The Canadian Society for Epidemiology and Biostatics 2012 National Student Conference

Abstract

Prenatal alcohol exposure is the leading cause of intellectual disability in the Western world. Due to the organic brain damage caused by alcohol, and the resulting cognitive, functional, and behavioural deficits, people with Fetal Alcohol Spectrum Disorder (FASD) are at high risk for becoming involved in the legal system, either as offenders or as victims, if appropriate diagnosis, interventions and support services are not initiated early in life and maintained throughout the life-course. The objective of this study was to estimate the risk of incarceration for youths (12-18 years) with FASD, compared to youths without FASD, in Canada. Using the epidemiological data available on the prevalence of incarceration in youths with FASD and data on the prevalence of incarceration in youths without FASD in the general population of Canada, it was estimated that youths with FASD are nineteen times more likely to be imprisoned than youths without FASD, on any given day in a specific year. These alarming study findings emphasize the need to incorporate screening for FASD as early as possible in the criminal justice process. It is crucial to better understand the mental disabilities of offenders prenatally exposed to alcohol and make appropriate referrals for mental health and other services. Vitamin D is a nutritional factor hypothesized to mitigate and prevent hypertensive diseases of pregnancy due to its effect on placental immunomodulation, vascularisation, and blood pressure regulation. The aim of this study was to estimate the effect of high-dose prenatal vitamin D supplementation on blood pressure during the third trimester of pregnancy. A randomized, double-blinded, placebo-controlled trial involving 160 pregnant women in the third trimester of pregnancy was conducted in Dhaka, Bangladesh (2010-2011). Participantswere randomized to receive either vitamin D3 (35,000 IU/week) or placebo until delivery. Blood pressure was measured at five timepoints and vitamin D status was assessed by serum 25-hydroxyvitamin D concentration. Generalized estimating equations were applied to longitudinally compare the change in systolic (SBP) and diastolic (DBP) blood pressure over time between the two groups. Participants in the vitamin D-supplemented group had statistically insignificant lower rates of increase in SBP (-3.2 [-9.0, 2.8] mmHg) and DBP (-2.4 [-7.8, 3.1] mmHg) compared to women in the placebo group during follow-up. In conclusion, this trial of vitamin D supplementation in pregnant Bangladeshi women did not demonstrate a significant effect of high-dose vitamin D supplementation on blood pressure during the third trimester of pregnancy. Unipolar major depression is one of the top ten contributors to global disease burden. Young people transitioning into college and university are particularly at risk of developing symptoms of stress and depression. The purpose of this research was to identify the major risk factors and correlates of depression and stress among Canadian and American undergraduate students. The search was conducted in the Ovid (Medline) database, using MeSH terms for disease terms (mental health, mental disorders, depression, depressive disorders, and stress (psychological)); risk terms (risk factors, indicators, and determinants; and hedge terms (university, post-secondary, and students). Inclusion criteria were country of origin (U.S. and Canada) and English language, and exclusion criteria were articles older than 15 years. The final search included eight articles from which data was collected. Identified risk factors and correlates of stress and depression were of behavioural nature or social or demographic nature. Positive risk factors/correlates for depression were marijuana use, social problem solving deficits, race [Black/Hispanic/multi-ethnic], smoking, and emotional abuse. Inverse risk factors/correlates for depression/stress were religiosity/spirituality, social problem solving abilities, vigorous physical activity, and social support. Statistically significant relationships between positive and negative risk factors and correlates, and stress/depression are identified in this review. Polybrominated diphenyl ethers (PBDEs) are flame retardants with widespread exposure. Although PBDEs are known thyroid toxicants in animal studies, human studies are sparse, especially during pregnancy and infancy when thyroid hormones are critical for early brain development. This study will examine associations between PBDE levels in maternal serum (at 15 weeks gestation), and thyroid hormones (free T4, total T4 and TSH) in both maternal serum (n = 152), collected in 2007-2008 at 15 and 18 weeks gestation) and umbilical cord serum (n = 116), using data from the Chemicals, Health and Pregnancy (CHirP) Study based in Vancouver, Canada. Median PBDE concentrations (ng/g lipid) were 9.1, 1.6, 1.9 and 3.2 for BDE 47, BDE 99, BDE 100 and BDE 153, respectively, and