Predicting Time to Return to Cannabis Use After a Cessation Attempt: Impact of Cumulated Exposure to Nicotine-Containing Products.

Objective: Cannabis is frequently co-used with tobacco/nicotine products, especially among young adults. Little is known about the effects of this co-use on cannabis cessation outcomes. Within a sample of young adults using cannabis frequently (current use of ≥5 days/week in the past 3 months), this study aimed to (a) document sources of exposure to tobacco/nicotine products, whether used simultaneously with cannabis or on different occasions, (b) examine if the level of cumulated exposure to tobacco/nicotine (self-reported or from biochemical testing) could predict time to cannabis lapse during a cannabis abstinence period, and (c) explore the relationship between nicotine/tobacco exposure and time to cannabis lapse according to tobacco cigarette smoking status. Method: Urine cotinine measures and self-reported data on use of different tobacco/nicotine products, collected from 32 participants (aged 19 to 23), were analyzed to predict time to lapse during a 2-week period of attempted abstinence from cannabis, controlling for cannabis dependence and sex. Results: Half of participants (56.3%) used at least one tobacco/nicotine product. Higher urine cotinine, representing higher cumulated tobacco/nicotine exposure, was related to a higher risk of lapsing (Hazard Ratio [HR] = 1.64; 95%CI [1.04, 2.58]). The risk of lapsing was even higher ([HR] = 3.46; 95%CI [1.17, 10.25]) among heavily tobacco/nicotine exposed (>600 ng/mL, urine cotinine) participants than among unexposed (<50 ng/mL) or lightly/moderately exposed (50-600 ng/mL) participants. Among those smoking cigarettes (solely or in combination with other products), there was no relation between cotinine level and time to lapse, likely due to a reduced variability in abstinence probability and a high likelihood of lapse observed for higher cotinine levels, mainly achieved by cigarette use. Conclusions: With a rapidly changing landscape of tobacco/nicotine use, our results underscore the need to consider all sources of tobacco/nicotine exposure to fully understand the specific and cumulative contributions of tobacco/nicotine to cannabis cessation outcomes.

Using latent class analysis to operationalize a wholistic assessment of Inuit health and well-being.

Many indigenous cultures conceptualize health wholistically, whereby physical, mental, spiritual and relational dimensions of health are interconnected. Yet, quantitative approaches to studying Indigenous health remain anchored in western perspectives, that separate the dimensions of health. This paper aims to operationalize a wholistic indicator of health based on the IQI model of Inuit health. Variables from the 2017 Nunavik Health Survey (N = 1196) were selected based on their representativeness of IQI model. Exploratory Latent Class Analysis (LCA) was used to identify wholistic health profiles. Once participants assigned to their health profile, sociodemographic characteristics were compared across profiles, and multinomial regression models were used to examine the relationship between community-level social determinants of health and the profiles. The LCA revealed three health profiles, labelled as "excellent", "good" and "fair" based on the distribution of answers to the indicators. Nunavimmiut in "excellent" and "good" health were more likely to: rate their health positively; be over 30 years old; be in a relationship; and have participated or volunteered in community events. Nunavimmiut in "fair" health tended to report lower levels of community cohesion, family relationships, and emotional support. Intergrating culturally relevant models of health can support improved health status assessments and identify opportunities for health promotion.

Smoking cessation attempts and successes among Nunavimmiut.

OBJECTIVES: The smoking rate in Canada has declined in past decades, yet smoking rates remain high in Nunavik (northern Québec), where an estimated 80% of adult respondents smoke. We investigated sociodemographic factors, smoking behaviours, harm perception, and social support as determinants of smoking cessation attempts and successes among Nunavimmiut. METHODS: Past year smoking frequency, quantity smoked, and cessation attempts and aids were documented in a sample of 1326 Nunavimmiut aged 16 and over in the Qanuilirpitaa? 2017 survey. Sociodemographic indicators, social support, cessation aids, and smoking harm perception were investigated as potential determinants. All factors were modeled by logistic regressions and adjusted for age and sex. RESULTS: Thirty-nine percent of smokers tried to quit smoking in the preceding year, and 6% of those were successful. Older Nunavimmiut (aOR = 0.84 [0.78, 0.90]) and those smoking 20 + cigarettes/day (aOR = 0.94 [0.90, 0.98]) were less likely to attempt to quit. Ungava coast residents (aOR = 1.87 [1.36, 2.57]), separated/widowed/divorced individuals (aOR = 2.43 [1.09, 5.38]), and occasional smokers (aOR = 2.77 [1.61, 4.76]) compared to those living on the Hudson coast, single individuals, and daily smokers, respectively, were more likely to report cessation attempts. Most used no particular cessation aid (58%), 28% relied on family/self-help/support programs, and 26% used medication. Women were more likely to rely on spirituality/traditional methods (aOR = 1.92 [1.00, 3.71]) and less likely to rely on electronic cigarettes (aOR = 0.33 [0.13, 0.84]), as were older participants (aOR = 0.67 [0.49, 0.94]). Those with more years of schooling were more likely to rely on electronic cigarettes (aOR = 1.47 [1.06, 2.02]). These estimates are prone to biases due to the relatively low participation rate in the survey (37%). CONCLUSION: Despite many attempts reported by participants, regional partners of this study underlined that successful smoking cessation remains a challenge for many Nunavimmiut. Key differences were identified in approaches and determinants of smoking cessation attempts, but most smokers did not use cessation aids. These results are in line with the experience of the Inuit partners of this study and can inform targeted public health interventions to support the many Nunavimmiut trying to quit smoking, notably increasing accessibility and acceptability of cessation aids. Inuit partners of this study highlighted the importance for interventions and communication efforts to reflect Nunavik's context.

