Food insecurity and body dissatisfaction in a sample of Canadian adults.

Food insecurity may predict poorer body image, which is associated with increased risk of mental health problems. However, minimal attention has been given to the food insecurity-body image link and to factors that may influence this link, such as assigned sex; importantly, females are more likely to experience both food insecurity and body dissatisfaction. The present study used data from the 2017 to 2018 Canadian Community Health Survey (N = 32,017) to investigate the effects of food insecurity and sex on body satisfaction via generalized ordered logistic regression. Results indicated: (1) Food insecurity predicted lower odds of body satisfaction, (2) Males were more likely than females to be satisfied with their bodies, and (3) Food insecurity no longer predicted body satisfaction following the inclusion of sex. Findings suggest the association between food insecurity and body satisfaction may largely be driven by the link between food insecurity and sex. Further investigation is warranted.

Access to Healthcare and Unmet Needs in the Canadian Lesbian-Gay-Bisexual Population.

Individuals who identify as a sexual minority, including those who are lesbian, gay, or bisexual (LGB), face barriers to healthcare as well as increased discrimination, stigmatization, and negative experiences during healthcare use. Further, few healthcare providers have education and training focused on the specific healthcare needs of individuals who are part of a sexual minority group. Given the limited research on Canadian healthcare access for sexual minorities, our purpose was to use data (n > 2,800) from the 2015-16 Canadian Community Health Survey (CCHS) to investigate the perceptions of healthcare access for LGB and non-LGB Canadians. Although non-LGB and LGB participants reported comparable access to a regular care provider and were equally likely to have consulted with a general practitioner in the past 12 months, LGB respondents were more likely to have seen a specialist and reported more unmet health needs. Although we expected the linear effects of both race and sex to vary by LGB status, this effect only occurred in one model. Current results have implications for addressing health inequalities for sexual minorities, including poorer health outcomes and greater discrimination.

Perceived Social Support on the Relationship Between ADD/ADHD and Both Anxious and Depressive Symptoms Among Canadian Adults.

OBJECTIVE: The primary goal of the present research was to examine whether the relationships that social support demonstrates with both anxiety and depression varied between adults with and without ADD/ADHD in a Canadian sample. METHOD: Data were obtained from the 2012 Canadian Community Health Survey-Mental Health (N ≥ 16,354). Presence of social support, diagnosis of generalized anxiety disorder (GAD), and experience of major depressive episodes (MDEs) were estimated in the self-report ADD/ADHD and non-ADD/ADHD groups. RESULTS: Although social support was negatively associated with having GAD or experiencing an MDE, and self-report ADD/ADHD was positively associated with these outcomes. Presence of self-report ADD/ADHD did not significantly modify the relationships between social support and GAD or MDE. CONCLUSION: Social support may be a protective factor against symptoms of anxiety and depression in the general Canadian population, for adults with and without ADHD.

Throw BABE Out With the Bathwater? Canadian Atheists are No Less Healthy than the Religious.

The belief-as-benefit effect (BABE) is a broad term for the positive association between religion/spirituality (R/S) and health outcomes. Functionally, religious variables and religious identities predict greater wellness, which implies that atheists should report worse health relative to religious groups. Using Cycle 29 of the cross-sectional General Social Survey from Statistics Canada (N > 15,900), I explored health differences in stress, life satisfaction, subjective physical wellbeing, and subjective mental wellbeing across R/S identities (atheists, agnostics, Nones, Catholics, Protestants, Eastern Religions). Results indicated that (1). religious attendance, prayer, and religiosity were generally unrelated to all health outcomes for all R/S identities, (2). averagely religious atheists reported health parity with averagely religious members of all other R/S identities, and (3). when comparing a maximally nonreligious atheist group against several maximally religiously affiliated groups, atheists largely showed health parity. If both low R/S and high R/S are associated with comparable wellness, researchers should actively question whether R/S is genuinely salutary.

Godless in the Great White North: Assessing the Health of Canadian Atheists Using Data from the 2011/2012 Canadian Community Health Survey.

An overlooked reason to study atheism and health is that it provides a reasonably strong test of the broader religion-health relationship. Using data from the 2011/2012 Canadian Community Health Survey (n > 8000) I explored the health differences between atheists and eight categories of religious identities (nonreligious, Anglican, Baptist, Christian, Protestant, Catholic, United Church, and All Others). Surprisingly, results showed no substantive differences between atheists and non-atheists for self-rated health, emotional well-being, and psychological well-being. In contrast, results showed substantive and consistent differences between atheists and non-atheists with respect to social well-being. Results appear to suggest that while religious groups report superior scores on health proxies relative to atheists, this does not translate into substantive health differences.

