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Evaluating primary suicide prevention in adolescents with risk factors (ESPAIR): study protocol for a cluster-randomized controlled trial
Get PDFBackground: Suicide is the leading cause of death among young people. Because it is preventable, suicide prevention has become a critical public health priority worldwide. Current evidence suggests that primary suicide prevention interventions are effective in promoting suicide awareness and reducing suicidal thoughts among adolescents. However, scarce research has been conducted in vulnerable populations who may be at increased risk of suicidal behaviour. This project aims to test the effectiveness of a primary suicide prevention intervention on suicide awareness, knowledge of suicide and local resources, suicidal thoughts, psychological distress, and safety.
Methods: This study is an open-label, multi-centre, superiority, cluster-randomized controlled trial with two parallel arms (randomization 1:1 in at least 8 study sites) of a primary suicide prevention intervention based on psychoeducation versus an art-based control intervention. Four groups of youth aged 14–25 with high suicide risk will be recruited (in total, n = 240), including those (1) detained in juvenile detention centres, (2) disconnected from school, (3) in treatment for psychiatric disorders, (4) belonging to a sexual or gender diversity, (5) affected by chronic conditions, and (6) with relational/familial problems. Participants will be randomly assigned to the suicide prevention or control intervention. The primary outcome is suicide awareness measured on a validated scale. Secondary outcomes include knowledge of suicide, knowledge of local resources, suicidal behaviour, psychological distress, access to primary suicide prevention, and safety. Measures will be collected at baseline, at 1-week, and 3-month follow-ups. Analyses will be conducted as intention-to-treat using mixed-effects models.
Discussion: We expect that a brief primary suicide prevention intervention (psychoeducation) will be effective and safe in vulnerable adolescents.
Trial registration: ClinicalTrials.gov NCT06551038. Registered on August 13, 2024
Perspectives on mental health information and program development needs among Canadian newcomer parents
Get PDFChildren who are newcomers to Canada comprise a rapidly growing portion of the population and face numerous unique mental health risk factors and barriers to care. Mental health literacy (MHL) is a common target for mental health promotion and prevention, and a valuable set of skills for parents as caregivers for their children. However, several aspects of settlement complicate solutions to these challenges, requiring a transformation of our conceptualizations of MHL and effective care. Through two qualitative studies, this dissertation critically evaluated application of MHL in diverse sociocultural contexts, given its non-integration of cultural differences in mental health and information needs. Study 1 (n = 10) explored how MHL aligns with newcomer parents’ unique lived experiences and perceptions of information needs surrounding child mental health through individual qualitative interviews. Data was collected and analyzed according to constructivist grounded theory. Findings suggested that the conventional framework of MHL appears to have limited applicability to the newcomer context, due to distinct sociocultural experiences that complicate how presentations of mental health and MHL can be understood (e.g., cultural definitions of mental health, sacrifices and losses during immigration). Findings also highlighted barriers that can limit access to relevant resources (e.g., language, discrimination, settlement stressors). Study 2 (n = 13) evaluated the need for and feasibility of developing a MHL program for newcomer parents via participatory focus groups with newcomer parents and settlement sector professionals. Data was collected and analyzed in line with reflexive thematic analysis. Findings yielded a thematic framework that was organized into program development recommendations for important content areas (e.g., impact of settlement and acculturation on child mental health) and community-based principles in MHL program development (e.g., integration into community settings, focus on family empowerment). This dissertation’s findings offer novel contributions regarding how newcomer families may interface with different perspectives on mental health and psychoeducational resources in central Canada, as well as directions for future settlement sector collaboration and program development for specific newcomer contexts (e.g., cultural groups, immigration categories). Foundations for future research and program development are also provided through a theoretical model and program development recommendations produced in this work.Sam and Esther Sair Scholarship (The Winnipeg Foundation)
Research Completion Scholarship (University of Manitoba)
Direct Aid to Achieve Award (University of Manitoba)February 202
IgG antibody responses to SARS-CoV-2 vaccination in Manitoba, Canada
