The Association of Frequency of Worry About Financial Debt With Substance Use Among Adults in Ontario, Canada.

BACKGROUND: Financial debt and associated stress might increase the risk of substance use problems or exacerbate existing ones. Little evidence is available about the degree of debt stress and its association with substance use. The objective of this study was to examine the associations of the frequency of worry about debt with heavy episodic drinking (HED), daily smoking, e-cigarette use, and cannabis use in the past 30 days. METHODS: Data were utilized from the 2020/2022 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The surveys employed a web-based panel survey of 6038 adults and collected data on debt-related stress, HED, tobacco smoking, e-cigarettes, and cannabis use in the past 30 days. Odds ratios (OR) were estimated from logistic regression models accounting for sociodemographic factors. RESULTS: Overall, 18.4% of respondents reported that they were worried about their debt most or all of the time. Accounting for household income, educational status, employment status, and other factors, the results revealed that there was a dose-response relationship between the frequency of worry about debt and substance use including daily smoking, e-cigarette use, and cannabis use in the past 30 days compared to those who were not worried at all about their debt. Sex differences were also found in the association between worry about debt and e-cigarette use. CONCLUSIONS: The frequency of worry about debt might have an important role in substance use, which suggests that financial well-being is vital in substance use prevention and harm reduction.

Disparities in cannabis-related emergency department visits across depressed and non-depressed individuals and the impact of recreational cannabis policy in Ontario, Canada.

BACKGROUND: Recreational cannabis policies are being considered in many jurisdictions internationally. Given that cannabis use is more prevalent among people with depression, legalisation may lead to more adverse events in this population. Cannabis legalisation in Canada included the legalisation of flower and herbs (phase 1) in October 2018, and the deregulation of cannabis edibles one year later (phase 2). This study investigated disparities in cannabis-related emergency department (ED) visits in depressed and non-depressed individuals in each phase. METHODS: Using administrative data, we identified all adults diagnosed with depression 60 months prior to legalisation (n = 929 844). A non-depressed comparison group was identified using propensity score matching. We compared the pre-post policy differences in cannabis-related ED-visits in depressed individuals v. matched (and unmatched) non-depressed individuals. RESULTS: In the matched sample (i.e. comparison with non-depressed people similar to the depressed group), people with depression had approximately four times higher risk of cannabis-related ED-visits relative to the non-depressed over the entire period. Phases 1 and 2 were not associated with any changes in the matched depressed and non-depressed groups. In the unmatched sample (i.e. comparison with the non-depressed general population), the disparity between individuals with and without depression is greater. While phase 1 was associated with an immediate increase in ED-visits among the general population, phase 2 was not associated with any changes in the unmatched depressed and non-depressed groups. CONCLUSIONS: Depression is a risk factor for cannabis-related ED-visits. Cannabis legalisation did not further elevate the risk among individuals diagnosed with depression.

Psychological distress, non-medical use of prescription medications, and perceived unmet mental health care needs: a cross-sectional study of Ontario students.

PURPOSE: The non-medical use of prescription medications among adolescents has become a concerning public health issue. This study assessed the prevalence of the non-medical use of prescription medications in Ontario high school students, and explored the moderating effect of this use on the relationship between psychological distress and unmet mental health needs. METHODS: Cross-sectional data for 4896 students, age 14-18, were drawn from the 2019 Ontario Student Drug Use and Health Survey. Psychological distress was measured using the Kessler-6 Distress Scale, unmet mental health needs were defined by self-report (yes/no), and non-prescription medication use was defined by self-reported frequency of use. Using logistic regression, we explored the effect of the non-medical use of prescription medications on the relationship between psychological distress and unmet mental health needs. RESULTS: High proportions of Ontario students reported serious psychological distress (22%), some degree of unmet mental health need (38%), and/or non-medical use of prescription medications (13%). While there were strong associations between psychological distress and unmet mental health need, this association was weaker among those reporting non-medical use of prescription medications (OR = 3.3, 95% CI 1.9-5.7) compared to non-users (OR = 5.6, 95% CI 4.5-7.1). CONCLUSION: Our findings suggest that Ontario students experiencing distress and using non-prescribed medications are less likely to identify a need for mental health support, highlighting the consequences of apparent self-medication through misuse of prescription medications. To assist in the redirection of adolescent perceptions of healthy coping strategies, population-based educational programming, with targeted promotion of both formal and informal mental health care resources, should be considered.

Whole genome landscapes of uveal melanoma show an ultraviolet radiation signature in iris tumours.