RéSUMé: OBJECTIFS: Le taux de tabagisme a diminué au Canada dans les dernières décennies, mais il demeure élevé au Nunavik (Nord du Québec) où on estime que 80 % des participants adultes fument. Cet article étudie les facteurs sociodémographiques, les habitudes tabagiques, le support social et la perception du risque comme déterminants de la cessation tabagique chez les Nunavimmiut. MéTHODE: Les habitudes de tabagisme (fréquence, quantité, tentatives d'abandon) sur 12 mois ont été documentées chez 1 326 Nunavimmiut (16 ans et plus) dans l'enquête Qanuilirpitaa? 2017. Tous les facteurs considérés comme déterminants potentiels ont été modélisés par régression logistique (ajustement pour âge et sexe). RéSULTATS: Trente-neuf pourcent des fumeurs ont tenté d'arrêter et 6 % de ceux-ci ont réussi. Les Nunavimmiut plus âgés (RCa = 0,84[0,78, 0,90]) et ceux fumant 20 + cigarettes/jour (RCa = 0,94[0,90, 0,98]) étaient moins susceptibles d'avoir rapporté une tentative d'abandon. Les résidents de l'Ungava (RCa = 1,87[1,36, 2,57]), ceux séparés/divorcés/veufs (RCa = 2,43[1,09, 5,38]) et les fumeurs occasionnels (RCa = 2,77[1,61, 4,76]), comparés aux résidents de l'Hudson, aux célibataires et aux fumeurs quotidiens, respectivement, étaient plus susceptibles d'avoir tenté un abandon. La majorité n'ont utilisé aucune aide (58 %), 28 % se sont tournés vers la famille/auto-assistance/groupe de soutien et 26 % a eu recours à la médication. Les femmes utilisaient plus fréquemment la spiritualité ou des méthodes traditionnelles (RCa = 1,92[1,00, 3,71]) et moins fréquemment la cigarette électronique (RCa = 0,33[0,13, 0,84]), tout comme les plus âgés (RCa = 0,67[0,49, 0,94]). Ceux ayant complété plus d'années d'éducation utilisaient plus la cigarette électronique (RCa = 1,47[1,06, 2,02]). Ces estimés pourraient être biaisés puisque le taux de participation à l'enquête était relativement faible (37 %). CONCLUSION: Malgré plusieurs tentatives rapportées par les participants, les partenaires régionaux de cette étude ont souligné que la cessation tabagique demeure un défi pour plusieurs Nunavimmiut. Différentes approches et des déterminants de tentatives de cessation ont été identifiés, mais la majorité n'ont pas utilisé d'aide à la cessation. Ces résultats, qui cadrent avec l'expérience des partenaires Inuit de cette étude, peuvent guider des interventions ciblées pour supporter les nombreux Nunavimmiut tentant de cesser de fumer, notamment faciliter l'accès et l'acceptabilité des méthodes de cessation. Les partenaires Inuit ont souligné l'importance d'avoir des interventions et méthodes de communication adaptées au contexte du Nunavik.

Sociocultural determinants of alcohol and cannabis use and misuse among Nunavimmiut.

OBJECTIVE: Stemming from historical traumas and changes in the Inuit way of life, substance use and its intertwined problems are a major cause of concern for Nunavimmiut. This study's objective is to investigate sociocultural determinants of substance use and misuse to inform culturally appropriate public health programs. METHODS: The 2017 Qanuilirpitaa? survey was conducted among a sample intended to be representative of Nunavimmiut aged 16 and over (total n = 1326). Sociocultural factors included cultural identity, land-based activities, involvement in community activities, social support, and family and community cohesion. The frequency of binge drinking (5 or more drinks on one occasion), cannabis use, and problematic substance use (CAGE and DAST-10) were documented. Data were analyzed using weighted multivariate logistic regressions. Inuit partners were involved from the planning of analyses to the co-interpretation of results. RESULTS: Nearly a third of Nunavimmiut aged 16 and over reported binge drinking at least once a week (29.3%), and 68.6% of drinkers were at risk of potential drinking problems. Forty-five percent (45%) reported using cannabis at least once a week, and 30% of drug users were at risk of potential drug abuse problems. Volunteering and participation in community activities were associated with lower odds of cannabis use, as was frequently going on the land with weekly binge drinking, potential drinking problems, and weekly cannabis use. Social support and community cohesion were associated with higher odds of weekly binge drinking, as was cultural identity (centrality scale) with potential drinking problems. CONCLUSION: Key determinants of substance use relevant to Inuit culture were identified. Results are in line with our Inuit partners' experience in their communities and are coherent with current land-based interventions implemented in Nunavik. A thorough understanding of substance use contexts and related stressors should guide the content and implementation of substance use programs in Nunavik.

