ECHO Women's Mental Health Research

ABSTRACT

Every day we perform countless reaching movements where we interact either directly or indirectly with the objects we are viewing. Such “standard” and “nonstandard” reaching behaviour require visuomotor transformations and engages a cortical network encompassing both the frontal and parietal regions of the brain. We carried out a dual-task paradigm study to further elucidate the frontoparietal network involved in reaching movements with different types of visuomotor mapping. Subjects performed standard reaching tasks while simultaneously performing added tasks designed to tax the dorsolateral prefrontal cortex (DLPFC), superior (SPL), and inferior parietal lobules (IPL). Our goal was to compare reaching behaviour differences seen between standard and nonstandard reaching to reaching behaviour observed with the addition of these neural load tasks.

Ten male and ten female subjects reached to 4 corner targets, 8.5 cm from a central start position by moving their finger over a clear, touch-sensitive screen. In the standard task, subjects centrally fixated and reached to targets on the screen in the vertical plane. Horizontal plane and cursor-feedback rotated (50 counterclockwise) conditions were also employed to study different types of nonstandard visuomotor mapping. A corollary study was carried out where subjects performed the simultaneous dual tasks while reaching under a 50 counterclockwise cursor feedback rotation. We used three tasks to investigate parietal involvement in visuomotor mapping. A Shepard-Metzler 3D mental rotation task was used as the SPL task, while a space-time collision judgment paradigm served as the IPL task. Subjects had the most difficulty in making a straight line trajectory during rotated feedback reaching (measured with number of direction reversals) when asked to simultaneously perform the ‘SPL’ Mental Rotation task. Furthermore, subjects had the greatest difficulty during 50° counterclockwise rotated cursor feedback reaching (measured with MT and linearity ratio) when asked to concurrently perform the ‘IPL’ Collision Judgment task. This lends behavioural evidence to support that separate parietal brain regions (the SPL and IPL) contribute differently to the control of reaching under different levels of visuomotor compatibility and corroborates previous findings of frontoparietal involvement in visuomotor transformation in healthy and patient populations.

Canada is experiencing a rapidly aging population (Kinsell and Wan, 2009). By 2031, it is predicted that 20% of Canadians will be over the age of 65 (Statistics Canada, 2007). Canada also faces elderly poverty. In 2000, over half a million seniors lived below the Low Income Cut-Off, with the majority living in urban areas (Canadian Council on Social Development, 2007). High levels of mental illness occurs in both those living in low-income situations (Statistics Canada, 2010) and in the elderly (McEwan et al., 1991). However, there is a dearth of information on the mental health of Canada’s low-income elderly population. Our study objective was to determine the correlates of mental health in community-dwelling individuals aged 65+ living in an immigrant-dense, low SES urban area in Toronto, Canada.

Background

Maternal alcohol consumption during pregnancy may potentially constitute a major public health concern in Canada but despite this, the available epidemiological data on both rates and predictors of alcohol consumption during pregnancy is limited. The present study assessed the prevalence and predictors of maternal alcohol consumption during pregnancy of women living in Canada from 2005-2006 who had a singleton live birth and whose child remained in their care 5-9 months following birth. Prevalence of maternal alcohol consumption was examined across the Canadian provinces.

Methods

The analysis was based on the Maternity Experience Survey (MES), a population-based survey that assessed pregnancy, delivery and postnatal experiences of mothers and their children between November 2005 and May 2006. The main outcome variable assessed was ever drinking alcohol during pregnancy. The sample of mothers who drank during pregnancy consisted mainly of low to moderate level-alcohol drinkers (95.8%), while only 1.7% of the sample were heavy drinkers (>1 drink per day). Socio-economic factors, demographic factors, maternal characteristics, and pregnancy related factors that proved to be significant at the bivariate level were considered for a logistic regression analysis. Bootstrapping was performed to account for the complex sampling design.

Results

Analysis of 5882 mothers, weighted to represent 72,767 Canadian women, found that 10.8% of women drank alcohol at some point during their pregnancies. This mainly reflects prevalence of low to moderate maternal alcohol consumption. Prevalence of drinking alcohol during pregnancy was 13.8% in Eastern-Central provinces, 7.8% in Western Provinces-British Columbia, 4.1% in Eastern-Atlantic provinces and 4.0% in Western-Prairie Provinces. Utilizing alcohol during gestation was significantly associated with several important factors including marital status, smoking status, reaction to the pregnancy and immigrant status. While being an immigrant to Canada appeared to confer a protective effect, women who have partners (odds ratio (OR) = 2.00; 95% confidence interval (CI): 1.20, 3.31) and smoked during pregnancy (OR = 1.54; 95% CI: 1.12, 1.87) were significantly more likely to drink alcohol during their pregnancies. Perhaps most importantly, pregnant women who reported indifference or being unhappy/very unhappy in regards to their pregnancies exhibited 1.89- and 2.5-fold increased risk of drinking alcohol during their pregnancies, respectively.

