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Microbial biofilms induce larval settlement for some invertebrates, including corals; however, the chemical cues involved have rarely been identified. Here, we demonstrate the role of microbial biofilms in inducing larval settlement with the Caribbean coral Porites astreoides and report the first instance of a chemical cue isolated from a marine biofilm bacterium that induces complete settlement (attachment and metamorphosis) of Caribbean coral larvae. Larvae settled in response to natural biofilms, and the response was eliminated when biofilms were treated with antibiotics. A similar settlement response was elicited by monospecific biofilms of a single bacterial strain, Pseudoalteromonas sp. PS5, isolated from the surface biofilm of a crustose coralline alga. The activity of Pseudoalteromonas sp. PS5 was attributed to the production of a single compound, tetrabromopyrrole (TBP), which has been shown previously to induce metamorphosis without attachment in Pacific acroporid corals. In addition to inducing settlement of brooded larvae (P. astreoides), TBP also induced larval settlement for two broadcast-spawning species, Orbicella (formerly Montastraea) franksi and Acropora palmata, indicating that this compound may have widespread importance among Caribbean coral species.

Microbial genomic sequence analyses have indicated widespread horizontal gene transfer (HGT). However, an adequate mechanism accounting for the ubiquity of HGT has been lacking. Recently, high frequencies of interspecific gene transfer have been documented, catalyzed by Gene Transfer Agents (GTAs) of marine α-Proteobacteria. It has been proposed that the presence of bacterial genes in highly purified viral metagenomes may be due to GTAs. However, factors influencing GTA-mediated gene transfer in the environment have not yet been determined. Several genomically sequenced strains containing complete GTA sequences similar to Rhodobacter capsulatus (RcGTA, type strain) were screened to ascertain if they produced putative GTAs, and at what abundance. Five of nine marine strains screened to date spontaneously produced virus-like particles (VLP's) in stationary phase. Three of these strains have demonstrated gene transfer activity, two of which were documented by this lab. These two strains Roseovarius nubinhibens ISM and Nitratireductor 44B9s, were utilized to produce GTAs designated RnGTA and NrGTA and gene transfer activity was verified in culture. Cell-free preparations of purified RnGTA and NrGTA particles from marked donor strains were incubated with natural microbial assemblages to determine the level of GTA-mediated gene transfer. In conjunction, several ambient environmental parameters were measured including lysogeny indicated by prophage induction. GTA production in culture systems indicated that approximately half of the strains produced GTA-like particles and maximal GTA counts ranged from 10-30% of host abundance. Modeling of GTA-mediated gene transfer frequencies in natural samples, along with other measured environmental variables, indicated a strong relationship between GTA mediated gene transfer and the combined factors of salinity, multiplicity of infection (MOI) and ambient bacterial abundance. These results indicate that GTA-mediated HGT in the marine environment with the strains examined is favored during times of elevated bacterial and GTA abundance as well as in areas of higher salinity.

Background: Given the highly stressful environment surrounding the SARS-CoV-2 pandemic, healthcare workers (HCW) and public safety personnel (PSP) are at an elevated risk for adverse psychological outcomes, including posttraumatic stress disorder (PTSD) and alcohol/substance use problems. As such, the study aimed to identify associations between PTSD severity, related dissociation and emotion dysregulation symptoms, and alcohol/substance use problems among HCWs and PSP. Methods: A subset of data (N =  498 ; HCWs =  299 ; PSP =  199 ) was extracted from a larger study examining psychological variables among Canadian HCWs and PSP during the pandemic. Structural equation modelling assessed associations between PTSD symptoms and alcohol/substance use-related problems with dissociation and emotion dysregulation as mediators. Results: Among HCWs, dissociation fully mediated the relation between PTSD and alcohol-related problems (indirect effect β = .133, p = .03) and emotion dysregulation partially mediated the relation between PTSD and substance-related problems (indirect effect β = .151, p = .046). In PSP, emotion dysregulation fully mediated the relation between PTSD and alcohol-related problems (indirect effects β = .184, p = .005). For substance-related problems among PSP, neither emotion dysregulation nor dissociation (ps >.05) had any effects. Conclusion: To our knowledge, this is the first study examining associations between PTSD severity and alcohol/substance use-related problems via mediating impacts of emotion dysregulation and dissociation among HCWs and PSP during the SARS-CoV-2 pandemic. These findings highlight dissociation and emotion dysregulation as important therapeutic targets for structured interventions aimed at reducing the burden of PTSD and/or SUD among Canadian HCWs or PSP suffering from the adverse mental health impacts of the SARS-CoV-2 pandemic. Among healthcare workers, dissociation mediated relation between posttraumatic stress disorder (PTSD) severity and alcohol-related problems and emotion dysregulation mediated relation between PTSD severity and substance-related problems. Among public safety personnel, emotion dysregulation mediated relation between PTSD severity and alcohol-related problems. Neither dissociation nor emotion dysregulation mediated relation between PTSD severity and substance-related problems. Results underscore dissociation and emotion dysregulation as potential key therapeutic targets for intervention for healthcare workers and public safety personnel struggling with PTSD and comorbid alcohol/substance use-related problems.