RéSUMé: OBJECTIF: Suite aux traumas historiques et changements au mode de vie, l'usage de substance et les problèmes associés sont une source d'inquiétude majeure pour les Nunavimmiut. L'objectif de cette étude est d'investiguer les déterminants socioculturels de l'usage de substances pour adapter les programmes de santé publique à la culture Inuit. MéTHODES: L'enquête Qanuilirpitaa? 2017 repose sur un échantillon sélectionné pour être représentatif des Nunavimmiut (16 ans et plus; n = 1 326). Les déterminants socioculturels incluent : identité culturelle, activités sur le territoire, activités communautaires, support social, cohésion familiale et communautaire. La fréquence de consommation excessive d'alcool (5 consommations ou plus), l'usage du cannabis et l'usage problématique (CAGE et DAST-10) ont été documentés. Données analysées par régression multiple pondérée. Nos partenaires Inuit ont été impliqués de la planification des analyses à la co-interprétation des résultats. RéSULTATS: Près du tiers des Nunavimmiut de 16 ans et plus ont rapporté une consommation hebdomadaire excessive d'alcool (29,3 %) et 68,6 % de ceux consommant de l'alcool étaient potentiellement à risque de consommation problématique. Quarante-cinq pourcent (45 %) ont rapporté consommer du cannabis au moins une fois par semaine et 30 % des consommateurs de drogue étaient à risque de consommation potentiellement problématique. Le bénévolat et la participation aux activités communautaires étaient associés à une cote plus faible d'usage de cannabis, tout comme la pratique fréquente d'activités sur le territoire avec la consommation hebdomadaire excessive d'alcool, d'usage potentiellement problématique d'alcool et d'usage hebdomadaire de cannabis. Le support social et la cohésion communautaire étaient associés à une cote plus élevée de consommation excessive hebdomadaire d'alcool, tout comme l'identité culturelle (centralité) avec l'usage potentiellement problématique d'alcool. CONCLUSION: Des déterminants clés de l'usage de substance spécifiques aux Inuit ont été identifiés. Les résultats concordent avec le vécu de nos partenaires dans leurs communautés et le cadre théorique d'interventions déjà implémentées impliquant des activités sur le territoire et de guérison. Les contextes de consommation et les stresseurs associés devraient guider l'élaboration des programmes au Nunavik.

Profiles of childhood adversities in Inuit from Nunavik: description and associations with indicators of socioeconomic characteristics, support, and community involvement.

OBJECTIVES: Distress and associated health problems reported by Nunavik Inuit emanate from heterogeneous roots, including adverse childhood experiences. This study aims to (1) identify distinct childhood adversity profiles and (2) examine associations between these profiles and sex, socioeconomic characteristics, social support, and community involvement among Nunavimmiut. METHODS: In a sample of 1109 adult Nunavimmiut, sex, socioeconomic characteristics, support, community involvement, residential school attendance, and 10 forms of adverse childhood experiences (ACEs) were documented using questionnaires. Latent class analyses and weighted comparisons were performed for three subgroups: 18-49 years; 50 years and above with experience of residential school; and 50 years and above without experience of residential school. The analysis design, the manuscript drafts, and the key findings were discussed and co-interpreted with the collaboration of community representatives, taking into consideration Inuit culture and needs. RESULTS: A total of 77.6% of Nunavimmiut reported having experienced at least one form of childhood adversity. Three ACE profiles were identified among the 18-49-year-olds: low ACEs (43.0%), household stressors (30.7%), and multiple ACEs (26.3%). Two profiles characterized ACEs experienced among the 50-year-olds and over with and without history of residential schooling: low ACEs (80.1% and 77.2%, respectively) and multiple ACEs (19.9% and 22.8%, respectively). Among the group of 18-49-year-olds, as compared to the low ACE profile, the profile with household stressors included proportionally more women (odds ratio [OR] = 1.5) and was associated with lower involvement in volunteering and community activities (mean score reduced by 0.29 standard deviation [SD]) and lower family cohesion (SD = - 0.11), while the multiple ACE profile was related to a lower rate of employment (OR = 0.62), lower family cohesion (SD = - 0.28), and lower satisfaction with ability to practice traditional activities (SD = - 0.26). CONCLUSION: Childhood adversities among Nunavimmiut do not occur in isolation and experiencing multiple forms of childhood adversities predicts lower socioeconomic status, support, and community involvement in adulthood. Implications for the planning of health and community services in Nunavik are discussed.

