerse, este artículo se centra inicialmente en las experiencias reales de los analistas de trabajar vía teleanálisis. Estas experiencias ponen de relieve una serie de cuestiones como la "fatiga de Zoom", la "desinhibición en línea", la disonancia, la confidencialidad, el marco y el trabajo con nuevos pacientes. Junto a estas cuestiones, hubo amplias experiencias por parte de los analistas tanto de psicoterapia productiva como de trabajo analítico con fenómenos de transferencia y contratransferencia, todo lo cual indica que puede darse un proceso analítico genuino y suficientemente bueno con el teleanálisis. Una visión general de la investigación y la literatura, tanto antes de la pandemia, y también como resultado de ella, confirma la validez de estas experiencias siempre y cuando los analistas sean conscientes de las especificidades de esta modalidad virtual. Posteriormente se discuten las conclusiones relacionadas con la pregunta "¿qué hemos aprendido?", junto con cuestiones de formación, ética y supervisión.

Management of Chronic Pain by Occupational Therapist: A Description of Practice Profile.

Background. Current state of knowledge regarding occupational therapy's contribution to chronic pain (CP) management has evolved over the past decade. Yet, has this been transferred to clinical practice? Purpose. Describe the current state of practice of CP management-specific occupational therapy. Method. An online survey was sent to occupational therapists working with CP patients. Findings. Of the 90 respondents (11.9%), 42.2% worked in primary care and 52.2% in secondary care. They reported that their primary role aimed at enabling occupation and providing vocational rehabilitation. The Canadian Model of Occupational Performance and Engagement (CMOP-E) (87.8%), semi-structured interview (86.7%), and education on energy conservation (65.6%) and postural hygiene (60.0%) were the most frequently reported conceptual model, assessment, and intervention methods. Implications. Results illustrate the diversity of current occupational therapy practice in CP management and suggest opportunities for improvement to ensure best practices are adopted, by emphasizing an occupation-based vision of health and well-being.

Opportunities of online analysis.

The question of whether tele-analysis is an acceptable way of conducting analysis has been discussed since it has become available. Merchant (2016) and others concluded that 'the essentials of a genuine analytic process are not necessarily precluded' (p. 1). In this paper, the author goes a step further and examines potential advantages of tele-analysis. There may be benefits for patients with a history of physical or sexual abuse who value the distance. The potential for a 'safe place' for work with erotic transference is also examined. In a further section the author is interested in allowing the analyst the freedom to practise in an authentic way, congruent with their personality. Also explored is the concept of the interactive field including the technological medium, which is subject to synchronistic events. Finally, the author gives examples of a deep connection between patient and analyst which came about despite the physical distance.

La question de savoir si l'analyse en ligne est une manière acceptable de conduire une analyse a été débattue dès l'apparition de cette modalité. Merchant (2016) et d'autres auteurs ont conclu que « les fondamentaux d'un processus analytique authentique ne sont pas nécessairement compromis ¼ (p.1). Dans cet article, l'auteur va plus loin et étudie les avantages potentiels de l'analyse en ligne. Il pourrait y avoir des avantages pour les patients qui ont vécu des abus sexuels ou de violence et pour qui la distance est bénéfique. L'article considère également le potentiel pour un 'environnement protégé' pour travailler le transfert érotique. Dans une autre partie l'auteur souligne l'intérêt de permettre à l'analyste la liberté de pratiquer d'une manière authentique, en cohérence avec sa personnalité. Le concept du champ interactif incluant l'intermédiaire technologique - qui est sujet aux événements synchronistiques - est aussi exploré. Pour terminer, l'auteur donne des exemples de liens profonds entre patient et analyste, liens qui se sont développés malgré la distance physique.

La pregunta acerca de si el tele-análisis es un modo aceptable de conducir el análisis se ha discutido desde que comenzó a implementarse. Merchant (2016) y otros han concluido que `lo esencial de un proceso analítico genuino no queda excluido necesariamente`(p.1). En el presente ensayo, el autor da un paso más y examina las ventajas potenciales del tele-análisis. Puede haber beneficios para pacientes con historia de abuso físico o sexual quienes valoran la distancia. También se indaga en el potencial de un `espacio seguro`en el que trabajar la transferencia erótica. En otra sección el autor se interesa en el permiso y la libertad del analista para practicar en un modo auténtico, congruente con su personalidad. También se explora el concepto de campo interactivo, incluyendo el soporte tecnológico, el cual es sujeto a eventos sincronísticos. Finalmente, el autor ofrece ejemplos de una conexión profunda entre paciente y analista la cual se produjo a pesar de la distancia física.

Acceptability of an Online Module Addressing Weight Bias: Perspectives and Attitudes of Undergraduate Health Students and Instructors.

Weight bias and discrimination are highly pervasive and harmful to Canadians with higher weights. Researchers and practitioners who deliver, evaluate, and advise on dietary and weight-related interventions may inadvertently perpetuate weight bias through their work; however, trainees in these fields rarely have access to weight bias education within their applied health programs. This study evaluated the acceptability of an online educational weight bias module developed for undergraduate students enrolled in health courses. The intervention included a pre-recorded 20-minute online module with prompts for reflection or discussion, a self-assessment quiz, as well as a separate module and range of resources for instructors. Overall, 211 students from applied health courses and 4 instructors completed an online survey querying the module's delivery, impact, and relevance. Students agreed that the module provided useful information (82%), was easy to understand (97%), and was the right length (75%), but reported wanting more interactivity and engagement with the content. Instructors found the module engaging and useful and expressed interest in additional resources and support for weight bias education. Future research should explore the impact of weight bias education on students' weight-related attitudes and perceptions as well as feasibility and relevance of online features such as multimedia tools.

[Medical space nutrition and obesity, a better management of patients with obesity]. / Espace médical nutrition et obésité, une meilleure prise en charge des patients atteints d'obésité.

The Medical Network for Nutrition against Obesity (Emno) breaks new ground in the treatment of obesity through a project within the legal framework of the so-called "Article 51". The medical and educational support it provides rests on four pillars: a continuum of care via a territorial network, multi-professional cooperation in e-healthcare, the partner-patient and the expert patient. Thanks to its Nuvee online platform for therapeutic patient education, Emno takes advantage of the current digital developments, in the spirit of rigorous medical as well as economic logic.

Impact of the COVID-19-induced shift to online dietetics training on PDEP competency acquisition and mental health.

Purpose: A pilot study to investigate the impact of the COVID-19 pandemic and shift to online learning and practicum training on dietetics students' perceptions of Partnership for Dietetic Education and Practice (PDEP) competency acquisition and mental health.Methods: Dietetics students (n = 19) at the University of Guelph (2020-2021) were invited to complete an anonymous online survey to assess self-reported online dietetics practicum training experiences including (i) benefits and challenges, (ii) PDEP competency acquisition, and (iii) impact on mental health.Results: The benefits of online dietetics training included schedule flexibility (42.1%), reduced commute time (31.6%), and acquiring virtual counselling experience (21.1%). Reported challenges were insufficient communication with preceptors (36.8%), increased project workload (57.9%), and technology (15.8%). In online practicum placements, 52.6% of dietetics students reported adequately acquiring all PDEP competencies, with Nutrition Care identified as the most challenging to obtain (63.2%). A negative impact on mental health and increased levels of stress/anxiety were reported in 94.7% of trainees. Notably, 63.2% of students favoured continuation of online dietetics training through a hybrid or entirely online format.Conclusion: Online dietetics training has the potential to complement the traditional in-person model; however, further adaptation is required to optimize PDEP competency acquisition and students' mental health.