In Doubt and Disbelief: How Mrdjenovich 2018 Misunderstands the (Non)Religion-Health Relationship.

The article, "Religiously/Spiritually Involved, but in Doubt or Disbelief-Why? Healthy?" (Mrdjenovich in J Relig Health. https://doi.org/10.1007/s10943-018-0711-2 , 2018) addressed why subsets of Nones would engage in religious activities. While the subject matter of Mrdjenovich's work is important and understudied, several problematic conclusions about the nonreligion-health field were drawn. We provide constructive criticisms of Mrdjenovich's methodologies, conclusions, and characterizations of the nonreligion-health field, and offer several solutions to the problems identified.

Negative Social Experiences Mediate the Relationship between Sexual Orientation and Mental Health.

The lesbian-gay-bisexual (LGB) population experiences a higher rate of psychopathology than the non-LGB population. Minority stress theory (MST) suggests that this pattern of findings is due to the increased negativity that LGB individuals face; however, MST is often employed as a post-hoc explanation for health inequalities as opposed to an a priori approach that explicitly tests this idea and has not been examined in the context of Canadian sexual minorities. Using the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH), we tested the MST on a sample 22,495 Canadians (n = 21,995 non-LGB; n = 500 LGB). Results indicated that respondents' scores on the Negative Social Interactions scale (NSI) partially mediated the relationship between LGB status and both depression and satisfaction with life. The findings suggest that a substantial component of the relationship between sexual orientation and mental health is influenced by deleterious social exchanges.

Improving Administrative Outcomes in Physiotherapy by Adopting Open-Access Booking.

Purpose: Long wait times for physiotherapy are associated with poorer health trajectories for clients. Clients' experiences with physiotherapy services in Saint John were suboptimal; thus, this study explored making administrative changes to improve those experiences. All physiotherapy services adopted an administrative model called open-access booking (OAB), which blended elements of advanced access, triage, and centralized wait lists. Method: OAB was instituted in the first week of February 2017 and has been active since. The researcher accessed more than 20,000 anonymized case records spanning 5 years (February 2014-January 2019) and compared the 3-year pre-OAB phase with the 2-year OAB phase using interrupted time series analysis models. Results: OAB appeared to not be associated with changes in client volume, but it was associated with fewer "on-paper" clients, shorter wait times to first appointment, more consistent record keeping, a greater likelihood of being discharged after one appointment, and fewer appointments before discharge. There was less variability in these outcomes after the adoption of OAB, suggesting a more stable client experience with the physiotherapy system. Conclusions: OAB appears to be associated with improved administrative outcomes, but strict causality cannot be assessed. The results are promising but not conclusive.

Objectif : les longues listes d'attente en physiothérapie sont liées à de moins bonnes trajectoires de santé pour les clients. Les expériences des clients à l'égard des services de physiothérapie étaient suboptimales à Saint John, et les chercheurs ont exploré les changements administratifs à apporter pour les améliorer. Tous les services de physiothérapie ont adopté un modèle administratif du nom de «livres en libre accès¼ (LLA), qui mêle des éléments d'accès avancé, de triage et de listes d'attente centralisées. Méthodologie : le modèle de LLA a été adopté la première semaine de février 2017 et se poursuit depuis. Les chercheurs ont accédé à plus de 20000 dossiers de cas anonymisés sur cinq ans (de février 2014 à janvier 2019) et ont comparé la phase de trois ans précédant les LLA aux deux ans de LLA suivants au moyen de modèles d'analyse chronologique interrompus. Résultats : le modèle de LLA ne semblait pas modifier le volume de clientèle, mais réduisait le nombre de clients «sur papier¼ et la période d'attente avant le premier rendez-vous, assurait une tenue de dossier plus uniforme, accroissait la probabilité d'obtenir un congé après un rendez-vous et limitait le nombre de rendez-vous avant le congé. Ces résultats étaient moins variables après l'adoption des LLA, ce qui laisse supposer une expérience plus stable des clients en physiothérapie. Conclusion : les LLA semblent assurer de meilleurs résultats administratifs, sans qu'il soit possible d'établir une causalité rigoureuse. Les résultats sont prometteurs, mais non concluants.

Pornography Consumption and Attitudes Towards Pornography Legality Predict Attitudes of Sexual Equality.