Introduction: Healthcare professionals (HCPs) appear to be at increased risk for negative psychological outcomes [e.g. depression, anxiety, post-traumatic stress disorder (PTSD), moral distress] and associated impacts on functioning throughout the COVID-19 pandemic. HCPs working on designated COVID-19 units may be further impacted than their colleagues not on these units given added demands of patient care and risk of contracting COVID-19. Little is known, however, about the mental health and functioning of specific professional groups beyond nurses and physicians, including respiratory therapists (RTs), over the course of the pandemic. Accordingly, the purpose of the present study was to characterize the mental health and functioning of Canadian RTs and compare profiles between RTs working on and off designated COVID-19 units. Methods: Canadian RTs completed an online survey between February and June 2021, including demographic information (e.g. age, sex, gender,) and measures of depression, anxiety, stress, PTSD, moral distress and functional impairment. Descriptive statistics, correlation analyses and between-groups comparisons were conducted to characterize RTs and compare profiles between those on and off COVID-19 units. Results: Two hundred and eighteen (N = 218) RTs participated in this study. The estimated response rate was relatively low (6.2%) Approximately half of the sample endorsed clinically relevant symptoms of depression (52%), anxiety (51%) and stress (54%) and one in three (33%) screened positively for potential PTSD. All symptoms correlated positively with functional impairment (p's < .05). RTs working on COVID-19 units reported significantly greater patient-related moral distress compared to those not on these units (p < .05). Conclusion: Moral distress and symptoms of depression, anxiety, stress and PTSD were prevalent among Canadian RTs and were associated with functional impacts. These results must be interpreted with caution given a low response rate, yet raise concern regarding the long-term impacts of pandemic service among RTs. Research on RTs' mental health prior to and during the COVID-19 pandemic is scant, especially in comparison to other HCPs. RTs in the present study reported experiencing moral distress and clinically significant symptoms of depression, anxiety and PTSD, with associated functional impairment. One in three RTs screened positive for likely PTSD on the PCL-5. There is a need to provide RTs with adequate mental health supports and to understand the long-term impacts of pandemic service among RTs.