RéSUMé: OBJECTIFS: La détresse et les problèmes de santé associés rapportés par les Inuits du Nunavik émanent de racines hétérogènes, notamment des expériences négatives durant l'enfance. Cette étude vise à : 1) identifier des profils distincts d'adversités vécues durant l'enfance; et 2) examiner les associations entre ces profils et le sexe, les caractéristiques socioéconomiques, le soutien social et l'engagement communautaire des Nunavimmiut. MéTHODES: Dans un échantillon de 1 109 adultes Nunavimmiut, le sexe, les caractéristiques socioéconomiques, le soutien, l'engagement communautaire, la fréquentation des pensionnats et 10 formes d'expériences négatives durant l'enfance (ENE) ont été documentés à l'aide de questionnaires. Des analyses de classes latentes et des comparaisons pondérées ont été réalisées pour trois sous-groupes : 18­49 ans; 50 ans et plus avec et sans expérience de pensionnat. Le plan d'analyses, les ébauches de manuscrit et les principaux résultats ont été discutés et co-interprétés avec la collaboration de représentants des communautés, en tenant compte de la culture et des besoins inuits. RéSULTATS: Un total de 77,6 % des Nunavimmiut ont déclaré avoir vécu au moins une forme d'adversité durant l'enfance. Trois profils d'ENE ont été identifiés chez les 18­49 ans : ENE faibles (43,0 %), facteurs de stress domestiques (30,7 %) et ENE multiples (26,3 %). Deux profils caractérisaient les ENE vécus chez les 50 ans et plus avec et sans antécédents de pensionnat : faibles ENE (80,1 % et 77,2 %, respectivement) et ENE multiples (19,9 % et 22,8 %, respectivement). Parmi le groupe des 18­49 ans, par rapport au profil des ENE faibles, le profil avec facteurs de stress domestiques incluait proportionnellement plus de femmes (rapport de cotes [RC] = 1,5) et était associé à une plus faible implication dans le bénévolat et les activités communautaires (score moyen réduit de 0,29 écart-type [ET]) et une cohésion familiale plus faible (ET = -0,11), tandis que le profil d'ENE multiples était lié à un taux d'emploi plus faible (RC = 0,62), à une cohésion familiale plus faible (ET = -0,28) et à une plus faible satisfaction à l'égard de la capacité à pratiquer des activités traditionnelles (ET = -0,26). CONCLUSION: Les adversités vécues en enfance par les Nunavimmiut ne surviennent pas de manière isolée et le fait de vivre de multiples formes d'ENE prédit un statut socio-économique, un soutien et une implication communautaire inférieurs à l'âge adulte. Les implications pour la planification des services de santé et communautaires au Nunavik sont discutées.

The psychosocial dimension of housing in Nunavik: does social support vary with household crowding?

OBJECTIVES: Studies show that living in overcrowded households can contribute to the erosion of social support, which is an important factor in health and well-being. In this study, we examine the relationship between household crowding and social support for Inuit living in Nunavik (hereafter referred to as Nunavimmiut), a region where housing shortages are considered a serious public health problem. We assess whether overcrowding is associated with lower levels of perceived social support and whether this association varies by gender and age group. METHODS: Cross-sectional data are from Qanuilirpitaa? the 2017 Nunavik Health Survey (N = 1306; aged 16 years and older). A perceived social support index was derived from answers to questions related to three different components of social support: positive interaction, emotional support, and love and affection. Associations between overcrowding (more than one person per room) and perceived social support were assessed using weighted linear and logistic regressions, adjusted for several factors. Sex- and age-stratified analyses were also conducted. RESULTS: Nunavimmiut report significantly lower levels of social support when living in overcrowded households, independently of other covariates. Analyses stratified by sex and age further show that the detrimental association between overcrowding and perceived social support is higher and stronger for men and older adults (both men and women 55 years and older). CONCLUSION: Overcrowding is associated with lower levels of perceived social support, which is a key component of health for the general population and for Nunavimmiut. Future research should examine the factors creating stronger associations between overcrowding and lower social support for men and older adults.

