Exploring relationships between socioeconomic position, family context, culture, and suicidality among Métis peoples : reflections from the 2006 Aboriginal Peoples Survey

According to a 2003 Health Canada report, suicide was the leading cause of death among Aboriginal individuals under the age of 45, accounting for 23% of all deaths in this at-risk population. While previous research has explored many potential risk factors for suicide among Aboriginal populations, none have considered the Métis population independent of other Aboriginal groups. Additionally, there have been no studies explicitly examining the relationship between family context and suicidality among either of these populations; this is the primary relationship of interest in this project. Data used for this project was taken from the 2006 Aboriginal People’s Survey (APS). The APS is a national cross-sectional survey of 61,041 First Nations, Inuit and Métis peoples. Within the APS, family context was constructed using several variables including parental divorce, childhood adoption, number of siblings, etc. Analyses for this project included a multi-stage process consisting of bivariate and multivariable analyses. Multivariable logistic regression analysis was separated by gender and examined those aged 25-54. Results showed that that for women, renting versus owning your home, the death of sibling under age 2, or being removed by a child welfare agency, the church, or government officials was significantly associated with suicidal ideation. For men, unemployment, living in the community of origin, death of a sibling under age 2, and participating in traditional craftwork all significantly associated with suicidal ideation. Not graduating from high school and unemployment were significantly associated with suicide attempts for men or women when controlling for all other demographic, family context, and culture variables within the final model. As has been the case in previous research surrounding culture, several of the results in the bivariate analysis of this project were counterintuitive (Wilson & Rosenberg, 2002). This shows that nuanced and contextual interpretations are critical, and a space is opened with this research to critically consider what exactly is being captured through the survey measures. I argue that the strength of the linkage between a measure and its conceptual basis becomes increasingly tenuous and problematic as the complexity of the circumstance the measure is attempting to capture increases

Laparoscopic adrenalectomy for resection of unilateral noninvasive adrenal masses in dogs is associated with excellent outcomes in experienced centers

OBJECTIVE: To report the short- and long-term outcomes of laparoscopic adrenalectomy (LA) for resection of unilateral adrenal masses and to document risk factors for conversion and peri- and postoperative morbidity. ANIMALS: 255 client-owned dogs. METHODS: Dogs were included if LA was attempted for resection of a unilateral adrenal mass. Medical records were evaluated and relevant data were reported, including complications, conversion, perioperative death, and long-term outcomes. Signalment, clinicopathological data, and surgical experience were factors statistically evaluated for possible associations with capsular penetration during surgery, conversion, surgical time, duration of hospital stay, death prior to discharge, mass recurrence, and survival time. RESULTS: 155 dogs had left-sided tumors, and 100 had right-sided tumors. Conversion to an open approach was performed in 9.4% of cases. Capsular penetration (19.2%) and major hemorrhage (5.4%) were the most prevalent intraoperative complications. Of the dogs operated on, 94.9% were discharged from the hospital. Lesion side, portion of the gland affected, and surgeon experience influenced surgical time. Conversion rate increased with increasing body condition score and lesion size. Risk of death prior to discharge increased with increasing lesion size. Risk of conversion and death prior to discharge were lower when performed by more experienced surgeons. Capsular penetration during LA increased the risk of tumor recurrence. CLINICAL RELEVANCE: LA for resection of unilateral adrenal masses is associated with excellent outcomes in experienced centers. Surgeons with greater experience with LA have lower surgical times, conversion rates, and risk of death prior to discharge

Prevalence of and Risk Factors for Self-Reported Chronic Bronchitis in a Canadian Population: The Canadian Community Health Survey, 2007 To 2008

BACKGROUND: Chronic bronchitis (CB) represents one of the respiratory disease phenotypes that affect the Canadian health care system significantly. Presently, almost 6.5% of total health care costs are related to respiratory diseases

What Impacts Perceived Stress among Canadian Farmers? A Mixed-Methods Analysis

Globally, farmers report high levels of occupational stress. The purpose of this study was to identify and explore factors associated with perceived stress among Canadian farmers. A sequential explanatory mixed-methods design was used. An online cross-sectional national survey of Canadian farmers (n = 1132) was conducted in 2015–2016 to collect data on mental health, demographic, lifestyle, and farming characteristics; stress was measured using the Perceived Stress Scale. A multivariable linear regression model was used to investigate the factors associated with perceived stress score. Qualitative interviews (n = 75) were conducted in 2017–2018 with farmers and agricultural sector workers in Ontario, Canada, to explore the lived experience of stress. The qualitative interview data were analyzed via thematic analysis and then used to explain and provide depth to the quantitative results. Financial stress (highest category—a lot: (B = 2.30; CI: 1.59, 3.00)), woman gender (B = 0.55; CI: 0.12, 0.99), pig farming (B = 1.07; CI: 0.45, 1.69), and perceived lack of support from family (B = 1.18; CI: 0.39, 1.98) and industry (B = 1.15; CI: 0.16–2.14) were positively associated with higher perceived stress scores, as were depression and anxiety (as part of an interaction). Resilience had a small negative association with perceived stress (B = −0.04; CI: −0.06, −0.03). Results from the qualitative analysis showed that the uncertainty around financial stress increased perceived stress. Women farmers described the unique demands and challenges they face that contributed to their overall stress. Results from this study can inform the development of mental health resources and research aimed at decreasing stress among Canadian farmers