Uveal melanoma (UM) is the most common intraocular tumour in adults and despite surgical or radiation treatment of primary tumours, ~50% of patients progress to metastatic disease. Therapeutic options for metastatic UM are limited, with clinical trials having little impact. Here we perform whole-genome sequencing (WGS) of 103 UM from all sites of the uveal tract (choroid, ciliary body, iris). While most UM have low tumour mutation burden (TMB), two subsets with high TMB are seen; one driven by germline MBD4 mutation, and another by ultraviolet radiation (UVR) exposure, which is restricted to iris UM. All but one tumour have a known UM driver gene mutation (GNAQ, GNA11, BAP1, PLCB4, CYSLTR2, SF3B1, EIF1AX). We identify three other significantly mutated genes (TP53, RPL5 and CENPE).

Associations between self-reported lifetime history of traumatic brain injuries and current disability assessment in a population sample of Canadian adults.

OBJECTIVE: This study describes the association between history of lifetime traumatic brain injury (TBI) and current disabling functional restrictions among Ontario adults. SETTING AND DESIGN: A two-stage rolling cross-sectional sample of 6,048 adults aged 18 to 93 were interviewed by computer assisted telephone interviewing between 2011-2013 regarding their mental health and substance use in Ontario, Canada. TBI criteria were defined by loss of consciousness for minimum five minutes or at least one overnight hospitalization. Dimensions of functionality restrictions in the last 30 days were measured with the WHO Disability Assessment Schedule (WHODAS). RESULTS: The estimated mean for global disability in this sample of Ontario adults was 2.75 (SD = 5.4, range 0-40). The estimated means of global disability for individuals who reported a history of lifetime TBI was 4.16 (SD = 7.12) and compared with 2.46 (SD = 4.98) for individuals who never had a TBI (p < 0.001). Adults with a history of lifetime TBI had greater odds of global and item disability including restricted cognition, decreased self-care, difficulties with social relationships, fewer life activities and reduced participation in society compared to adults without a history of TBI (p < 0.001), even after adjusting for values of age, sex, marital status, household income and education. CONCLUSION: The co-occurrence of history of lifetime TBI with self-reported disability within the past 30 days provide evidence that careful consideration, planning and understanding of short and long term health needs of TBI survivors are critical.

Therapeutic use of cannabis: Prevalence and characteristics among adults in Ontario, Canada.

OBJECTIVE: To investigate the prevalence of therapeutic cannabis use within a general population sample of adults and to describe various characteristics associated with use. METHODS: Data were derived from the 2013 and 2014 CAMH Monitor Survey of adults in Ontario, Canada. This repeated cross-sectional survey employed a regionally stratified design and utilized computer-assisted telephone interviewing. Analyses were based on 401 respondents who reported using cannabis. RESULTS: The data indicated that 28.8% of those who used cannabis in the past year self-reported using cannabis for therapeutic purposes. Of therapeutic users, 15.2% reported having medical approval to use cannabis for therapeutic purposes. Cannabis use for therapeutic purposes was associated with more frequent use of cannabis, a moderate to high risk of problematic cannabis use, and a greater likelihood of using prescription opioids for medical purposes. There was little difference in cannabis use for therapeutic purposes according to sex, age, and marital status after adjusting for opioid use and problematic cannabis use. CONCLUSION: Findings suggest some potential negative consequences of cannabis use for therapeutic purposes; however, further research is needed to better understand the range and patterns of use and their corresponding vulnerabilities.

Does socioeconomic status moderate the relationships between school connectedness with psychological distress, suicidal ideation and attempts in adolescents?

OBJECTIVE: Research has indicated that school connectedness acts as a buffer against depressive symptoms and suicidality. However, little is known about the role of socioeconomic status (SES) on these links. The present study examined the moderating role of subjective SES and parental education on the relationships between school connectedness and psychological distress, suicidal ideation and suicide attempts. METHODS: Data were gathered from 4955 participants within the 2013 cycle of the Ontario Students Drug Use and Health Survey, a province-wide repeated school-based survey of students in grade 7 to 12 across Ontario, Canada. RESULTS: Results indicated that higher subjective SES is associated with high levels of school connectedness. Subjective SES is also a significant moderator of the association between school connectedness and psychological distress, but not between school connectedness and suicidal ideation or attempts. At low subjective SES, there was no difference in risk of psychological distress between students with high and low levels of school connectedness. However, at higher subjective SES, students with high levels of school connectedness have lower odds of psychological distress than those with low levels of school connectedness. The associations between school connectedness and each of the mental health outcomes did not significantly vary with parental education. CONCLUSIONS: These findings suggest that the beneficial effects of school connectedness on mental health problems may be more strongly related to adolescents' status beliefs rather than parental education. Future research is needed to better understand the mechanism through which subjective SES and school connectedness influence psychological distress.

Use of Social Networking Sites and Risk of Cyberbullying Victimization: A Population-Level Study of Adolescents.