RéSUMé: OBJECTIFS: Des études montrent que le fait de vivre dans un ménage surpeuplé peut contribuer à l'érosion du soutien social, qui est un facteur important de santé et de bien-être. Dans cette étude, nous examinons la relation entre le surpeuplement des ménages et le soutien social chez les Inuits du Nunavik, une région où la pénurie de logements est considérée comme un grave problème de santé publique. Nous évaluons si le surpeuplement est associé à des niveaux plus faibles de soutien social perçu chez les Inuits vivant au Nunavik (ci-après appelés Nunavimmiut), et si cette association varie selon le sexe et le groupe d'âge. MéTHODES: Les données transversales proviennent de Qanuilirpitaa? l'enquête sur la santé au Nunavik de 2017 (N = 1 306; âgés de 16 ans et plus). Un indice de soutien social perçu a été dérivé des réponses aux questions relatives à trois composantes différentes du soutien social : interaction positive, soutien émotionnel, et amour et affection. Les associations entre le surpeuplement résidentiel (plus d'une personne par pièce) et le soutien social perçu ont été évaluées à l'aide de régressions linéaires et logistiques pondérées, ajustées pour plusieurs facteurs. Des analyses stratifiées par sexe et par âge ont également été réalisées. RéSULTATS: Les Nunavimmiut déclarent des niveaux de soutien social significativement plus faibles lorsqu'ils vivent dans des ménages surpeuplés, indépendamment d'autres covariables. Les analyses stratifiées par sexe et par âge montrent en outre que l'association néfaste entre le surpeuplement et le soutien social perçu est plus élevée et plus forte chez les hommes et les adultes plus âgés (hommes et femmes de 55 ans et plus). CONCLUSION: Le surpeuplement résidentiel est associé à des niveaux inférieurs de soutien social perçu, lequel est une composante clé de la santé pour la population générale et pour les Nunavimmiut. Les recherches futures devraient examiner les facteurs en cause derrière l'association entre le surpeuplement résidentiel et l'affaiblissement du soutien social chez les hommes et les adultes plus âgés.

Gut metagenome profile of the Nunavik Inuit youth is distinct from industrial and non-industrial counterparts.

Comparative metagenomics studies have highlighted differences in microbiome community structure among human populations over diverse lifestyles and environments. With their unique environmental and historical backgrounds, Nunavik Inuit have a distinctive gut microbiome with undocumented health-related implications. Using shotgun metagenomics, we explored the taxonomic and functional structure of the gut microbiome from 275 Nunavik Inuit ranging from 16 to 30-year-old. Whole-metagenome analyses revealed that Nunavik Inuit youths have a more diverse microbiome than their non-industrialized and industrialized counterparts. A comparison of k-mer content illustrated the uniqueness of the Nunavik gut microbiome. Short-chain fatty acids producing species, and carbohydrates degradation pathways dominated Inuit metagenomes. We identified a taxonomic and functional signature unique to the Nunavik gut microbiome contrasting with other populations using a random forest classifier. Here, we show that the Nunavik Inuit gut microbiome exhibits high diversity and a distinct community structure.

Early temperamental and biological predictors of dimensions of social withdrawal in childhood.

Social wariness and preference for solitude, two dimensions of social withdrawal, show unique associations with various socioemotional difficulties in childhood, including internalizing and peer problems. However, their early childhood predictors remain vastly undocumented. The present study aimed to examine whether early indicators of reactivity in situations of unfamiliarity such as behavioral inhibition, affect, and cortisol independently, or in interaction with emotion regulation as indexed by vagal tone, predict later social wariness and preference for solitude. Participants were 1209 children from the Quebec Newborn Twin Study. Vagal tone was assessed at 5 months, and behavioral inhibition, affect, and cortisol were assessed at 19 months in situations of unfamiliarity. Mothers, teachers, and peers evaluated social wariness and preference for solitude repeatedly from 4 to 10 years old. Findings show that three temperamental dimensions, social inhibition, nonsocial inhibition, and affect accounted for the variability in reactions to unfamiliarity. Behavioral inhibition to social unfamiliarity at 19 months predicted social wariness during the preschool years. Poor vagal regulation at 5 months exacerbated the risk associated with negative affect at 19 months to predict preference for solitude during the preschool years. Overall, results show that social wariness and preference for solitude may follow different developmental pathways.

Sociocultural factors in relation to mental health within the Inuit population of Nunavik.

OBJECTIVE: Built on the Inuit determinants approach of health, this study aimed to identify sociocultural factors associated with mental health among Inuit of Nunavik to guide programs and services. METHODS: The data were collected through the Qanuilirpitaa? 2017, a survey characterized by the involvement of several Inuit representatives. Depressive symptoms (10-item Center for Epidemiologic Studies-Depression scale, CES-D), lifetime suicide ideation and attempts, and past-year ideation were self-reported mental health indicators. Sociocultural factors represented four thematic domains: social support, community activities, traditional practices, and cultural identity. Analyses tested whether the sociocultural factors were associated with indicators of mental health using weighted multivariate regressions. RESULTS: Among the sociocultural factors considered, family cohesion and weekly hunting/fishing activities were associated with lower depression scores. Community cohesion and lower cultural identity (centrality scale) were associated with a lower likelihood of past-year and lifetime ideation while family cohesion was related to a lower likelihood of lifetime attempts. People with psychological distress (higher CES-D, suicidal ideation or attempts) were more likely to participate in healing and wellness activities. CONCLUSION: Although limited by their cross-sectional character, these analyses, based on the community component of the Qanuilirpitaa?, suggest that strengthening of family and community cohesion, and support of regular hunting and fishing deserve further attention as potential cumulative preventive avenues for Inuit mental health.