A Systematic Review and Meta-Analysis of Depression among Farming Populations Worldwide

A systematic review and meta-analysis were conducted to determine the overall prevalence of depression among farming populations globally, and explore any heterogeneity present. Eligible studies were primary research articles published in English, which involved the collection of data for the purpose of determining the prevalence of depression among a farming population. Four relevant databases were searched in January 2019. Potential for bias was assessed using a modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. From 7662 records, 72 articles were deemed relevant and had data extracted. Of these, 45 utilized the Center for Epidemiologic Studies—Depression Revised scale (CES-D/DR) to quantify depression, 42 of which were conducted in the United States (U.S.). As a result, meta-analyses were restricted to this geographic location. Substantial heterogeneity was seen in the initial whole-group analysis (I2 = 97%), and while sub-group exploration suggested a significantly higher prevalence of depression among migrant farm workers (26%, 95% CI = 21–31%) than in studies examining a non-migrant farming population (12%, 95% CI = 8–17%), substantial heterogeneity remained (I2 = 96%), indicating that the majority of between study variation was due to factors other than sampling error. Additionally, the majority of studies (81%) in migrant farm worker populations were published since 2010, while only 21% of studies in non-migrant farming populations were published in this timeframe. It is possible with recent efforts to de-stigmatize mental illness, participants in more recent studies may be more likely to self-report depressive symptoms. Hence, while it appears that migrant farmworker populations may have an elevated prevalence of depression, it is also apparent that little research in the U.S. has been done to evaluate depression among non-migrant farming populations in recent years. Perhaps a reporting bias may account for some of the difference between the two populations. A research gap also appears to exist in estimating the prevalence of depression among farming populations outside of the US. Assessment for bias at the study level revealed challenges in reporting of key study design elements, as well as potential for selection bias in the majority of studies

“An Incredible Amount of Stress before You Even Put a Shovel in the Ground”: A Mixed Methods Analysis of Farming Stressors in Canada

Farming is widely regarded as a highly stressful occupation, and many farming stressors have been studied globally. Research on farming stressors in Canada is scarce, yet there is some indication that Canadian farmers have high perceived stress scores and score more severely across mental health outcomes compared to the general population. This study provides a comprehensive exploration of farming stressors in Canada with the aim to inform avenues to reduce stress and/or boost the well-being of farmers. An exploratory sequential mixed-methods design was used. First, qualitative data were collected from 75 in-depth interviews with farmers and industry professionals from Ontario, Canada from 2017 to 2018. These data were then used to inform items measuring self-reported stress across 12 farming stressors in a national cross-sectional survey of farmers’ mental health conducted February–May 2021. Results from both data sources provide an initial understanding of the episodic and chronic stressors faced by farmers in Canada, and the context within which these stressors are experienced. Implications and focus areas for stress reduction and well-being promotion are discussed in this paper

Research trends in farmers' mental health: A scoping review of mental health outcomes and interventions among farming populations worldwide.

BACKGROUND:Mental health issues among farmers are identified population health concerns. While one systematic review focused on suicide in farming populations in the United States, there have been no scoping studies examining mental health in farming communities worldwide. The objectives of this scoping review were to: provide a descriptive analysis of the literature pertaining to mental health outcomes in farming populations; describe the international scope of the research; and highlight published mental health services and interventions that have been evaluated. METHODS:Following Arksey and O'Malley's scoping review framework, five major health and science platforms were used to identify studies examining mental health outcomes in farming populations, worldwide. Studies that met a priori inclusion criteria that were published prior to December 31, 2017 were included in this review. Data synthesis and descriptive statistics were conducted using STATA 15® software; proportions were calculated by country. RESULTS:The initial literature search yielded 9,906 records. After title and abstract screening, 676 articles were reviewed in-full. Of these, 341 met a priori inclusion criteria. Studies included were conducted between 1979 and 2017; the majority (265; 77.7%) were published between 2002-2017. The most frequently measured outcomes were stress (41.9%), suicide (33.1%), and depression (32.6%). Over 70% of studies that examined stress described using quantitative research methods, most predominantly, cross-sectional designs (42.7%). Approximately 64% of studies that measured suicide reported using a quantitative approach; the largest proportion of included suicide studies (33.6%) described using cohort designs. Approximately 84% of studies that measured depression described using quantitative approaches; sixty percent of these studies reported using a cross-sectional study design. Twenty included studies described a mental health service or intervention (5.9%). CONCLUSIONS:This scoping review provides a critical overview of the literature examining mental health outcomes in farming populations worldwide. Given the importance of farming and agriculture, this review can be used to ensure future research complements existing work, avoids unnecessary overlap, and begins to tackle the less-studied mental health outcomes amongst farmers. These results can guide researchers to identified gaps in research and services, leading to a more informed approach to future work, and ultimately, a more comprehensive understanding of mental health among farmers worldwide