Social networking sites (SNSs) have gained considerable popularity among youth in recent years; however, there is a noticeable paucity of research examining the association between the use of these web-based platforms and cyberbullying victimization at the population level. This study examines the association between the use of SNSs and cyberbullying victimization using a large-scale survey of Canadian middle and high school students. Data on 5,329 students aged 11-20 years were derived from the 2013 Ontario Student Drug Use and Health Survey. Logistic regression was used to examine the relationship between the use of SNSs and cyberbullying victimization while adjusting for covariates. Overall, 19 percent of adolescents were cyberbullied in the past 12 months. Adolescents who were female, younger, of lower socioeconomic status, and who used alcohol or tobacco were at greater odds of being cyberbullied. The use of SNSs was associated with an increased risk of cyberbullying victimization in a dose-response manner (p-trend <0.001). Gender was not a significant moderator of the association between use of SNSs and being cyberbullied. Results from this study underscore the need for raising awareness and educating adolescents on effective strategies to prevent cyberbullying victimization.

The role of social factors in the use of licit drugs among university students from one university in Kingston, Jamaica / El papel de fatores sociales en el uso de drogas licitas en estudiantes universitarios de una universidad de Kingston, Jamaica / O papel de fatores sociais no uso de drogas lícitas em estudantes de uma universidade em Kingston, Jamaica

A quantitative, descriptive and exploratory study, with a cross-sectional design aimed at examining whether social factors are related to licit drug use among university students in one university in Kingston, Jamaica. The non-probabilistic sample was composed of 335 students from a specific university in Kingston, Jamaica. A questionnaire was developed with five validated scales that interrogated about the influence of the peer group, the family relationships, the entertainment, the spirituality, and drug consumption. The data indicated that respondents with one or more friend who engaged in drug use were 9.5 times more likely to smoke tobacco and twice as likely to consume alcohol. Notably, respondents who had low spirituality were twice as likely to smoke tobacco and 1.3 times more likely to consume alcohol. These results suggest that having friends who use drugs may be a risk factor for alcohol and tobacco use, whereas greater spirituality may serve as a protective factor.

Investigación cuantitativa de tipo descriptiva-exploratoria, con diseño transversal que examinó el efecto moderador de ciertos factores socio-culturales en el consumo de drogas licitas entre estudiantes universitarios de una universidad en Kingston, Jamaica. La muestra non probabilistica fue conformada por 335 estudiantes de una universidad especifica de Kingston, Jamaica. Fue elaborado un cuestionario con cinco escalas ya validadas, que interrogaba sobre la influencia del grupo de pares, las relaciones familiares, el entretenimiento, la espiritualidad y el consumo de drogas. Se utilizó el programa SPSS versión 18 para el análisis estadística. Los datos indicaran que los respondientes con uno o mas anmigos que estaban involucrados con el uso de drogas eran 9.5 veces mas disponibles para fumar y dos veces mas para consumir alcole. Los respondientes que tinian baja espiritualidad eran dos veces mas proponientes para fumar y 1.3 veces mas proponientes de consumir alcole. Los datos indicaran haber asociacion significante entre los factores sociales y el consume de drogas licitas.

Pesquisa quantitativa, descritiva e exploratória, com desenho transversal, que examinou o efeito moderador de certos fatores demográficos e socioculturais no consumo de drogas lícitas entre estudantes universitários em uma universidade de Kingston, Jamaica. A amostra não probabilística foi composta por 335 estudantes de uma universidade na cidade de Kingston, Jamaica. Foi elaborado um questionário com cinco escalas validadas que questionavam sobre a influência dos pares, as relações familiares, o entretenimento, a espiritualidade e o consumo de drogas. Se utilizou o programa SPSS versão 18 para a análise estatística. Verificou-se que os estudantes da amostra que tinham pelo menos um amigo envolvido com drogas eram 9.5 vezes mais disponíveis para fumar e duas vezes mais para consumir álcool. Os estudantes que responderam que tinham baixa espiritualidade eram duas vezes mais proponentes a fumar e 1.3 vezes mais proponentes a consumir álcool. Os dados indicaram uma associação significativa entre os fatores sociais e o consumo de drogas líicitas.

Subjective social status, immigrant generation, and cannabis and alcohol use among adolescents.

Research indicates that subjective perceptions of socioeconomic status (SES) affect aspects of health and behavior. There has been little research attention to how objective (e.g., education) and subjective aspects of SES may differ in their influence on the substance use of adolescent immigrants. The present study examined whether the associations between subjective SES and substance use, and between parental education and substance use varied by immigrant generation. Data were derived from the 2011 Ontario Student Drug Use and Health Survey, a representative survey of students in the 7th to 12th grade. The sample for this study consisted of 9177 students 12-19 years of age; 48.4 % were female, 66.4 % were White/European, 5.2 % Black/Afro-Caribbean, 16.4 % Asian and 12 % other. Results indicated that subjective SES was more strongly associated with cannabis and alcohol use among first-generation immigrants than among adolescents of other immigrant generations even after adjusting for parental education. First-generation immigrants with low subjective SES had a lower probability of cannabis and regular alcohol use, but there was no difference in use between immigrant generations at high subjective SES. The associations between parental education and cannabis and alcohol use did not significantly vary with immigrant generation. The findings highlight the importance of status beliefs among adolescents, particularly among first-generation immigrants, and suggest that further research attention to such beliefs would enhance our understanding of SES and its links to adolescent health risk behaviors.