Conclusion

A number of important factors associated with maternal alcohol utilization during pregnancy have been identified, indicating areas where increased focus may serve to reduce maternal and pediatric morbidity and mortality.
Keywords:
Alcohol utilization; pregnancy; prevalence; predictors; Canada

This report summarizes the challenges and recommendations for Canada's healthcare system in the areas of mental health, sexual health, and chronic disease health for South Asian communities in Toronto, Canada. This report captures the views of multiple stakeholders (community members, healthcare service providers, health researchers etc...), which has been recommended as one of the best ways of conducting research to aid the health policy process (Exworthy, 2008).

We have attempted to provide a voice for South Asian communities in Toronto by writing this report. As was mentioned by our participants, it is important for South Asian communities to be involved in the creation of health policy and the administration of health services in Canada. We are an integral part of the community and we need to provide our input.

We hope this report can be used by policy makers and healthcare service providers to better tailor policy and healthcare services to be inclusive of South Asian communities.

Elderly Mental Health in a Low Socioeconomic Status (SES) Urban Population. ISLAM, F.1, MANSON, J.1, & TAMIM, H.1

1Kinesiology and Health Science, York University

Introduction: Canada is experiencing a rapidly aging population (Kinsell and Wan, 2009). By 2031, it is predicted that 20% of Canadians will be over the age of 65 (Statistics Canada, 2007). Canada also faces elderly poverty. In 2000 over half a million seniors lived below the Low Income Cut-Off, with the majority living in urban areas (Canadian Council on Social Development, 2007). High levels of mental illness occurs in both those living in low-income situations (Statistics Canada, 2010) and in the elderly (McEwan et al., 1991). However, there is a dearth of information on the mental health of Canada’s low-income elderly population. Our study objective was to determine the correlates of mental health in community-dwelling individuals aged 65+ living in an immigrant-dense, low SES urban area in Toronto, Canada. Methods: A total of 63 participants (14 male; 49 female) were recruited. The three mental health outcome measures used were the Short Form (36) Health Survey (SF-36) emotional health, Perceived Stress Scale (PSS), and Subjective Happiness Scale (SHS). Sociodemographic (age, sex, marital status, education, and income), behavior (overall physical activity and alcohol drinking), and health (SF-36 general health and SF-36 role of limitations due to physical health) variables acted as potential correlates. Following bivariate-level analysis, three separate step-wise multivariate linear regression models were created for the mental health outcome measures. Results: At the bivariate level, older age significantly predicted poorer emotional health (t48 = 2.84, p = 0.07). Being female (t57 = 2.03, p = 0.047), having better general health (β = -0.33, p = 0.011), and fewer limitations due to physical activity (β = -0.27, p = 0.036) was significantly correlated with less perceived stress. Being in better general health (β = 0.58, p = 0.001) and having fewer limitations due to physical health (β = 0.49, p = 0.001) was significantly correlated with higher levels of happiness. According to the step-wise multivariate linear regression analysis, older elderly individuals experienced significantly poorer levels of emotional health (β = -0.41, p = 0.005). Elderly individuals with better general health perceived significantly less stress in their life (β = -0.33, p = 0.015). Not being married (β = 0.23, p = 0.039) and having better general health (β = 0.59, p = 0.001) was significantly associated with greater levels of happiness. Conclusions: General health is a robust predictor of mental health. Older seniors, as well as those in poorer general health, could potentially be targeted for mental health outreach. Future studies could look into the effect of marital status on mental health in low-income elderly populations. Stress management programs could be specifically tailored for this elderly population.

References:

Canadian Council on Social Development. (2007). Urban Poverty Project: Age, Gender, and Family: Urban Poverty in Canada, 2000 Available: <http://www.ccsd.ca/pubs/2007/upp/age_gender_family.pdf> (accessed 2011 Jan 12).

Kinsell, K. & Wan, W. (2009). US Census Bureau, International Population Reports, P95/09-1, An Aging World: 2008, US Government Printing Office, Washington, D.C.


McEwan K.L., Donnelly M., Robertson D., Hertzman C. (1991). Mental Health Problems Among Canada’s Seniors: Demographic and Epidemiologic Consideration. Ottawa: Mental Health Division, Health Services and Promotion Branch, Department of National Health and Welfare.

Statistics Canada. (2007). Canadian Social Trends. Census snapshot of Canada – Population (age and sex). Available: <www.statcan.gc.ca/pub/11-008-x/2007006/article/10379-eng.pdf> (accessed 2011 Jan 12).

