Résumés - Lauréat.e.s du concours de soutien à la participation à des conférences internationales 2022-2023
Félicitations aux lauréat.e.s de la première édition du concours
2022-2023 !
Michaela Bunakova (UMcGill) et al. “Changes in opioid use, non-prescription drug use and help-seeking behaviors in Canada during the COVID-19 pandemic”. American Sociological Association (ASA)’s Annual Meeting. 5 au 9 août, Los Angeles, presentation orale.
Résumé
Background/Objectives The COVID-19 pandemic and the resulting uncertainty it brought has negatively impacted the lives and mental health of many Canadians and exacerbated barriers for people already suffering from anxiety and substance abuse problems. This paper assesses patterns of opioid use, non-prescription drug (NPD) use and help-seeking behavior for substance misuse in Canada during the COVID-19 pandemic and explores how these changes relate to different sociodemographic characteristics in the Canadian population.
Methods Using data from Canadian Perspectives Survey on substance use and stigma during the pandemic and binomial logistic regression models, we assessed the associations between sociodemographic determinants of health and two primary outcomes: changes in drug use and help-seeking behavior for substance misuse
Results We found an association between increase in opioid and NPD use and poor mental health outcomes during the COVID-19 pandemic. Compared to Canadians with ‘excellent’ mental health, those who self-rated their mental health as ‘poor’ were 8.1 and 5.7 times as likely to have increased their opioid and NPD use, respectively, all else kept constant. Poor mental health was also significantly associated with inability to find needed help. The odds of unmet need for substance misuse services were over 19 and 14 times higher for opioid and NPD users in poor mental health respectively, compared to those in ‘excellent or good’ mental health and we saw a clear gradient in increased inability to find help as mental health scores worsened. We also found that that the odds of being unable to find help were around twice as high for single Canadians compared to their partnered counterparts.
Discussion Our findings raise awareness of comorbid mental health and drug use problems among Canadians during the COVID-19 pandemic and point to the need for accessible and targeted interventions for those unable to access much-needed help during the pandemic.
Catherine Côté (ULaval) et al. « Rétention des infirmières : quelles sont les attentes de la relève? ». 8e Congrès mondial des infirmières et infirmiers francophones (SIDIIEF). 16 au 20 octobre 2022, Ottawa, communication orale, présentiel.
Résumé
INTRODUCTION Les conditions de travail difficiles poussent certaines infirmières à quitter leur poste, voire même la profession. C’est d’autant plus vrai pour les infirmières constituant la relève pour qui le désir de quitter est croissant dans les premières années d’embauche. Devant cette problématique, une posture d’engagement professionnel est une avenue prometteuse pour les gestionnaires dans l’élaboration de stratégies organisationnelles de rétention.
OBJECTIF Caractériser les attentes de la relève infirmière face à l’employeur pour favoriser l’engagement.
MÉTHODE Dans le cadre d’une étude plus large et lors d’une première consultation en ligne, des infirmières de la relève (n=14) ont répondu par de brefs énoncés à la question « Que peut faire l’employeur pour favoriser l’engagement professionnel? ». Dans une deuxième consultation virtuelle, chaque infirmière a catégorisé les 49 réponses formulées, puis leur a accordé des cotes « d’importance » et « de probabilité de succès d’implantation ». Des analyses statistiques d’échelonnement multidimensionnel et en grappe ont permis de produire des « cartes conceptuelles » telles que suggérées par Trochim.
RÉSULTATS Pour favoriser leur engagement, les infirmières requièrent un employeur qui : s’adapte à l’employé, offre du soutien, assure un environnement sécuritaire, favorise le développement professionnel, motive ses troupes. Par ailleurs, les actions prioritaires sont de démontrer du respect, d’offrir un environnement sain et d’éviter les déplacements sur des départements non souhaités.
CONCLUSION Ces résultats offrent des pistes de solutions aux employeurs qui, dans l’optique de favoriser la rétention des infirmières de la relève, devraient arrimer les processus de gestion à la volonté de susciter l’engagement professionnel.
Carina D'Aiuto (USherbrooke) et al. “Patient and health system factors associated with potentially inappropriate opioid use in non-cancer community-dwelling older adults”. 38th International Conference on Pharmacoepidemiology & Therapeutic Risk Management (ICPE 2022). 24 au 28 août 2022, Copenhague (Danemark), affiche, présentiel.
