Browsing by Author "Kiryanova, Veronika"

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    Behavioural outcomes of mice perinatally exposed to fluoxetine
    (2011) Kiryanova, Veronika; Dyck, Richard H.
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    Long-Term Outcomes Resulting from Exposure to Stress and Fluoxetine During Development
    (2017) Kiryanova, Veronika; Dyck, Richard; Antle, Michael; Hill, Matthew; Pittman, Quentin; Olivier, Jocelien
    Depression, anxiety, and stress are common in pregnant women. One of the primary pharmacological treatments for anxiety and depression is the antidepressant fluoxetine (Flx). Maternal stress, depression, and Flx exposure are known to effect neurodevelopment of the offspring; however, their combined effects have been scarcely studied. In this thesis, we examine the combined effects of maternal stress during pregnancy and perinatal exposure to Flx on the behaviour and the biochemical outcomes of mice as adults. Furthermore, we examine whether serotonin 1A (5-HT1A) receptors mediate the effects of maternal stress on mouse behaviour. In the adult male offspring, while perinatal exposure to Flx increased aggressive behaviour, prenatal maternal stress decreased aggressive behaviour. Interestingly, the combined effects of stress and Flx normalized aggressive behaviour. Furthermore, perinatal Flx treatment led to a decrease in anxiety-like behaviour in male offspring. In adult female offspring, maternal stress led to hyperactivity and alterations of prepulse inhibition. Maternal treatment with Flx had a potentially beneficial effect on spatial memory. The combination of prenatal stress and perinatal Flx exposure did not interact in their effects. Examination of the circadian behaviour demonstrated that mice exposed to prenatal stress had smaller light-induced phase-delays. Mice exposed to perinatal Flx required more days to re-entrainment to an 8-hour phase advance of their light-dark cycle. Mice subjected to either perinatal Flx or to PS had larger light-induced phase-advances and smaller phase advances to 8-OH-DPAT. Flx treatment partially reversed the effect of PS on phase shifts to late-night light exposure and to 8-OH-DPAT. An examination of the biochemical outcomes showed that the serotonergic, the endocannabinoid and the glucocorticoid systems were altered following exposure to perinatal stress and Flx. These alterations were long-lasting and sex-specific. Using the 5-HT1A receptor knockout mouse model, we show that, 5-HT1A receptor genotype moderated the effects of stress on social behaviour of male mice and on activity levels of females. Furthermore, independent of genotype, prenatal stress resulted in a change in locomotor activity and fear memory in male mice and a change in prepulse inhibition in female animals. 5-HT1A receptor knockout affected anxiety in male mice and fear memory and prepulse inhibition in female mice. Together, these data indicate that maternal exposure to stress and Flx have a number of sustained effects on the brain and behaviour of male and female offspring, however, females appear to be protected from the behavioural effects of Flx and some of the effects of stress. Our findings also indicate that 5-HT1A receptor availability can affect outcomes of the offspring following prenatal stress; these effects are highly sex specific.
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    Patient-reported experiences and outcomes of virtual care during COVID-19: a systematic review
    (2023-12-01) Bajgain, Bishnu; Rabi, Sarah; Ahmed, Sadia; Kiryanova, Veronika; Fairie, Paul; Santana, Maria J.
    Abstract Introduction The onset of COVID-19 has caused an international upheaval of traditional in-person approaches to care delivery. Rapid system-level transitions to virtual care provision restrict the ability of healthcare professionals to evaluate care quality from the patient's perspective. This poses challenges to ensuring that patient-centered care is upheld within virtual environments. To address this, the study’s objective was to review how virtual care has impacted patient experiences and outcomes during COVID-19, through the use of patient-reported experience and outcome measures (PREMs and PROMs), respectively. Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to evaluate patient responsiveness to virtual care during COVID-19. Using an exhaustive search strategy, relevant peer-reviewed articles published between January 2020 and 2022 were pulled from MEDLINE, CINAHL, EMBASE, and PsychInfo databases. Study quality was independently assessed by two reviewers using the Mixed Methods Appraisal Tool. A patient partner was consulted throughout the study to provide feedback and co-conduct the review. Results After removing duplicates, 6048 articles underwent title and abstract review, from which 644 studies were included in the full-text review stage. Following this, 102 articles were included in the study. Studies were published in 20 different countries, were predominantly cross-sectional, and reported on the delivery of virtual care in specialized adult outpatient settings. This review identified 29 validated PREMs and 43 PROMs. Several advantages to virtual care were identified, with patients citing greater convenience, (such as saving travel time and cost, less waiting experienced to see care providers) and increased protection from viral spread. Some studies also reported challenges patients and caregivers faced with virtual care, including feeling rushed during the virtual care appointment, lack of physical contact or examination presenting barriers, difficulty with communicating symptoms, and technology issues. Conclusion This review provides supportive evidence of virtual care experiences during the COVID-19 pandemic from patient and caregiver perspectives. This research provides a comprehensive overview of what patient-reported measures can be used to record virtual care quality amid and following the pandemic. Further research into healthcare professionals’ perspectives would offer a supportive lens toward a strong person-centered healthcare system.