Get PDFUnderstanding variables that influence antibody responses to SARS-CoV-2 vaccination within a population can provide valuable information on future vaccination strategies. In this study, I examined the antibody responses to SARS-CoV-2 vaccination in Manitoba, Canada using serum specimens collected by Cadham Provincial Laboratory between March 2020 and March 2023. Specimens were tested for spike and nucleocapsid IgG against SARS-CoV-2 using clinically validated assays. I assessed the impacts of multiple factors on post-vaccination antibody titres including type of vaccine, age, sex, geographic location, number of doses received, timing of vaccination, and influence of previous infections. My investigation demonstrated that vaccination with one dose of Moderna mRNA-1273 elicited higher anti-spike IgG titres overall compared to Pfizer BNT162b2 vaccination, while one dose of Pfizer BNT162b2 followed by a second dose of Moderna mRNA-1273 exhibited higher titres than two doses of Pfizer BNT162b2 or Moderna mRNA-1273, irrespective of age. Age had the greatest effects on antibody responses, with older age groups exhibiting consistently lower anti-spike IgG titres of than younger ages. Antibody titres did not appear to be affected by sex or geographic location. My results identify how factors such as age and type of vaccine can influence antibody responses to vaccination. This information highlights the importance of tailoring vaccine regimens to those at increased risk of severe COVID-19 and can be used to inform future vaccination strategies, scheduling of booster doses and public health measures.February 202
The role of KATP channels in mitochondrial function and neurite outgrowth: implications in peripheral neuropathy
No full textDorsal root ganglion (DRG) sensory neurons play a critical role in processing and modulation of sensory information, including that experienced in peripheral neuropathy. In response to injury of peripheral nerves the DRG undergo changes in potassium channel (K+) function including KATP channels. KATP channels are integral in the regulation of membrane excitability and inhibited by physiological ATP and activated during events of energy depletion, such as metabolic stress. KATP activation plays a neuroprotective role in peripheral neuropathy via membrane hyperpolarization, decreased cell excitability and prevention of cell death. Similarly, the AMP-activated protein kinase (AMPK) signaling pathway enhances mitochondrial functioning and plays a neuroprotective role in peripheral neuropathy. Hypothesis: agonists of KATP channels enhance mitochondrial function and neurite outgrowth via the AMPK pathway and modulate neuronal excitability in DRG neurons. DRG neurons from adult Sprague-Dawley male rats were isolated and cultured under defined conditions. KATP channel openers pinacidil and VU0071063 increased levels of phosphorylated AMPK in a dose and time dependent manner. Additionally, opening of KATP channels augmented neurite outgrowth in the DRG neurons. Interestingly, pinacidil as well as VU0071063 treatment resulted in decreased ATP production as well as coupling efficiency and negatively impacted a plethora of other oxidative phosphorylation parameters. Lastly, pharmacological inhibition of AMPK via Compound C negated the enhancement effect of pinacidil and VU0071063 on neurite outgrowth. This data confirmed the ability of AMPK to act downstream of KATP channels and acts as a key mediator of KATP opening effects on neurite outgrowth. This study reveals for the first time that opening of KATP channels increases AMPK activity and augments neurite outgrowth. However, this mechanism of action of KATP activation did not positively effect mitochondrial respiration. The ability of pharmacological opening of KATP channels to drive neurite outgrowth indicate a potential therapeutic application in peripheral neuropathy.February 202
Summary report
No full textGroup-based exercise programs have been shown to be one means of not only increasing activity levels for older adults but sustaining physical activity. However, research has shown that only a small proportion of older Manitobans participate in exercise classes. There are several factors that could affect attendance and adherence to group-based exercise programs amongst older adults which are 1) person-level factors including current/previous physical activity levels, educational attainment, health status, and personal motivators, 2) instructors’ characteristics including personality, professionalism and previous experience, 3) program design including location, affordability and variety of exercise classes and 4) social interaction. In this study, we focused on factors that are related to exercise programs and instructors, which are instructors’ characteristics, program design and social interaction in accordance with the purposes of our study
Identifying the cannabinoid effects against breast cancer in vitro
No full textOver 25% of medical marijuana users are cancer patients who use cannabis in conjunction with standard therapy to relieve cancer/treatment-related nausea, anxiety, etc…, 25% of these patients are diagnosed with breast cancer (BC) (half of which are in stage 4 of their disease). World Health Organization declared BC to be the number one cancer worldwide, surpassing lung cancer as of last year. There are certain types of BC that are difficult to treat and often do not have targeted treatments; thus, leading to enhanced disease progression and decreased quality of life. The limited treatment options combined with some BC subtypes exhibiting increased aggressivity has led to BC being the second leading cause of cancer-related deaths in women. Therefore, other treatment options need to be explored, including the use of cannabis as a viable option.