RéSUMé: OBJECTIF: Basée sur la conception Inuit des déterminants de la santé, cette étude identifie des facteurs socioculturels associés à la santé mentale chez les Inuit du Nunavik afin de guider les programmes et les services de santé. MéTHODE: Les données proviennent de Qanuilirpitaa? 2017, une enquête ayant impliqué plusieurs représentants Inuit. Les symptômes dépressifs (échelle Center for Epidemiologic Studies-Depression, 10 items, CES-D), les idéations suicidaires et les tentatives de suicide à vie, et les idéations au cours des derniers mois furent les indicateurs de santé mentale analysés. Des facteurs socioculturels investigués représentaient, eux, quatre domaines : support social, activités communautaires, pratiques traditionnelles et identité culturelle. Des régressions multivariées pondérées ont testé les associations entre les facteurs socioculturels et la santé mentale. RéSULTATS: Parmi les facteurs socioculturels investigués, la cohésion familiale et une pratique hebdomadaire de chasse/pêche étaient associées au score dépressif inférieur. La cohésion communautaire et une identité culturelle (centralité) plus faible s'associaient à une probabilité moindre d'idéations suicidaires à vie et au cours des 12 derniers mois; la cohésion familiale était associée à une probabilité moindre des tentatives suicidaires à vie. Les personnes rapportant une détresse supérieure (CES-D élevé, idéations ou tentatives) participaient davantage à des activités de guérison/de bien-être. CONCLUSION: Limitées par leur caractère transversal, ces analyses, inspirées du volet communautaire de Qanuilirpitaa?, suggèrent qu'un renforcement de la cohésion familiale et communautaire, ainsi qu'un soutien d'activités de chasse et de pêche régulières méritent davantage d'attention en tant qu'avenues préventives cumulatives potentielles pour la santé mentale des Inuit.

Maternal Pregnancy Diet Quality Is Directly Associated with Autonomic Nervous System Function in 6-Month-Old Offspring.

BACKGROUND: Many pregnant women are consuming diets of poor overall quality. Although many studies have linked poor prenatal diet quality to an increased risk of specific diseases in offspring, it is not known if exposure to poor prenatal diet affects core neurophysiological regulatory systems in offspring known to lie upstream of multiple diseases. OBJECTIVE: We aimed to examine the association between prenatal diet quality and autonomic nervous system (ANS) function in infants at 6 mo of age. METHODS: Data from 400 women (aged >18 y, with uncomplicated pregnancies) and their infants participating in the Maternal-Infant Research on Environmental Chemicals-Infant Development cohort were used to investigate links between prenatal diet quality and infant ANS function at 6 mo of age. Prenatal diet quality was assessed using the Healthy Eating Index (2010), calculated from a validated FFQ completed by women during the first trimester. Infant ANS function was measured using 2 assessments of heart rate variability (HRV) including root mean square of successive differences (RMSSD) and SD of N-N intervals (SDNN). Associations were analyzed before and after adjustment for socioeconomic status, maternal depression symptoms, maternal cardiometabolic dysfunction, breastfeeding, and prenatal smoking. RESULTS: Poorer prenatal diet quality was associated with lower infant HRV assessed using RMSSD (B: 0.07; 95% CI: 0.01, 0.13; R2 = 0.013) and SDNN (B: 0.18; 95% CI: 0.02, 0.35; R2 = 0.011). These associations remained significant after adjustment for confounding variables [RMSSD: B: 0.09; 95% CI: 0.003, 0.18; squared semipartial correlation (sp2) = 0.14 and SDNN B: 0.24; 95% CI: 0.0, 0.49; sp2 = 0.13]. CONCLUSIONS: In a large cohort study, poorer prenatal diet quality was associated with lower offspring HRV, a marker of decreased capacity of the ANS to respond adaptively to challenge. Therefore, poor prenatal diet may play a significant role in the programming of multiple organ systems and could increase general susceptibility to disease in offspring.

Genetic Correlation between Child Callous-Unemotional Behaviors and Fear Recognition Deficit: Evidence for a Neurocognitive Endophenotype.

This study investigates emotion recognition deficits as candidate neurocognitive endophenotypes for callous-unemotional (CU) behaviors. Using a twin design, we tested genetic correlations between child CU behaviors and poor processing of fearful and sad facial expressions. Participants were 504 twin pairs (209 MZ pairs; 295 DZ pairs) from the Quebec Newborn Twin Study, a longitudinal study of a population-based sample of twins. Teachers in kindergarten and first grade rated children's CU behaviors and other behavior problems (attention deficit and hyperactivity symptoms, physical aggression, and depressive symptoms). In first grade (mean age 7 years), the children completed the visual subtest of the Diagnostic Analysis of Nonverbal Accuracy Scale 2 (DANVA-II) to assess emotion recognition from facial stimuli. Using structural equation modeling, we examined the genetic-environmental etiology of the association between fear/sadness recognition and child CU behaviors, controlling for other behavior problems and recognition of other emotions. We found a significant genetic correlation between poor fear recognition and CU behaviors that was independent of other behavior problems. Poor recognition of sadness was not significantly associated with CU behaviors after taking into account other behavior problems. Our results suggest that CU behaviors and fear recognition have a partly shared genetic aetiology. This provides support for poor fear recognition as a key neurocognitive endophenotype for CU behaviors. Future research should test a hypothesized causal chain from specific genes, through amygdala functioning and fear recognition, to CU behaviors, and identify specific environmental factors (including intervention) that may disrupt this chain.