Table of contents Preamble Terms Acute stress disorder (ASD) Adverse childhood experiences (ACEs) Anxiety disorder Burnout Caregiver, informal Caregiver burden Caregiver satisfaction Clinical anxiety Clinical depression Compassion fatigue Complex posttraumatic stress disorder (C-PTSD) Complex trauma Critical incident Cultural competency / Cultural competence Diagnosis / Diagnostic Equity, diversity, and inclusion (EDI) Evidence-based activities Evidence-based medicine (EBM) First responder Gender-based violence Health Informal caregiver Institutional betrayal / Sanctuary trauma Interpersonal violence Intersectionality LGBT purge Mental disorder Mental health Mental health condition / Mental health challenge Mental health injury / Psychological injury Mental illness Military sexual trauma (MST) Moral injury / Moral distress / Moral dilemma Occupational stress injury / Organizational stress injury Operational stress injury (OSI) Panic attack Peer support People with lived experience [of a mental disorder or mental health condition] / Experts by experience [of a mental disorder or mental health condition] Posttraumatic growth (PTG) Posttraumatic psychological stress / Posttraumatic stress / Posttraumatic stress syndrome / Posttraumatic stress symptoms / Psychological stress / Psychological trauma / Psychologically traumatic stress / Traumatic stress Posttraumatic stress (PTS) Posttraumatic stress disorder (PTSD) Posttraumatic stress injury (PTSI) Potentially psychologically traumatic event (PPTE) / Psychologically traumatic event / Potentially psychologically traumatic stressor / Psychologically traumatic stressor (PTS) / Traumatic event / Traumatic stressor Provider Psychological trauma / Psychologically traumatic injury Public safety personnel (PSP) Recovery Resilience / Resiliency Sanctuary trauma Secondary traumatic stress Social support Stigma Stress / Stressor / Stressful event Trauma / Traumatic injury Tri-services Vicarious trauma Vicarious traumatic stress Well-being (wellbeing) Wellness Wellness check Acknowledgements Senior authors team Statement Preamble Background Posttraumatic stress disorder (PTSD) is a potentially disabling condition that is now widely recognized as a public health issue.1 PTSD and other mental disorders are more common among first responders and other public safety personnel (PSP), Canadian Armed Forces members, Veterans, and health care personnel than among the general population in Canada.2 The COVID-19 pandemic increased our reliance on the health care workers and public safety personnel and took an additional toll on their physical, mental, and emotional health.3 In 2018, the Federal Framework on Post-Traumatic Stress Disorder Act (Act C-211) was passed by the Parliament of Canada to address the “clear need for persons who have served as first responders, firefighters, military personnel, corrections officers and members of the RCMP to receive direct and timely access to PTSD support.” Prevalence of PTSD The first nationwide research investigating the proportion of Canadian PSP reporting symptom clusters consistent with various mental disorders found that 23.2% of the total sample screened positive for PTSD.2 By contrast, estimates of the prevalence of PTSD in the general population range from 1.1% to 3.5%.2 Prior to the COVID-19 pandemic, pan-Canadian research, using the Carleton et al.1 online survey and the same psychiatric scales, reported rates of PTSD similar to those found in PSP among the regulated nurses (i.e. registered nurses, licensed practical nurses, registered practical nurses, registered psychiatric nurses, nurse practitioners) who participated in the survey, with almost one-quarter of respondents (23%) screening positive for current symptoms consistent with PTSD.5 6 7 Recent research suggests that since the start of the COVID-19 pandemic, rates of PTSD have increased among both health care providers and PSP.3 Evolution of the glossary of terms Discussions around PTSD and related mental health conditions often lack a common language for people living and working in different contexts. The first version of the glossary was planned and developed to facilitate open discourse among the many academics, researchers, clinicians, policy experts, non-governmental organization members, PSP, serving and veteran Canadian Armed Forces members, and people with lived experience of PTSD who attended the 2019 National Conference on PTSD; to assist in the development of the Federal Framework on Posttraumatic Stress Disorder;1 and to address key priority areas in Supporting Canada’s Public Safety Personnel: An action plan on post-traumatic stress injuries.8 A revised version of the glossary was released the same year, based on feedback on the first version, and version 2.1, with minor editorial revisions, was posted on the CIPSRT website in 2020. [...]disorder” communicates important information to health care providers about a person’s condition, functional limitations, and the optimal lines of treatment.

Respiratory therapists (RTs) faced morally distressing situations throughout the COVID-19 pandemic, including working with limited resources and facilitating video calls for families of dying patients. Moral distress is associated with a host of adverse psychological and functional outcomes (e.g. depression, anxiety, symptoms of posttraumatic stress disorder [PTSD] and functional impairment) and consideration of position departure. The purpose of this study was to understand the impact of moral distress and its associated psychological and functional outcomes on consideration to leave a clinical position among Canadian RTs during the COVID-19 pandemic. Canadian RTs (N = 213) completed an online survey between February and June 2021. Basic demographic information (e.g. age, sex, gender) and psychometrically validated measures of moral distress, depression, anxiety, stress, PTSD, dissociation, functional impairment, resilience and adverse childhood experiences were collected. One in four RTs reported considering leaving their position. RTs considering leaving reported elevated levels of moral distress and adverse psychological and functional outcomes compared to RTs not considering leaving. Over half (54.5%) of those considering leaving scored above the cut-off for potential diagnosis of PTSD. Previous consideration to leave a position and having left a position in the past each significantly increased the odds of currently considering leaving, along with system-related moral distress and symptoms of PTSD, but the contribution of these latter factors was small. Canadian RTs considering leaving their position reported elevated levels of distress and adverse psychological and functional outcomes, yet these individual-level factors appear unlikely to be the primary factors underlying RTs' consideration to leave, because their effects were small. Further research is required to identify broader, organizational factors that may contribute to consideration of position departure among Canadian RTs.