In my research, it was first determined that, although low, BC cell lines do express the cannabinoid receptors 1 and 2. Following this, BC cell lines were then treated with varying ratios and combinations of trans-Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC and CBD in combination and as a single agent, exhibited anti-neoplastic properties across all BC subtypes, such as anti-proliferative properties and increase in cell death. The most notable combination was the 1THC to 1CBD ratio which has been shown to exhibit the enhanced anti-proliferative effects and cell death in vitro. More specifically, the 1THC to 1CBD ratio is shown to have caused apoptotic properties in vitro.
This study provides a starting basis to comprehensively examine the integration of cannabinoids as part of the standard BC treatment regimen, which may be coordinated with use of cannabinoids for symptom relief for BC patients.February 202
Continuing education/ professional development in aging survey
Get PDFDuring 2022, the Continuing education/professional development in aging survey was sent to various organizations and people that work and connect with older adults. The aim of this survey was to know what continuing education and topics of professional development training were required for individuals and organizations who work with older people. A total of 146 participants responded to this online survey, which consisted of 35 questions. These respondents were from different health regions of Manitoba, with the majority located in the Winnipeg Regional Health Authority
Engaging Red River Métis families in Manitoba in the development of child health resources – findings from a qualitative study
Get PDFAbstract Background Most research that includes Red River Métis tends to be pan-Indigenous. Grouping Métis with First Nations and Inuit can diminish their unique and diverse experiences, as well as distinctions-based approaches. Taking a step toward addressing this problem, the Manitoba Métis Federation (MMF; the national government of the Red River Métis) invited researchers within the Canadian network Translating Emergency Knowledge for Kids to partner in this research, which focuses on understanding engagement strategies that can help expose Red River Métis parents to child health research opportunities and build trust and transparency amongst research partners and participants. Methods A qualitative descriptive approach underpinned by a participatory paradigm guided this study. Semi-structured interviews were conducted with 19 Red River Métis parents and Elders via Zoom or telephone. An inductive thematic analysis approach was used to explore patterns and themes across the data. Results Analysis generated four themes: (a) show me why you are here; (b) make it easier for me to take part; (c) create welcoming spaces; and (d) it should be a give and take experience. Parents emphasized the importance of kinship and personal connections, and said they want to hear about child health study opportunities from trusted organizations. They want researchers to be transparent about their research motivations and to offer multiple ways to participate to help them fit research into their busy lives. Relational approaches within the research process (e.g., creating informal/welcoming environments, gathering over food, fostering shared learning/creative opportunities) are prominent in the findings. Conclusion There is a dearth of research focused on the distinct experiences of Red River Métis families. Engaging Red River Métis parents early in the research process will help incorporate their preferences and perspectives into the design of a larger project to adapt child health resources. More training is needed to help researchers improve their abilities to engage in self-reflection, listen, recognize power relationships, and demonstrate trust and transparency in each research interaction. It is only through respectful and successful engagement that child health research can be relevant, applicable and positively impact Red River Métis children, families and communities.Plain English Summary What we know Most research involving Red River Métis tends to group them together with First Nations and Inuit, which can overlook their unique experiences. To address this, the Manitoba Métis Federation (the national government for the Red River Métis) invited us to collaborate on a study. This research focuses on finding ways to engage Red River Métis parents/families in child health research, aiming to build trust and openness between research teams and participants. What we did We interviewed 19 Red River Métis parents and Elders in the Canadian province of Manitoba. We asked them how to improve access to and participation in child health research. We analyzed the data to identify common themes and patterns. What we learned Four main themes emerged: (a) show me why you are here; (b) make it easier for me to take part; (c) create welcoming spaces; and (d) it should be a give and take experience. Parents stressed the importance of personal connections and wanted to hear about child health research opportunities from trusted sources. They wanted transparency from researchers about their motives and flexible participation options due to their busy lives. Building relationships during research is important, such as through informal gatherings and shared learning experiences. Researchers need more training to reflect on their own biases, listen effectively, and foster trust and transparency in their interactions. Engaging Red River Métis parents early in the research process is crucial to incorporating their views into a larger project to adapt child health resources
Writing, teaching, healing, becoming: poetic inquiry as praxis
Get PDFThis poetic inquiry contemplates how creative writing may contribute to discovering and articulating the Self. Themes of healing and becoming are explored through a diasporic feminist lens. The tension between traditional scholarly writing and poetic inquiry as an act of decolonization has political overtones that challenge expectations of academia and identity. Poetry communicates the progression and arc of meaning as various themes intersect to explore the culture of Self, of the classroom, and of otherness. Symphonic terms are used for headings to frame the movement of theoretical and pedagogical ideas that arise from the analysis. This structure is metaphorical as each chapter is a variation on the theme of becoming through poetry.