Some scholars argue that the existence of pornography is an ongoing assault on women and that it should be banned. However, the existing evidence suggests the connection between pornography consumption and sexism is overstated and may actually run in the opposite direction. Using data from the General Social Survey (2010-2018), the current study investigated if "pornography consumption" and "pornography tolerance" predicted sexism and whether these associations varied by sex. Results indicated that pornography consumption predicted lower levels of sexism, although these effects were rendered nonsignificant with the inclusion of sociodemographic, religious, and sociocultural covariates. When comparing the results of the current study to findings based on data from the 1970s-1990s, it appears that pornography consumption is now irrelevant to sexism rather than promoting egalitarianism. Our analyses focusing on "pornography tolerance" revealed that people who supported regulated pornography were more egalitarian than people who supported a pornography ban. Generally, men were more likely to report sexist attitudes than women, but sex moderated the relationship that pornography variables had with sexism in several of the models. Overall, pornography consumption and pornography tolerance were either irrelevant in predicting sexism or were associated with greater egalitarianism.

Investigating Open-access Booking in New Brunswick Occupational Therapy.

BACKGROUND.: Open-access booking (OAB) describes administrative changes to improve system efficiency. However, OAB studies have focused on GP practices and have not applied OAB to other health care services. PURPOSE.: The purpose of the study was to investigate the associations between OAB and administrative outcomes in the Saint John region. METHOD.: Evaluators compared three years of pre-OAB data against two years of post-OAB data using an interrupted-time series design (February 2014-January 2019). FINDINGS.: OAB was associated with a 12% jump in the likelihood of being discharged within three months even though clients received an equivalent level of service. OAB was not associated with more missed appointments (∼8% vs. ∼7%). While OAB was not associated with reduced wait times, the post-OAB period handled a larger number of client referrals, which may explain the null finding. IMPLICATIONS.: OAB shows potential for improving administrative outcomes, but further research is needed.

With a little help from my (Canadian) friends: Health differences between minimal and maximal religiosity/spirituality are partially mediated by social support.

RATIONALE: Higher levels of religion and spirituality (R/S) are associated with better health in both Canadian and American samples. One mechanism that can account forthis relationship is social support, which is positively associated with higher R/S and is positively associated with overall wellness. Although social support has been found to mediate the relationship between R/S and health in American samples, parallel research on Canadian samples is lacking. OBJECTIVE: While having cultural similarities, Canada and the United States have noteworthy differences with respect to religion, politics, and demographics. Consequently, it is problematic to assume that social support accounts for the R/Shealth relationship for Canadians. The goal of the current study was to explore whether social support mediated the relationship between R/S and health outcomes. METHOD: Using individuals ≥20 years of age from the 2012 Canadian Community Health Survey - Mental Health component (N ≥ 9043), we isolated people who had either the lowest or highest possible score on a composite measure of R/S. We then compared 'minimal R/S' respondents to 'maximal R/S' respondents on 11 health outcomes and investigated if these health disparities attenuated when accounting for differences in social support. RESULTS: Maximal R/S was associated with better health for nine of the tested outcomes, but seven of these relationships were attenuated when social support was added to the model. The two remaining outcomes, drug abuse/dependence and alcohol abuse/dependence, were not significantly impacted by the inclusion of social support. CONCLUSION: Social support plays a mediating role in many R/S-health relationships for Canadians. Although R/S appears to have a statistical relationship with many health outcomes, several of these lack practical significance.

Diazole and triazole inhibition of nitrification process in return activated sludge.

Azoles are emerging contaminants that are resistant to biodegradation during wastewater treatment. Their presence has been widely reported in wastewater effluents and receiving waters. In this work, the potential inhibition of nitrification process by six different azole compounds in wastewater treatment plants was investigated in batch bioassays. The azoles studied included three diazoles: pyrazole (Pz); 1-methylpyrazole (MePz); 3,5-dimethylpyrazole (DMePz); and three triazoles: 1,2,4-triazole (Tz); benzotriazole (BTz); and 5-methyl benzotriazole (MeBTz). The concentration of azoles causing 50% inhibition (IC50) increased (azoles became less inhibitory) in the following order (mg L-1): BTz (1.99) < MeBTz (2.18) < Pz (2.69) < Tz (3.53) < DMePz (17.3) < MePz (49.6). No clear structure-inhibitory relationships were found using Log P and pKa as structural properties. The toxicity of any given azole may be related to the role of substituent groups on disabling/enabling binding to the active sites of metallo-enzymes in nitrifying microorganisms. This is exemplified by the low toxicity of MePz, which has a cyclic N blocked by a methyl group. The observed inhibition caused to nitrifying bacteria is more severe than their cytotoxicity to other target organisms (e.g., methanogens and heterotrophic bacteria), suggesting a specific inhibition to the copper-containing enzyme, ammonium monooxygenase, in ammonia oxidizing nitrifying microorganisms.

