Side-by-Side: A One-on-One Peer Support Program for Medical Students.

PROBLEM: Medical students experience high levels of burnout and face barriers to accessing support services. However, few studies have considered the feasibility and/or effectiveness of one-on-one peer support programs for medical students. This report aims to describe the development and implementation of such a program, the Side-by-Side Peer Support Program, at the University of Ottawa (August 2018-June 2020). APPROACH: Thirty-five medical students enrolled at the University of Ottawa Faculty of Medicine were selected to participate in a training course aimed at developing the skills necessary to provide one-on-one support to their peers. The main responsibilities of peer supporters were to reach out to classmates, particularly those displaying changes in their usual behavior that might be indicative of mental illness, to provide basic counseling, and to refer at-risk students to professional services. Peer supporters offered weekly hours during which classmates could contact them for support. Information on interactions between students and peer supporters was recorded in an electronic database. An end-of-year survey collected information on barriers to seeking help perceived by medical students. OUTCOMES: A total of 303 interactions were recorded. Interactions took place in various formats, including in-person, via telephone or video call, or via texting or online messaging. Interactions were initiated by both students and peer supporters. Survey respondents identified more barriers to seeking help from Faculty of Medicine services than Side-by-Side, including fear of impact on career (22.2% vs 2.5%; P < .01) and belief that the services would not be helpful (42.0% vs 23.5%; P = .02). NEXT STEPS: The authors plan to quantify well-being through academic engagement metrics as well as mental health outcome metrics in future studies. Future studies should also consider whether peer support increases help-seeking behaviors and/or the use of professional services.

Public health emergency and psychological distress among healthcare workers: a scoping review.

BACKGROUND: Pandemics and natural disasters are immensely stressful events for frontline healthcare workers, as they provide patient care to a population undergoing the impacts of the disaster while experiencing such impacts to their personal lives themselves. With increased stressors to an already demanding job, frontline healthcare workers are at a higher risk of adverse effects to their mental health. The current COVID-19 pandemic has already shown to have had significant impact on the mental health of healthcare workers with increased rates of burnout, anxiety and depression. There is already literature showing the utility of individual programs at improving mental health, however, interventions at the organizational level are not well explored. This scoping review aims to provide an overview and determine the utility of a systematic review of the current body of literature assessing the effectiveness of mental health interventions at the organizational level for healthcare workers during or after a public health emergency. METHODS: Electronic databases such as Medline on OVID, CENTRAL, PsycINFO on OVID and Embase on OVID were searched. A targeted search of the grey literature was conducted to identify any non-indexed studies. The population, concept and context approach was used to develop the eligibility criteria. Articles were included if (1) they assessed the impact of interventions to improve wellbeing or reduce the distress on healthcare personnel, first responders or military actively providing medical care; (2) provided quantitative or qualitative data with clearly defined outcomes that focused on established mental health indicators or qualitative descriptions on distress and wellbeing, validated scales and workplace indicators; (3) focused on organizational level interventions that occurred in a public health crisis. RESULTS: The literature search resulted in 4007 citations and 115 potentially relevant full-text papers. All except 5 were excluded. There were four review articles and one experimental study. There were no other unpublished reports that warranted inclusion. CONCLUSIONS: There is a distinct lack of research examining organizational interventions addressing mental resilience and well-being in healthcare workers in disaster settings. A systematic review in this area would be low yield. There is a clear need for further research in this area.

A muscle cell-macrophage axis involving matrix metalloproteinase 14 facilitates extracellular matrix remodeling with mechanical loading.

The extracellular matrix (ECM) in skeletal muscle plays an integral role in tissue development, structural support, and force transmission. For successful adaptation to mechanical loading, remodeling processes must occur. In a large cohort of older adults, transcriptomics revealed that genes involved in ECM remodeling, including matrix metalloproteinase 14 (MMP14), were the most upregulated following 14 weeks of progressive resistance exercise training (PRT). Using single-cell RNA-seq, we identified macrophages as a source of Mmp14 in muscle following a hypertrophic exercise stimulus in mice. In vitro contractile activity in myotubes revealed that the gene encoding cytokine leukemia inhibitory factor (LIF) is robustly upregulated and can stimulate Mmp14 expression in macrophages. Functional experiments confirmed that modulation of this muscle cell-macrophage axis facilitated Type I collagen turnover. Finally, changes in LIF expression were significantly correlated with MMP14 expression in humans following 14 weeks of PRT. Our experiments reveal a mechanism whereby muscle fibers influence macrophage behavior to promote ECM remodeling in response to mechanical loading.

Changes in task self-efficacy and emotion across competitive performances in golf.

This research aimed to investigate (a) the effect of golfers' perceptions of coach motivation efficacy on golfers' precompetition task self-efficacy, (b) the effect of performance on pre-to-postround changes in self-efficacy, (c) the effect of pre-to-postround changes in self-efficacy on pre-to-postround changes in affect and emotion, and (d) whether any effects of performance on pre-to-postcompetition changes in affect and emotion were mediated by pre-to-postcompetition changes in self-efficacy. In Study 1, a scale measuring golf self-efficacy was developed and validated using data from 197 golfers. In Study 2, 200 golfers completed this measure alongside measures of coach motivation efficacy, and positive and negative affect before a golf competition; all measures (except coach motivation efficacy) were again completed following the competition. Structural equation modeling showed that coach motivation efficacy positively predicted precompetition self-efficacy, performance positively predicted pre-to-postcompetition changes in self-efficacy, which had positive and negative effects, respectively, on pre-to-postcompetition changes in positive and negative affect; mediation analyses demonstrated that pre-to-postcompetition changes in self-efficacy mediated effects of performance on pre-to-postcompetition changes in positive and negative affect. In Study 3, the Study-2 procedures were replicated with a separate sample of 212 golfers, except measures of excitement, concentration disruption, somatic anxiety, and worry replaced those for positive and negative affect. Structural analyses showed the findings from Study 2 were largely replicated when specific emotions were investigated in place of general indices of affect. This investigation makes novel contributions regarding the potential importance of perceptions of coach efficacy for golfers' own efficacy beliefs, and the role personal efficacy beliefs may play in facilitating the effects of performance on affective outcomes.

Psychological variables impacting weight gain rapidity in adolescents hospitalized for eating disorders.

OBJECTIVE: This prospective study examined whether psychological variables related to the transdiagnostic theory of eating disorders measured at admission predicted length of time to reach 85 per cent of ideal body weight (IBW) among underweight adolescents hospitalized for an eating disorder. METHOD: Thirty-three girls (aged 12-17) weighing below 85 per cent of IBW, admitted to an inpatient and/or partial hospitalization eating disorder programme completed self-report measures at admission. Cox regression tested whether scores on admission measures predicted time to reach 85 per cent of IBW. RESULTS: After controlling for IBW at admission, higher self-esteem and lower perfectionism predicted shorter time to reach 85 per cent of IBW, with emotion regulation as a marginally significant predictor. CONCLUSION: Self-esteem and perfectionism may be predictors of responsiveness to weight-gain efforts during hospitalization. Further studies are necessary to determine whether these variables might be appropriate targets for intervention to promote weight gain in underweight girls with eating disorders.