Statistics Canada. (2010). A descriptive study of the prevalence of psychological distress and mental disorders in the Canadian population: comparison between low-income and non-low-income populations. Public Health Agency of Canada Statistics Canada report prepared by Caron, J. & Liu, A. Chronic Diseases in Canada, 30(3). Available < http://www.phac-aspc.gc.ca.ezproxy.library.yorku.ca/publicat/cdic-mcc/30-3/ar_03-eng.php> (accessed 2011 Jan 12).

"This paper is a literature review examining the evidence for and against the existence of the “healthy
immigrant effect” for mental health in Canada, a
phenomenon where the foreign-born population
has better levels of mental health compared to the
national-born population. The methodological
strengths and weaknesses of the present body of
literature are examined, followed by recommendations for future research. The literature review yielded inconclusive evidence. The “healthy immigrant
effect” for mental health did not hold true across all
immigrant populations. It varied by factors such as
country of origin, visible minority status, and wave
of immigration. Future studies need to consider
these important factors and include analyses of longitudinal data to further elucidate the “healthy immigrant effect” for mental health in Canada."

Mental health stigma in Muslim communities may be partly due to a commonly held belief among some Muslims about the supernatural causes of mental illness (i.e. jinn-possession brought on by one's sinful life). A thematic analysis was carried out on four English translations and the Arabic text of the Qur'an to explore whether the connection between jinn-possession and insanity exists within the Muslim holy book. No connection between spirit-possession and madness or mental illness was found. Pagans taunted and labelled people as jinn-possessed only to ostracize and scapegoat. Linking the labelling of people as jinn-possession to a pagan practice may be used to educate Muslims, so they can reassess their community's stigma towards the mentally ill.

Canada is home to a growing immigrant population. However, immigrant mental health declines over time following arrival in Canada. Canada's Mental Health Strategy emphasizes the importance of research that gathers information from multiple sources of knowledge to identify the mental health challenges faced by diverse immigrant populations. Mixed methods research (MMR) is well suited for this task. However, a dearth of research exists on the application of MMR to the study of immigrant mental health. A systematic review of the published MMR literature in Canadian immigrant mental health was carried out. Overall, existing MMR studies failed to incorporate correct mixed methods terminology and fully integrate the quantitative and qualitative components of the research. A checklist of important elements to include in MMR studies is offered.

Background:

South Asian populations are the largest visible minority group in Canada; however, there is very little information on the mental health of these populations. The objective of this study was to determine the prevalence rates and characteristics of mental health outcomes for South Asian first-generation immigrant and second-generation Canadian-born populations.

Methods:

The Canadian Community Health Survey (CCHS) 2011 was used to calculate the estimated prevalence rates of the following mental health outcomes: mood disorders, anxiety disorders, fair-poor self-perceived mental health status, and extremely stressful life stress. The characteristics associated with these four mental health outcomes were determined through multivariate logistic regression analysis of merged CCHS 2007-2011 data.

Results:

South Asian Canadian-born (3.5%, 95% CI 3.4-3.6%) and South Asian immigrant populations (3.5%, 95% CI 3.5-3.5%) did not vary significantly in estimated prevalence rates of mood disorders. However, South Asian immigrants experienced higher estimated prevalence rates of diagnosed anxiety disorders (3.4%, 95% CI 3.4-3.5 vs. 1.1%, 95% CI 1.1-1.1%) and self-reported extremely stressful life stress (2.6%, 95% CI 2.6-2.7% vs. 2.4%, 95% CI 2.3-2.4%) compared to their Canadian-born counterparts. Lastly, South Asian Canadian-born populations had a higher estimated prevalence rate of poor-fair self-perceived mental health status (4.4%, 95% CI 4.3-4.5%) compared to their immigrant counterparts (3.4%, 95% CI 3.3-3.4%). Different profiles of mental health determinants emerged for South Asian Canadian-born and immigrant populations. Female gender, having no children under the age of 12 in the household, food insecurity, poor-fair self-rated health status, being a current smoker, immigrating to Canada before adulthood, and taking the CCHS survey in either English or French was associated with greater risk of negative mental health outcomes for South Asian immigrant populations, while not being currently employed, having a regular medical doctor, and inactive physical activity level were associated with greater risk for South Asian Canadian-born populations.

Conclusions:

Mental health outreach programs need to be cognizant of the differences in prevalence rates and characteristics of mental health outcomes for South Asian immigrant and Canadian-born populations to better tailor mental health services to be responsive to the unique mental health needs of South Asian populations in Canada.

Adolescence is a very trying time for young people. They feel hurt, misunderstood, betrayed and angry at the world. Parental expectations regarding academics and relationships just add fuel to the fire. Often these parent-child conflicts exacerbate the situation. The constant need to please one's parents with high grades and stellar careers can be too much for a young adult. Around this time, romantic relationships also start and become another breeding ground for conflict. Battles ensue regarding suitable "mates" and "potential spouses". In the end, parents and young adults can be left feeling angry and betrayed.