Résumé
Background Opioid use and related harms are rising in older adults. Given the prevalence of polypharmacy and multimorbidity, older adults are at increased risk for potentially inappropriate medication use. Yet, few studies have explicitly focused on potentially inappropriate opioid use.
Objectives To study the factors associated with opioid use and potentially inappropriate opioid use in older adults.
Methods Secondary analyses were conducted using health surveys and administrative data from Quebec, Canada. Older adults aged 65 and above were recruited between 2011 and 2013 in primary care clinics to participate in face-to-face interviews. The sample included 945 older adults without a malignant cancer diagnosis over the study period or any cancer diagnosis in the two years surrounding opioid use. Opioid use was identified using data from the public drug plan. Potentially inappropriate opioid use was defined using the Beers 2019 list. Multinomial regression analyses were conducted to study the factors associated with opioid use and potentially inappropriate opioid use during a 3-year follow-up. Factors were selected based on the conceptual framework developed by the American Agency for Healthcare Research and Quality.
Results In this cohort, 26.2% used an opioid and 18.4% were categorized as potentially inappropriate opioid users, according to the Beers criteria. Factors associated with potentially inappropriate opioid use compared to opioid use included patient factors such as sex (OR=2.75, CI:1.39-5.41), psychological distress score measured using the Kessler K10 scale (OR=1.06, CI: 1.01-1.12), and the number of emergency department visits in the 3 years before opioid use (OR=1.50, CI: 1.10-2.06), and healthcare system factors, such as consulting in a private clinic with 3 physicians or more (OR=2.40, CI: 1.20-4.81). Factors associated with opioid use compared to no use included the number of emergency department visits (OR=0.71, CI: 0.52-0.96) and consulting in a private clinic with 3 physicians or more (OR=0.52, CI: 0.29-0.94).
Conclusions This study highlights key factors associated with potentially inappropriate opioid use and opioid use, both at the individual and healthcare system levels. These findings can be used to develop targeted interventions aimed at reducing potentially inappropriate opioid use in older adults at risk.
Cécile Duval (ULaval) et al. « Compression pneumatique intermittente adjuvante : revue systématique et méta-analyse ». Congrès International d'Épidémiologie 2022. 18 au 20 août 2022, Québec, communication orale, présentiel.
Résumé
CONTEXTE Les accidents thromboemboliques sont des complications fréquentes et l’une des principales causes de décès évitables à l'hôpital. Les anticoagulants sont le traitement préventif de référence. La valeur ajoutée de la compression pneumatique intermittente adjuvante est incertaine. Nous avons cherché à évaluer l'efficacité de la compression pneumatique intermittent en plus des anticoagulants pour prévenir les accidents thromboemboliques chez les adultes hospitalisés.
MÉTHODES Nous avons conduit une revue systématique et une méta-analyse selon les recommandations Cochrane. Nous avons cherché dans CENTRAL, Embase, MEDLINE, CINAHL, ClinicalTrials.gov et International Clinical Trials Registry Platform des essais contrôlés randomisés comparant l'utilisation de la compression pneumatique intermittent en plus des anticoagulants aux anticoagulants seuls chez des adultes hospitalisés. Nous avons calculé les rapports de risque d’accidents thromboemboliques, de thrombose veineuse profonde et d'embolie pulmonaire à l’aide d’un modèle à effet aléatoire. Nous avons évalué le risque de biais avec le Cochrane Risk of Bias 2 et la qualité de la preuve avec l'approche GRADE.
RÉSULTATS Nous avons inclus 17 essais, avec 8796 participants. L'utilisation de la compression pneumatique intermittente en plus des anticoagulants est associée à une diminution du risque d’accident thromboembolique (15 essais, rapport de risque = 0,53 [0,35-0,81]) et de thrombose veineuse profonde (14 essais, rapport de risque = 0,51 [0,33-0,81]) mais pas d'embolie pulmonaire (8 essais, rapport de risque = 0,74 [0,35-1,60]), avec une faible qualité de la preuve. Les analyses de sous-groupes indiquent une influence de la source de financement et de la durée de la compression.
DISCUSSION/CONCLUSION Les avantages apparents de la compression pneumatique intermittente adjuvante aux anticoagulants pour prévenir les accidents thromboemboliques et la thrombose veineuse profonde résultent de preuves de faible qualité dans des populations hétérogènes. De larges essais randomisés de haute qualité sont nécessaires pour en soutenir l'utilisation et pour identifier les patients pour lesquels elle pourrait être bénéfique.