Meanings of home and mental well-being among Sudanese refugees in Canada.

OBJECTIVES: This article examines family and social factors that affect refugee mental health during resettlement by presenting qualitative analysis of the concept of home and its functional and psychological meanings based on findings from research with Sudanese refugees in Canada. DESIGN: Data were collected in two successive multi-method, community-based studies between 2003 and 2007 with Sudanese refugee participants in Ontario and Alberta, Canada. The first study used survey methods with 220 participants in seven sites and the second, in-depth qualitative interviews with 30 community members in three sites. RESULTS: In the first study, economic hardship and family adaptation challenges were reported to affect Sudanese mental well-being. The second study explored cultural aspects of Sudanese family and community well-being in greater depth. Meanings of home emerged from data as a key concept linking social support, resettlement, and mental health. Findings highlight how the presence or absence of the social supports associated with home affect refugees' mental health during resettlement. The analysis focuses on four themes: emotional support; fulfilling social roles and expectations; problem solving and conflict resolution; and dignity and growth, as well as perceived impact on community mental health. CONCLUSION: Qualities of home that Sudanese lack during resettlement points to critical gaps that must be filled by mental health and other service providers to promote positive refugee mental health in countries of resettlement.

Predictors of emotional problems and physical aggression among children of Hong Kong Chinese, Mainland Chinese and Filipino immigrants to Canada.

BACKGROUND AND STUDY AIMS: Data from the New Canadian Children and Youth Study (NCCYS), a national study of immigrant children and youth in Canada, are used to examine the mental health salience of putatively universal determinants, as well as of immigration-specific factors. Universal factors (UF) include age, gender, family and neighbourhood characteristics. Migration-specific (MS) factors include ethnic background, acculturative stress, prejudice, and the impact of region of resettlement within Canada. METHODS: In a sample of children from Hong Kong, the Philippines and Mainland China, the study examined the determinants of emotional problems (EP), and physical aggression (PA). A two-step regression analysis entered UF on step 1, and MS variables on step 2. RESULTS: Universal factors accounted for 12.1% of EP variance. Addition of MS variables increased explained variance to 15.6%. Significant UF predictors: parental depression, family dysfunction, and parent's education. Significant MS variables: country of origin, region of resettlement, resettlement stress, prejudice, and limited linguistic fluency. UF accounted for 6.3% of variance in PA scores. Adding migration-specific variables increased variance explained to 9.1%. UF: age, gender, parent's depression, family dysfunction. MS: country of origin, region of resettlement, resettlement stress, and parent's perception of prejudice. CONCLUSIONS: Net of the effect of factors affecting the mental health of most, if not all children, migration-specific variables contribute to understanding immigrant children's mental health.

Perceived financial status, health, and maladjustment in adolescence.

This study examines the relationship between adolescent perception of family financial status and diverse aspects of health and maladjustment. Data were derived from the 2005 Ontario Student Drug Use Survey of 7th-12th grade students in ontario, Canada. This biennial survey monitors mental and physical health, substance use, and delinquent behavior in adolescent students. Results indicate that the significance of perceived financial status varies across adolescent outcomes. Greater emotional distress and lower self-rated health are associated with a perception of below average financial status. The associations of illicit drug use and hazardous and harmful drinking with perceived financial status vary for younger and older adolescents. Adjustments for parental education highlight differences in the influences of perceived financial status and parental education on health and behavior. Results highlight the utility of perceived family financial status in examinations of adolescent health and behavior, and the importance of examining diverse aspects of health and maladjustment.

Mental distress, economic hardship and expectations of life in Canada among Sudanese newcomers.

As part of a settlement needs assessment of 220 recently arrived Sudanese refugees and immigrants in seven cities, we examined overall health status, indicators of mental distress, economic hardship and expectations of life in Canada. Data were collected in a community-based study using qualitative and quantitative techniques. Results indicate that those Sudanese for whom life in Canada was not what they expected and those who experienced economic hardship as measured by worry over having enough money for food or medicine experienced poorer overall health and reported a greater number of symptoms of psychological distress. After controlling for demographic and related variables, we found that individuals who were experiencing economic hardship were between 2.6 and 3.9 times as likely to experience loss of sleep, constant strain, unhappiness and depression, and bad memories as individuals who do not experience hardship. Healthcare providers should be aware of how postmigration social disadvantages may increase the risk of mental distress particularly among refugees.