were similar to those in the Canadian population. Final results are forthcoming, as this is a proposed Master's thesis. However, PBDEs are hypothesized to be positively associated with free T4, and negatively associated with TSH - similar to previous studies of women later in pregnancy. This study will provide some of the first evidence about the thyroid disrupting potential of PBDEs during the most critical window of thyroid-mediated fetal brain development, and provide important missing information for ongoing risk assessments. The Maternal Mental Health Program (MMHP) in Saskatoon, Canada was developed to: 1) improve access to and quality of mental health care for preconceptual, pregnant, and postpartum women and 2) promote collaboration between a specialist mental health team and physicians using a shared care model of service delivery. The study evaluated the effects of the MMHP on anxiety and depression symptoms, the determinants of these symptoms, and participants' and physicians' satisfaction with the MMHP, using established questionnaires and Likert-style surveys. Descriptive and logistic regression analyses were performed. Participants included 99 women who completed the MMHP between 2006 and 2011 and 98 physicians who delivered care to childbearing women. There was a significant reduction in anxiety and depression symptoms among participants. Symptoms were associated with the social determinants of health. The majority of women (n = 75, 75.8%) and physicians (n = 75, 93.7%) were satisfied with the MMHP, in particular with: 1) accessibility, 2) comfort and skill level in treating maternal mental health patients, and 3) support from and competency of the staff. The MMHP exemplifies a shared care model in practice; however, to improve the mental health of women overall, the social determinants of health must also be addressed. Massage therapists (MTs) are increasingly becoming important providers of health and wellness care. Conducted in Saskatchewan, Canada in 2009-2010 the study aimed to determine if massage therapists held positive or negative attitudes toward research and to explore the association between attributes of providers and reported use of research. The study was conducted in two phases using a sequential explanatory mixed methods design. In phase one, a mail-out survey was sent to all 815 members of the Massage Therapist Association of Saskatchewan (MTAS). In phase two, interviews with six members further explored their attitudes toward research. Survey data was analyzed using SPSS. Univariate and logistic regression analysis was conducted. Qualitative data was explored using thematic content analysis. Forty-one percent of the questionnaires were completed and returned. Survey results revealed that most study participants held positive attitudes toward research. The factors most strongly associated with self-reported research use included a positive attitude toward research-based practice and searching research databases. While case study participant's attitudes toward research were largely positive they described experiencing some frustration with accessing and understanding research. Greater emphasis on research literacy training in pre-service and continuing education is necessary to support massage therapists in using research their work. Acellular dermal matrix (ADM) is used in breast reconstruction surgery to increase implant expansion and improve capsular reinforcement. The objective was to conduct a systematic review and meta-analysis to assess the risk of postoperative complications in patients using ADM in implant-based reconstruction. Electronic databases and health technology assessment reports were searched. Meta-analysis was performed of the risk ratios of complications reported in studies that compared ADM to conventional reconstruction. There were 27 cohort studies and one systematic review eligible for inclusion published since 2005. The pooled risk of any complication with ADM was 20.8% (95% confidence interval [CI] 15.3, 27.7). The meta-analysis of nine comparative studies showed that ADM use was associated with a higher risk of implant loss (risk ratio [RR] 3.98; 95% CI 1.96, 8.11) infection without implant removal (RR 2.49; 95% CI 1.4, 14.37) and seroma (RR 2.72; 95% CI 1.75, 4.23), and lower risk of capsular contracture (RR 0.3; 95% CI 0.09, 0.998), compared to conventional reconstruction. The evidence suggests that there is a higher risk of certain types of complications with ADM use compared to non-ADM use. Further research is needed to assess the aesthetic outcomes of breast reconstruction surgeries using ADM. Social network patterns influence risk behaviors for HIV and other infectious diseases. This study hypothesizes that condom use is related to the closeness of participants to social network members, length of time known and multiple roles. Using respondent driven sampling, social network data were collected from underhoused people, sex workers, people who use drugs, and street youth (n = 226) from Ottawa