Marimée Godbout-Parent (UQAT) et al. “Gender Identity and Gender Roles Differences in Multimodal Chronic Pain Management”. International Association for the Study of Pain (IASP) 2022 World Congress on Pain. 19 au 23 septembre 2022, Toronto, affiche, présentiel
Résumé à venir
Ellen Jackson (UdeM) et al. “Using directed acyclic graphs to identify confounders of the relationship between pig roaming and pig cysticercosis (Taenia solium)”. 16th International Symposium of Veterinary Epidemiology and Economics. 7 au 12 août 2022, Halifax, communication orale, présentiel.
Résumé
Objective Taenia solium cysticercosis/taeniasis is a neglected tropical parasitic disease of humans and pigs that causes significant economic losses in endemic areas. Its complex life cycle suggests multiple points for control, such as by confining pigs to reduce their exposure to the parasite. However, this complexity also renders confounders of the relationship between risk factors and infection difficult to identify.
Methods Multiple databases were searched for studies on the epidemiology of Taenia solium. After screening, 151 studies containing a total of 183 potentially causal associations were included. Two criteria for causality (one requiring a weak threshold, the other strong) were combined with expert opinions to draw “strong” and “weak” directed acyclic graphs (DAGs). These were used to identify confounders of the association between pig roaming and antigen seropositivity in a cross-sectional survey of 2187 pigs in 60 villages in Burkina Faso conducted in 2011-12. This association was analyzed using hierarchical logistic regression to control for clustering of infections within villages with confounding variables chosen by the strong and weak DAGs.
Results The strong DAG identified no confounders of the association between pig roaming and pig cysticercosis. The weak DAG demonstrated that at minimum four confounders (household density, pig age, season, and socioeconomic status) needed to be adjusted in the analysis. Pig roaming was not associated with pig cysticercosis (OR 0.90, 95%CI 0.74-1.10) in our model with no confounders. Adjusting for possible confounders produced similar results (OR 0.87, 95%CI 0.71-1.07).
Conclusions Pig roaming is not significantly associated with pig cysticercosis in our models using differing strengths of causality. Our work demonstrates how DAGs can be used to perform sensitivity analyses of epidemiologically-defined confounders. During our presentation, we will discuss using Bayesian methods to correct for misclassification when measuring our outcome. We will also present results using different definitions of pig confinement.
Paul Rodrigues (UQAM) et al. « Influence de l’accès aux espaces verts et aux équipements sportifs et récréatifs sur la violence dans les relations amoureuses chez les adolescents à Montréal ». Congrès International d'Épidémiologie 2022. 2022. 18 au 20 août 2022, Québec, communication orale, virtuel.
Résumé
Introduction La violence dans les relations amoureuses concerne de nombreux adolescents et pourrait entraîner d’importantes conséquences sur leur santé. Les quartiers pourraient jouer un rôle sur ces comportements mais aucune étude ne semble avoir analysé l’effet de l’accès aux espaces verts et à leurs équipements. L’objectif de ce travail est d’analyser l’association entre l’accès aux espaces verts et aux équipements sportifs et récréatifs sur la violence dans les relations amoureuses.
Méthodologie L’Enquête Québécoise sur la Santé des Jeunes du Secondaire (2016-2017) a été utilisée pour décrire la violence dans les relations amoureuses. À partir des données fournies par les municipalités de l’île de Montréal, le nombre d’espaces verts et le nombre d’équipements sportifs et récréatifs dans un rayon de 500 et 1 000 mètres autour du lieu de résidence des adolescents ont été calculés. Des modèles de régressions logistiques multiniveaux ont été élaborés pour les filles et les garçons séparément afin d’évaluer l’association entre la violence dans les relations amoureuses et le nombre d’espaces verts ainsi que le nombre d’équipements sportifs et récréatifs dans un rayon de 500 et 1 000 mètres, en contrôlant pour plusieurs caractéristiques au niveau des individus et des quartiers.
Résultats Le nombre d’espaces verts dans un rayon de 1 000 mètres serait négativement associé à la probabilité de perpétrer de la violence psychologique chez les garçons. Le nombre d’équipements sportifs et récréatifs dans un rayon de 500 mètres serait négativement associé à la probabilité de subir de la violence psychologique chez les filles.