Microbial genomic sequence analyses have indicated widespread horizontal gene transfer (HGT). However, an adequate mechanism accounting for the ubiquity of HGT has been lacking. Recently, high frequencies of interspecific gene transfer have been documented, catalyzed by Gene Transfer Agents (GTAs) of marine [alpha]-Proteobacteria. It has been proposed that the presence of bacterial genes in highly purified viral metagenomes may be due to GTAs. However, factors influencing GTA-mediated gene transfer in the environment have not yet been determined. Several genomically sequenced strains containing complete GTA sequences similar to Rhodobacter capsulatus (RcGTA, type strain) were screened to ascertain if they produced putative GTAs, and at what abundance. Five of nine marine strains screened to date spontaneously produced virus-like particles (VLP's) in stationary phase. Three of these strains have demonstrated gene transfer activity, two of which were documented by this lab. These two strains Roseovarius nubinhibens ISM and Nitratireductor 44B9s, were utilized to produce GTAs designated RnGTA and NrGTA and gene transfer activity was verified in culture. Cell-free preparations of purified RnGTA and NrGTA particles from marked donor strains were incubated with natural microbial assemblages to determine the level of GTA-mediated gene transfer. In conjunction, several ambient environmental parameters were measured including lysogeny indicated by prophage induction. GTA production in culture systems indicated that approximately half of the strains produced GTA-like particles and maximal GTA counts ranged from 10-30% of host abundance. Modeling of GTA-mediated gene transfer frequencies in natural samples, along with other measured environmental variables, indicated a strong relationship between GTA mediated gene transfer and the combined factors of salinity, multiplicity of infection (MOI) and ambient bacterial abundance. These results indicate that GTA-mediated HGT in the marine environment with the strains examined is favored during times of elevated bacterial and GTA abundance as well as in areas of higher salinity.

Table des matières Préambule Termes Abandon institutionnel / Traumatisme du sanctuaire Activités fondées sur des données probantes Aidant naturel / Proche aidant Anxiété clinique Bien-être Blessure de santé mentale / Blessure psychologique Blessure de stress opérationnel (BSO) Blessure de stress post-traumatique (BSPT) Blessure de stress professionnel / Blessure de stress organisationnel Blessure morale / Détresse morale / Dilemme moral Compétence culturelle Crise de panique Croissance post-traumatique (CPT) Dépression majeure Diagnostic Équité, diversité, et inclusion (ÉDI) Épuisement professionnel Événement potentiellement traumatisant sur le plan psychologique (ÉPTP) / Événement traumatisant sur le plan psychologique / Facteur de stress potentiellement traumatique sur le plan psychologique / Facteur de stress traumatique sur le plan psychologique (SPTP) / Événement traumatisant / Facteur de stress traumatique Expérience négative de l’enfance (ENE) Fardeau des aidants naturels Incident critique Intersectionnalité Maladie mentale Médecine fondée sur des données probantes (médecine factuelle) Mieux-être Personnel de la sécurité publique (PSP) Personnes ayant une expérience vécue [de trouble mental ou de problème de santé mentale] / Experts par expérience [de trouble mental ou de problème de santé mentale] Premier répondant Prestataire Problème de santé mentale / Mauvais état de santé mentale Purge LGBT Résilience Rétablissement Santé Santé mentale Satisfaction des aidants naturels Soutien par les pairs Soutien social Stigmatisation Stress / Facteur de stress / Événement stressant Stress post-traumatique (SPT) Stress psychologique post-traumatique / Stress consécutif à un traumatisme / Syndrome de stress post-traumatique / Symptômes de stress post-traumatique / Stress psychologique / Traumatisme psychique / Stress traumatique sur le plan psychologique / Stress traumatique Stress traumatique indirect Stress traumatique secondaire Traumatisme / Blessure traumatique Traumatisme complexe Traumatisme du sanctuaire Traumatisme indirect Traumatisme psychique / Blessure traumatisante sur le plan psychologique Traumatisme sexuel militaire (TSM) Trois services d’intervention d’urgence Trouble d’anxiété Trouble de stress aigu Trouble de stress post-traumatique (TSPT) Trouble de stress post-traumatique complexe (TSPT-C) Trouble mental Usure de compassion Vérification du bien-être Violence fondée sur le genre Violence interpersonnelle Remerciements Équipe des auteurs principaux Avis Préambule Contexte Le trouble de stress post-traumatique (TSPT) constitue une invalidité potentielle maintenant largement reconnue comme un problème de santé publique1. Prévalence du TSPT La première recherche nationale à porter sur la proportion de membres du personnel de sécurité publique canadiens présentant des ensembles de symptômes correspondant à divers troubles mentaux a révélé que 23,2 % des participants faisant partie de l’échantillon total ont obtenu un dépistage positif pour le TSPT2. La première version du glossaire a été planifiée et élaborée afin de favoriser une discussion ouverte entre les nombreux universitaires, chercheurs, cliniciens, spécialistes en politiques, membres d’organisations non gouvernementales, membres du personnel de la sécurité publique, membres actifs et vétérans des Forces armées canadiennes ainsi que personnes ayant souffert d’un TSPT qui ont assisté à la Conférence nationale sur le TSPT de 2019, afin de contribuer à l’élaboration du Cadre fédéral relatif à l’état de stress post-traumatique1 et afin d’aborder les principaux domaines prioritaires énoncés dans le document intitulé Soutenir le personnel de la sécurité publique du Canada : Plan d’action sur les blessures de stress post-traumatique8. Évolution des termes Les cliniciens choisissent soigneusement leurs mots pour décrire et résumer les signes, les symptômes et les diagnostics complexes et pour proposer aux patients et aux clients les traitements les plus susceptibles de les aider.