The Relationship Between Tobacco and Cannabis Use: A Review.

BACKGROUND: Based on the prevalence and health implications of tobacco and cannabis use, aiming to reduce their use, especially among youth, is a sound objective at both the individual and public health level. A proper understanding of the relationships between tobacco and cannabis use may help to achieve this goal. OBJECTIVES: To review the relationships between tobacco and cannabis use. METHODS: A selective review of the literature. RESULTS: We present an overview of the motivations for tobacco and cannabis use, and their perceived harmfulness. The article then reviews the gateway theory, reverse gateway theory, route of administration theory, and common liability theory. We describe the link between co-use and dependence symptoms, and the substitution phenomenon between tobacco and cannabis use. Three forms of simultaneous use-mulling, blunt smoking, and chasing-and their impacts are explained. We summarize the impact of tobacco use on cannabis (and vice versa) treatment outcomes, and, finally, review new treatments that simultaneously target tobacco and cannabis dependence. Most of the literature reviewed here relates to substance use among adolescents and young adults. CONCLUSIONS: The use of tobacco and cannabis-two of the most widely used substances around the world-are strongly intertwined in several respects. Both health professionals and researchers should have well-informed views on this issue to better evaluate, understand, inform, and provide care to their patients.

Does shyness interact with peer group affiliation in predicting substance use in adolescence?

Cigarette use and binge drinking are risky behaviors emerging during adolescence. Although many beneficial factors are well documented, studies linking shyness to substance use are somehow conflicting, which may be due to the contribution of moderators. Therefore, the present study has 2 objectives: (a) to prospectively analyze the association between shyness and substance use during adolescence, and (b) to test the moderating role of peer group affiliation on the relationship between shyness and substance use. Participants are 1447 adolescents from the Quebec Longitudinal Study of Child Development, a representative cohort of single-birth children born between 1997 and 1998 in the province of Quebec, Canada. Shyness was assessed at age 12 years. Peer group affiliation, as well as past year cigarette use and binge drinking were assessed at age 15 years. Logistic regressions were used to analyze the data. All analyses were carried out using weighted data accounting for the complex multistage sample design. Results show that shyness negatively predicts the use of tobacco and the occurrence of binge drinking while controlling for confounding variables. However, shyness does not interact with peer group affiliation in predicting substance use. This is the first study that confirms the presence of a negative relationship between shyness and substance use during adolescence over a 3-year period. Results suggest that shyness could exert a beneficial effect against substance use notwithstanding the adolescent's social context. (PsycINFO Database Record

Human Papillomavirus types distribution among women with cervical preneoplastic, lesions and cancer in Luanda, Angola.

INTRODUCTION: Cervical cancer is the leading cause of cancer deaths among females in Angola and human papillomavirus (HPV) is the main risk factor for the development of pre-cancerous squamous intraepithelial lesions. The diversity and frequency of HPV types in Angola has yet to be reported. AIM: To determine the frequency of HPV among women with squamous intraepithelial lesions from women in Luanda, Angola. METHODS: Study participants included women diagnosed with cytological abnormalities that voluntarily provided Pap smears (n = 64). Genomic DNA was extracted from the samples for use as templates in the PCR amplification of HPV sequences. PCR products were sequenced to determine HPV type. RESULTS: HPV DNA was detected in 71.9% (46/64) in the samples. A higher diversity of HPV types was found in the cytological lesions, such as ASCUS and LSIL (HPV16, 6, 18, 31, 58, 66, 70 and 82, in order of frequency) than that detected for HSIL and SSC (HPV16, 18, 6 and 33). The most prevalent HPV type were: HPV16, HPV6 and HPV18. CONCLUSION: This is the first report on HPV type diversity and frequency in woman of Angola. The results suggest that large-scale studies across Africa would improve our understanding of interrelationship between HPV infections and cervical cancer. More directly, the identification of the HPV types most prevalent suggests that women in Angola would benefit from currently available HPV vaccines.

A methodological comparison of the Porges algorithm, fast Fourier transform, and autoregressive spectral analysis for the estimation of heart rate variability in 5-month-old infants.

Little empirical evidence exists on the comparability of heart rate variability (HRV) quantification methods commonly used in infants. The aim was to compare three methods of HRV estimation: (1) fast Fourier transform (FFT), (2) autoregressive (AR), and (3) the Porges methods. HRV was estimated in 63 healthy 5-month-old infants. HRV parameters were strongly correlated across methods (.92-.99) but yielded significantly different mean HRV estimates (Porges method > FFT > AR). There was no systematic bias over the whole range of values between the two spectral approaches, while differences between the Porges method and the spectral estimates were systematically greater for larger values. Additional comparative studies are needed to explore the between-method agreement across a range of physiological conditions.