Conclusion Les espaces verts et leurs équipements pourraient avoir des effets positifs chez les adolescents et contribuer à prévenir les comportements violents. Les politiques publiques devraient favoriser l’implantation de nouveaux espaces verts et l’amélioration de l’offre d’équipements dans les espaces verts existants afin de lutter contre la violence dans les relations amoureuses.
Tania Sabatino (UdeM) et al. “Perceived Mental Health and Intervention Needs Among Undergraduate Students Pursuing Health-Professional Degrees in Rehabilitation: A Photovoice Project”. 6th International Association of Youth Mental Health Conference. 29 septembre au 1er octobre 2022, Copenhague (Danemark), affiche.
Résumé
Introduction Young people face numerous challenges (i.e., new financial responsibilities, changes in social roles, and discovering their identity), as they transition into young adulthood. For those entering university, these challenges are compounded by issues related to transitioning to an academic environment with high performance requirements, such as meeting expectations of health professional undergraduate programs. Several interventions and initiatives have been developed or proposed to meet the needs of these students; however, there has been limited research on student perceptions of the proposed interventions and on whether these interventions meet their needs.
Objective This project explores the mental health and intervention needs of undergraduate students pursuing health-professional degrees in the rehabilitation field.
Methods The project uses a qualitative design and is inspired by an innovative participatory researchapproach, photovoice. This method aims to promote group discussions by sharing photos taken by participants. In this study, participants will be invited to take photos that illustrate factors that positively and negatively influence their well-being and mental health needs. These photos will then be used to lead group discussion exploring interventions that participants believe could help them achieve mental wellness. A total of 15 to 24 students, divided into 3 groups, will be recruited from a 1st year undergraduate health-professional program in Canada. Three, 1.5 hour sessions will take place for each group. The data will be analysed using a thematic analysis approach. A multi stakeholder advisory committee including professors, students, researchers and members of the university administration will also be involved throughout the researchprocess.
Implications for practice This project will allow students to express their mental health difficulties and needs using a participatory-based approach. The project promotes empowerment and awareness about mental health challenges that students studying in a health-professional field face. This project is also expected to encourage reflection among the academic community and increase the scientific knowledge available on student mental health.
Conclusion This student project is currently underway and preliminary results will be ready for presentation at the time of the conference. This project is expected to produce positive impacts for students and the academic community in health-professional fields. Improving students' mental health will limit its negative impact on their physical health, and on their academic and professional careers.
Stephanie Sersli (USherbrooke) et al. “Where can I get a drink around here? Association between neighbourhood disadvantage and alcohol outlet density in a liveable city”. International Medical Geography Symposium (IMGS). 19 au 24 juin 2022, Édimbourg (Écosse), communication orale, présentiel
Résumé
Background High spatial concentration of alcohol outlets is considered a public health harm, and previous studies have found correlations between outlet density and neighbourhood disadvantage, leading to inequitable exposure. However, there is a paucity of Canadian-specific studies—a notable absence because Canadian cities may have different land use patterns, zoning practices, and historical contexts. This exploratory analysis aimed to describe spatial inequities in alcohol outlet density in Vancouver, Canada, a city that promotes liveability as part of its urban brand.
Methods We examined the association between neighbourhood disadvantage and density of alcohol outlets (stratified by outlet type: offsite, onsite, and licensed restaurant). We used nonspatial bivariate negative binomial models, complemented by Bivariate Local Moran’s I to assess and visualize clustering. Our spatial unit of analysis was dissemination area (the smallest census geographic area, 400-700 persons).
Findings Outlet densities per neighbourhood were highly skewed toward zero: most (83%) had no offsite or onsite outlet, and 66% had zero licensed restaurants. We found an inverse association between neighbourhood disadvantage and density for each outlet type (offsite: RR=0.64, 95% CI(0.53, 0.79); onsite: RR=0.51, 95% CI (0.43, 0.61); restaurant: RR=0.59, 95% CI (0.53, 0.64)). There was no spatial clustering for offsite outlets, but some clustering for onsite outlets and restaurants. Spatial results reinforced nonspatial models, showing a negative relationship between outlet density and disadvantage, with onsite and restaurant outlets tending to cluster in less disadvantaged areas. There were very few instances of high outlet density in disadvantaged neighbourhoods.
Conclusion Our findings challenge common understandings of alcohol outlet distribution across space. Our next step will be to repeat this analysis for other Canadian cities to compare trends.