Cultural abstraction,
colonized writing, now an obstruction
to my predilection for introspection.
Oh! But here is music of a different canon.
Melodies and rhythms of language
Stretches of silence
Giving body.
My body
Betrayed strayed afraid
Healing to words towards healing
Poetic music/the music of poetry.
Intro/Outro
structure beginning to end
A meaning found/made/felt
And a pen to scribe
The poetry movement
From a moment to a method
To contemplate on reflex,
On purpose, on self.
Ars Poetica in/of/as research
To search and stretch and sense and state
I am
mother.
teacher.
writer.Manitoba Teachers' Society Scholarship in Educational Scholarship
award # 46161
URL: none providedOctober 202
An Evaluation of Handheld Ultrasonography in Comparison to MRI for the Diagnosis of Temporomandibular Joint Disorders
Get PDFMRI is the gold standard of imaging modalities for the diagnoses of internal derangement (ID) of the Temporomandibular Joint (TMJ). MRI scans are non-invasive, use non-ionizing radiation, and provide valuable information on the position and morphology of joints, tissues and bony structures. MRI has disadvantages and patients with severe TMJ pain may find it difficult to complete a full TMJ scan series. The heavy demand for MRI utilization and resulting wait times prolong the interval between initial consultation and diagnosis. MRI is also expensive, inconvenient, and contraindicated in patients with certain metallic implants (Orhan & Aksoy, 2019). For these reasons, the author believes that finding an alternative diagnostic device for ID that is convenient and reliable is of critical importance.
There is a limited body of encouraging evidence demonstrating that mobile ultrasound sonography (mUS), can act as a diagnostic adjunct to MRI for assessment of Temporomandibular Joint Disorders (TMD’s), including ID and Degenerative Joint Disease (DJD). The use of mUS has no known contraindications, is readily accessible, comparatively inexpensive, and requires no special preparation (Orhan & Aksoy, 2019).
The purpose of this paper is to summarize the findings of original research into the Accuracy of handheld ultrasound sonography (HHU), in comparison to MRI, for the diagnoses of patients with TMD. The scans focussed on Anterior Disk Displacement (ADD) without reduction (ADDwoR), ADD with reduction (ADDwR) and arthritic changes (OA). Using a 95% CI and 5% p-value, when diagnosing ADDwoR, HHU was found to have a Sensitivity of 96.77%, Specificity of 100%, PPV of 100%, and NPV of 90%. When diagnosing ADDwR, Sensitivity was 76.50%, Specificity 100%, PPV 100%, and NPV 85.20%. The perfect Specificity means HHU is good at identifying patients that have a normal disc-condyle relationship and do not have ADD, while the perfect PPV means a high likelihood the tested patient has ADD.
Results indicate that HHU is a highly Specific test, with no false negatives, and an acceptable Sensitive test, with few false positives. HHU, in conjunction with questionnaires and clinical examination, shows promise as a first line imaging modality and screen for MRI referral