Impact of Substance Use and Mental Health Comorbidity on Health Care Access in Canada.

Objective: Psychological disorders and substance use comorbidity is associated with greater symptomatology and a worse prognosis. Previous research has highlighted discrepancies in the level of use of health care services in individuals experiencing comorbidity compared to those with mental disorders or substance use disorders alone. The purpose of the current study was to compare mental health service use (i.e., access, number of professionals accessed, helpfulness of services received, and number of hours of services received) among individuals with mental disorders, substance use disorders, and comorbid disorders. Methods: Participants consisted of respondents to the 2012 Canadian Community Health Survey-Mental Health (N = 25,133). The researchers used a mixture of binary logistic regressions, Poisson regressions, linear regressions, and ordinal logistic regression to explore the impact of demographic variables, psychological distress, and clinical categories on health care access. Results: The mental disorders group, OR = 0.52, p = .008, 95% CI [0.32, 0.85], d = 0.36, and the substance use disorders group, OR = 0.31, p = .001, 95% CI [0.16, 0.60], d = 0.65, were significantly less likely than the comorbid group to report having accessed a professional in the past year. There were no significant differences in the perceived level of helpfulness for interventions received or in the time spent in professional consultation when comparing the substance use disorders and mental disorders groups to the comorbid group. Conclusions: Although the level of access to health care was low overall, those with concurrent disorders were more likely to access mental health services than those with substance use disorders or mental disorders only. The findings of this study reveal various treatment gaps, especially in those experiencing substance use disorders, and reaffirm the importance of improving treatment accessibility for these individuals.

Probabilities of ADD/ADHD and Related Substance Use Among Canadian Adults.

Objective: The aim of this study was to estimate the prevalence and probabilities of comorbidities between self-reported ADD/ADHD and smoking, alcohol binge drinking, and substance use disorders (SUDs) from a national Canadian sample. Method: Data were taken from the Public Use Microdata File of the 2012 Canadian Community Health Survey-Mental Health (N = 17 311). The prevalence of (a) smoking, (b) alcohol binge drinking, and (c) SUDs was estimated among those with an ADD/ADHD diagnosis versus those without an ADD/ADHD diagnosis. Results: After controlling for potential socioeconomic and mental health covariates, self-reported ADD/ADHD acted as a significant predictor for group membership in the heaviest smoking, heaviest drinking, and heaviest drug usage categories. Conclusion: Individuals self-reporting a diagnosis of ADD/ADHD were found to have a significantly higher likelihood of engaging in smoking and alcohol binge drinking, and were more likely to meet criteria for SUDs than individuals not reporting an ADD/ADHD diagnosis.

The influence of social support on psychological distress in Canadian adults with bipolar disorder.

INTRODUCTION: Individuals with bipolar I disorder (BD-I) and bipolar II disorder (BD-II) are at higher risk for experiencing high levels of psychological distress and low levels of social support. OBJECTIVES: The primary objectives of this study were to examine perceived social support and psychological distress among Canadian adults with self-reported BD-I or BD-II as diagnosed by a health professional and explore the relationship between types of social support and psychological distress within this sample. METHODS: Using a cross-sectional, national datafile, 563 Canadian male and female adults (20-64 years) who reported being diagnosed with BD-I or BD-II were investigated using the Social Provisions Scale (SPS), and the Kessler Psychological Distress Scale (K10). RESULTS: It was observed that while the BD-I or BD-II sample had significantly lower SPS scores and significantly higher K10 scores than the overall Canadian sample, age and support in the form of reassurance of worth and social integration were associated with decreased psychological distress. Further, a diagnosis of BD-I and BD-II was found to moderate the effect of social support on psychological distress. CONCLUSIONS: Despite the limitations, which include self-reported diagnosis of BD-I and BD-II and potential exclusion of those who are not diagnosed but have BD-I or BD-II, these findings suggest that reassurance of worth and social integration may act as protective factors for psychological distress among individuals with BD-I or BD-II.

Mixed Blessings? Religion/Spirituality Predicts Better and Worse Screening Behaviours.