Influence of obesity indices, metabolic parameters and age on cardiac autonomic function in abdominally obese men.

Heart rate variability (HRV) is affected by age, hyperglycemia and accumulation of body fat. This study compares the predictive value of four measurements of adiposity/obesity on HRV and investigates the specific role of age, metabolic contributors and degree/distribution of fat in HRV alterations. The sample consisted of 97 non-diabetic and non-medicated men with features of the metabolic syndrome (50±8 years of age, body mass index [BMI] 31±3 kg/m(2), waist circumference [WC] 107±9 cm, triglycerides 2.3±0.7 mmol/L, fasting glucose 6.0±0.5 mmol/L, insulin 156±71 pmol/L; mean±SD). WC, BMI, percent body fat (% fat, from dual energy X-ray absorptiometry) and visceral adipose tissue volume (VAT, from computed tomography) were used as measures of adiposity/obesity. HRV measures were obtained from 24-h, day- and night-time segments of Holter recordings. BMI presented no independent association with HRV. Percentage fat was the strongest obesity index to be associated with HRV: 24-h pNN50, rMSSD, HF and daytime pNN50, rMSSD, HF and LF (-0.27≤std ß≤-0.20, P<.05). VAT was associated with 24-h SDNN, LF (std ß=-0.25 and -0.20, P<.05, respectively) and daytime SDNN (std ß=-0.24, P<.05) while WC was associated with nighttime SDNN and SDANN (std ß=0.22 and 0.32, P<.05). In addition, age, fasting glucose, 2-h oral glucose tolerance test and triglycerides presented independent association with HRV. Adiposity/obesity measurements seem to be differently associated with HRV. An approach considering the combination of age, obesity and glucose metabolism factors could be helpful in the global cardiovascular risk management in abdominally obese men.

Presence of melanocortin (MC4) receptor in spiny dogfish suggests an ancient vertebrate origin of central melanocortin system.

We report the cloning, expression, pharmacological characterization and tissue distribution of a melanocortin (MC) receptor gene in a shark, the spiny dogfish (Squalus acanthias) (Sac). Phylogenetic analysis showed that this receptor is an ortholog of the MC4 subtype, sharing 71% overall amino acid identity with the human (Hsa) MC4 receptor. When expressed and characterized by radioligand binding assay for the natural MSH (melanocyte-stimulating hormone) peptides alpha-, beta-, and gamma-MSH, the SacMC4 receptor showed pharmacological properties very similar to the HsaMC4 receptor. Stimulation of SacMC4 receptor transfected cells with alpha-MSH caused a dose-dependent increase in intracellular cAMP levels. The SacMC4 receptor has Ala in position 59 where all other cloned MC receptors have Glu. We confirmed that this was not due to individual polymorphism and subsequently mutated the residue 'back' to Glu but the mutation did not affect the pharmacological properties of the receptor. SacMC4 receptor mRNA was detected by RT-PCR in the optic tectum, hypothalamus, brain stem, telencephalon and olfactory bulb but not in cerebellum or in peripheral tissues. This study describes the first characterization of an MC receptor in a cartilaginous fish, the most distant MC receptor gene cloned to date. Conservation of gene structure, pharmacological properties and tissue distribution suggests that this receptor may have similar roles in sharks as in mammals and that these were established more than 450 million years ago.

One melanocortin 4 and two melanocortin 5 receptors from zebrafish show remarkable conservation in structure and pharmacology.

We report the cloning, genome mapping, functional expression, pharmacology and anatomical distribution of three melanocortin (MC) receptors from zebrafish (z). Phylogenetic analysis showed with high bootstrap support that these genes represent one MC4 receptor and two MC5 receptors. Chromosomal mapping showed conserved synteny between regions containing zMC4 and human (h) MC4 receptors, whereas the two zMC5 receptor genes map on chromosome segments in which the zebrafish has several genes with two orthologues of a single mammalian gene. It is likely that the two copies of zMC5 receptors arose through a separate duplication in the teleost lineage. The zMC4, zMC5a, and zMC5b receptors share 70-71% overall amino acid identity with the respective human orthologues and over 90% in three TM regions believed to be most important for ligand binding. All three zebrafish receptors also show pharmacological properties remarkably similar to their human orthologues, with similar affinities and the same potency order, when expressed and characterized in radioligand binding assay for the natural MSH) peptides alpha-, beta-, and gamma-MSH. Stimulation of transfected mammalian cells with alpha-MSH caused a dose-dependent increase in intracellular cAMP levels for all three zebrafish receptors. All three genes were expressed in the brain, eye, ovaries and gastrointestinal tract, whereas the zMC5b receptor was also found in the heart, as determined by RT-PCR. Our studies, which represent the first characterization of MC receptors in a nonamniote species, indicate that the MC receptor subtypes arose very early in vertebrate evolution. Important pharmacological and functional properties, as well as gene structure and syntenic relationships have been highly conserved over a period of more than 400 million years implying that these receptors participate in vital physiological functions.