Introduction. Les thérapeutes respiratoires ont été confrontés à des situations moralement difficiles tout au long de la pandémie de COVID-19, en particulier le fait d’avoir peu de ressources pour effectuer leur travail ou encore la participation à des appels vidéo avec les familles de patients mourants. La détresse morale (c’est-à-dire la détresse psychologique résultant de l’interdiction de suivre un plan d’action reconnu et approprié d’un point de vue éthique) est associée à une foule de conséquences psychologiques et fonctionnelles négatives (dépression, anxiété, symptômes du trouble de stress post‑traumatique [TSPT], déficience fonctionnelle, etc.) et au fait d’envisager de quitter son poste. L’objectif de cette étude était de comprendre l’effet de la détresse morale et de ses conséquences psychologiques et fonctionnelles sur le fait que des thérapeutes respiratoires canadiens aient envisagé de quitter leur poste clinique pendant la pandémie de COVID‑19.Méthodologie.Des thérapeutes respiratoires canadiens (N = 213) ont répondu à un sondage en ligne entre février et juin 2021. Des caractéristiques inividuelles de base (âge, sexe/genre, etc.) ont été recueillies, ainsi que des mesures psychométriques validées de la détresse morale, de la dépression, de l’anxiété, du stress, du TSPT, de la dissociation, de la déficience fonctionnelle, de la résilience et des expériences négatives vécues durant l’enfance.Résultats. Un thérapeute respiratoire sur quatre a déclaré envisager de quitter son poste en raison d’une détresse morale. Ceux qui envisageaient de le faire ont fait état de niveaux élevés de détresse morale et de conséquences psychologiques et fonctionnelles négatives comparativement aux thérapeutes respiratoires qui n’envisageaient pas de quitter leur poste. Plus de la moitié (54,5 %) de ceux qui envisageaient de quitter leur poste ont obtenu un score supérieur au seuil indiquant un diagnostic potentiel de TSPT. Le fait d’avoir déjà envisagé de quitter un poste auparavant en raison d’une détresse morale et le fait d’avoir effectivement quitté un poste antérieur augmentaient significativement la probabilité d’envisager de quitter son poste, tout comme la détresse morale liée au système et les symptômes de TSPT, mais la contribution de ces derniers facteurs était faible.Conclusion.Les thérapeutes respiratoires canadiens qui envisageaient de quitter leur poste en raison d’une détresse morale ont signalé des niveaux élevés de détresse et de conséquences psychologiques et fonctionnelles négatives. Il semble néanmoins peu probable que ces facteurs individuels soient les principaux facteurs pour lesquels ils envisageaient de quitter leur poste, car les effets en étaient faibles. D’autres recherches sont nécessaires pour cerner les facteurs organisationnels plus vastes susceptibles d’inciter les thérapeutes respiratoires canadiens à vouloir quitter leur poste.

Throughout the COVID-19 pandemic, healthcare workers (HCWs) have been exposed to highly stressful situations, including increased workloads and exposure to mortality, thus posing a risk for adverse psychological outcomes, including acute stress, moral injury, and depression or anxiety symptoms. Although several reports have sought to identify the types of coping strategies used by HCWs over the course of the pandemic (e.g., physical activity, religion/spirituality, meditation, and alcohol), it remains unclear which factors may influence HCWs’ choice of these coping strategies. Accordingly, using a qualitative approach, the purpose of the present study was to gain a deeper understanding of the factors influencing HCWs’ choice of coping strategies during the COVID-19 pandemic in Canada. Fifty-one HCWs participated in virtual, semi-structured interviews between February and June 2021. Interview transcripts were analysed through an inductive thematic approach, yielding two primary themes. First, HCWs described an ongoing shift in their approach to coping depending on their mental “bandwidth”, ranging from “quick fix” to more “intentional effort” strategies to engage in proactive strategies to improve mental health. Second, many HCWs identified various barriers to desired coping strategies during the pandemic, including the preponderance of pandemic- and other circumstantial-related barriers. The findings from this study offer a unique understanding of the factors influencing HCWs’ choice of coping strategies under novel and increased stress. This knowledge will be central to developing appropriate forms of support and resources to equip HCWs throughout and after the pandemic period, and in mitigating the potential adverse mental health impacts of this period of prolonged stress and potential trauma.