Some health research suggests that religious and spiritual variables positively predict health-screening behaviours. However, much of the literature on this topic has utilized exclusively religious samples, or has sampled from populations without uniform access to health care. Either of these issues may have artificially inflated the relationship between religion/spirituality and health-screening behaviours. The current study used data from the 2012 Canadian Community Health Survey to examine a general sample of women from New Brunswick and Manitoba (N > 1200). Results indicated that lower levels of church attendance were positive predictors of papanicolaou tests and mammograms, while higher levels of attendance were generally associated with poorer screening behaviours. Religiosity was a uniformly non-significant predictor of screening behaviours. Finally, religious affiliation was inconsistently related to screening behaviours, but tended to favour religious non-affiliation when it was. Religion/spirituality does not appear to have a uniformly positive nor linear effect in predicting health-screening behaviours in women.

Putting research in place: an innovative approach to providing contextualized evidence synthesis for decision makers.

BACKGROUND: The Contextualized Health Research Synthesis Program (CHRSP), developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. METHODS: As an integrated knowledge translation (KT) method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies. Although it was developed in the Canadian province of Newfoundland and Labrador, the CHRSP methodology is adaptable to a variety of settings with distinctive features, such as those in rural, remote, and small-town locations. RESULTS: CHRSP has published 25 syntheses on priority topics chosen by the provincial healthcare system, including: Clinical and cost-effectiveness: telehealth, rural renal dialysis, point-of-care testing; Community-based health services: helping seniors age in place, supporting seniors with dementia, residential treatment centers for at-risk youth; Healthcare organization/service delivery: reducing acute-care length of stay, promoting flu vaccination among health workers, safe patient handling, age-friendly acute care; and Health promotion: diabetes prevention, promoting healthy dietary habits. These studies have been used by decision makers to inform local policy and practice decisions. CONCLUSIONS: By asking the health system to identify its own priorities and to participate directly in the research process, CHRSP fully integrates KT among researchers and knowledge users in healthcare in Newfoundland and Labrador. This high level of decision-maker buy-in has resulted in a corresponding level of uptake. CHRSP studies have directly informed a number of policy and practice directions, including the design of youth residential treatment centers, a provincial policy on single-use medical devices, and most recently, the opening of the province's first Acute Care for the Elderly hospital unit.

Evaluation of and Feedback for Academic Medicine Leaders: Developing and Implementing the Memorial Method.

PROBLEM: Giving and receiving honest and helpful feedback for leadership development is a common challenge in all types of organizations but particularly in academic medicine. APPROACH: At Memorial University of Newfoundland, in 2014, a consensus emerged to develop a new method for evaluating the leadership performance of the discipline chairs, dean, and vice dean, and to provide these leaders with the evaluation results to help them improve their performance. The leaders responsible for developing and implementing this method (called the Memorial Method) decided to use a survey to obtain faculty members' perceptions about their leader's performance. Beginning in October 2014, a portion of several regular meetings of the discipline chairs with the dean and vice dean was used to develop the survey, by first discussing the broad dimensions of leadership performance, then discussing these dimensions in more detail and drafting specific questions. The resulting survey included 44 quantitative questions addressing eight leadership dimensions. In March-April 2015, the survey was administered electronically to full-time faculty members on a confidential basis. The results were compiled and reported to each discipline chair and to the dean and vice dean. OUTCOMES: In total, 144/249 faculty responded to the survey (response rate: 58%). For the various dimensions, individual chairs' mean scores ranged from 2.82 to 4.70, and overall mean scores ranged from 3.57 to 4.24. Psychometric properties of the survey suggested it was both reliable and valid. NEXT STEPS: The survey will be repeated, this time with part-time as well as full-time faculty included.

Unbelievable?! Theistic/Epistemological Viewpoint Affects Religion-Health Relationship.

Research suggests that Religion/Spirituality promotes a variety of positive health outcomes. However, despite reporting lower levels of Religion/Spirituality, non-believers report comparable levels of health to believers. The current study tested the hypothesis that Religion/Spirituality does not have a uniform effect on health for all persons, and tested theological/epistemological categories as moderators. Using the 2012 and 2014 General Social Survey (N = 2670), the relationship between Religion/Spirituality and happiness and self-rated health was investigated. Results indicated that Gnostic Theists experienced Religion/Spirituality more positively than their peers did; Agnostic Theists experienced Religion/Spirituality less positively than their peers did; and Negative Atheists experienced Religion/Spirituality less positively than their peers did. These findings suggested that Religion/Spirituality is not associated with salutary effects for all persons, and that whether a person believes in god(s) and how confident he/she was in god(s)' existence, influenced his/her experience with Religion/Spirituality.