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2024 Inaugural CAMH womenmind Conference: Advancing Research on Women’s Mental Health

rominagdl — Fri, 10 May 2024 16:30:00 +0000

2024 Inaugural CAMH womenmind Conference: Advancing Research on Women’s Mental Health

Author: Romina Garcia de leon, PhD Student, University of Toronto/CAMH & Laura Gravelsins, PhD, Postdoctoral Fellow, CAMH | Editors: Jena Roy, Manager, Philanthropic Gifts, Research (womenmind) CAMH; Bonnie Lee, PhD Candidate, University of British Columbia, CAMH

Published: May 10th, 2024

On April 17th and 18th 2024, CAMH womenmind hosted the inaugural conference on Advancing Research on Women’s Mental Health in Toronto. Across 9 symposia, this conference delved into diverse areas of women’s health research. Women’s mental health research has been chronically underfunded and understudied, which has resulted in worse health outcomes for women, girls, and gender-diverse people. Over 450 people gathered from around the world with a shared purpose: to learn from leading experts and catalyze meaningful change in the field of women’s mental health research.

The diversity of speakers made the event dynamic, with research scientists, clinicians, people with lived and living experience experiences, and healthcare advocates sharing the stage. As Dr. Liisa Galea, the inaugural womenmind Trevling Family Chair in Women’s Mental Health and Senior Scientist at CAMH, emphasized during the closing speech: “If healthcare is our boat and our healthcare practitioners are the crew, research is the compass that shows them where to go.” It is the synergy of these forces that will reshape the landscape of healthcare for women, and ultimately lead to better health for all. This blog will highlight a couple of lessons learnt from some of the brilliant speakers at this conference.

What do we know about how hormonal cycles impact mental health?

For some time now, we have understood that hormones impact mood. As Dr. Benicio De Frey and Dr. Marija Kundakovic both stated in their talks, it is times of hormonal fluctuations that increase the risk for mood disorders (like depression, and anxiety). Premenstrual dysphoric disorder (PMDD), the severe form of premenstrual syndrome (PMS), appears to affect 5-8% of individuals who menstruate. PMDD is often difficult to diagnose as it shares similar symptoms to depression, PMS, and bipolar disorder, and this leads to incorrect or delayed treatments. Additionally, an accurate diagnosis requires consistent data for 2 months, showing that symptoms coincide in the period preceding menstruation (luteal phase). Dr. Frey’s team created the ‘McMaster Premenstrual and Mood Symptom Scale (MAC-PMSS)’ to track symptoms across the menstrual cycle, allowing individuals suffering from symptoms of PMS or PMDD to take control of their health and bring this data directly to their healthcare providers.

Do we know how sexual orientation plays into mental health?

Structural stigma and discrimination are associated with adverse mental health outcomes. Dr. Robert Paul Juster's talk revealed that structural stigma can directly impact an individual’s physiology. Dr. Juster’s research considered whether stress and sex hormones varied depending on sexual orientation. Following a mild stressor, lesbian, gay and bisexual (LGB) women had higher levels of testosterone, progesterone, and cortisol reactivity compared to heterosexual women - the same wasn’t seen in gay and bisexual men. Another study investigated daily morning cortisol levels of LGB versus heterosexual individuals and found that differences in cortisol levels only became apparent when the data was separated by those who had disclosed their sexuality to their friends and family, as those who had not disclosed their sexuality showed higher levels of diurnal cortisol. Understanding how stress and biomarkers of stress differ by sexual orientation and individual experiences brings us closer to achieving precision medicine.

How does menopause affect the aging brain?

Menopause involves a steep depletion of circulating sex hormones, with implications for profound changes in the brain, as several speakers discussed. For instance, Dr. Natasha Rajah talked about how her team has been contributing to the Brain Health at Midlife and Menopause Study (BHAMM). A central aim of BHAMM is to diversify the cognitive neuroscience of aging research, recognizing that much of our aging research comes from highly educated white individuals. Another is to investigate how menopause status affects memory and memory-related brain activity. Some notable findings are that lower spatial context memory and decreased activity in certain brain regions associated with encoding and retrieval were associated with postmenopausal status and advanced age. Her research suggests that menopause amplifies the effects of chronological aging. Studying female-specific experiences such as menopause can reveal differences in the aging trajectory and implications for disease risk. Moreover, research must examine specific hormonal experiences across different sexes and genders, as they can have unique contributions to health and disease outcomes

The impact on people with lived experiences and advocates driving change:

The symposium titled “Elevating Voices: Integrating Expertise and Advocacy in Collaborative Research for Greater Impact” was the heart of the conference. Megan Pilatze shared the story of her late autism diagnosis and the difficulties she faced navigating the healthcare system that didn’t understand her. Megan had sought help for her mental health on several occasions and was diagnosed and medicated but her symptoms prevailed. It was only after reading a book titled “Women and Girls With Autism Spectrum Disorder” by Sarah Hendrickx that Megan realized she had been misdiagnosed her whole life. After seeking an (expensive) Autism assessment, she received her diagnosis at the age of 31. Megan highlighted that males are predominantly diagnosed with autism (3:1 male-to-female), but most research insufficiently focuses solely on caucasian males. There is also a diagnostic sex bias where females are less likely to be diagnosed because the screening criteria cater to characteristics that do not reflect the presentation of autistic females. Furthermore, Dr. Meng-Chuan Lai presented his research that demonstrates that females display more masking behaviours than males. Together, it is apparent that more research is needed on how symptoms and manifestations of autism differ in females versus males, and excluding these differences in research can be extremely harmful.

Patricia Tomasi, co-founder and Executive Director of the Canadian Perinatal Mental Health Collaborative(CPMHC), shared that 1 in 5 individuals in the postpartum stage develop postpartum depression - affecting 80,000 families in Canada per year. Patricia suffered from an extreme form of postpartum depression and psychosis throughout both of her pregnancies (read her story here). While seeking medical help, Patricia was sent home without any support on multiple occasions and had to continuously advocate for herself to her doctor to receive a diagnosis. As a result of her lived experiences, Patricia works tirelessly to amplify the stories of women who have suffered through postpartum depression, as not all people suffering end up receiving appropriate care and support before catastrophic consequences, such as suicide. The CPMHC does an annual walk for perinatal mental health named “Flora’s Walk for Perinatal Mental Health.” The stories that Patricia and those at the CPMHC have brought to life fuel the research and help bring perinatal mental health to the forefront of healthcare concerns. Patricia proposes that Canada implement a Perinatal Mental Health Strategy that would create lasting and systemic change for birthing parents, and families.

All the speakers and inspiring conversations during the womenmind^TMconference provided invaluable insights and underscored the stark reality that achieving health equity across sex and gender remains a long journey ahead. Advancing women’s mental health research will improve care for 51% of the world’s population, through early intervention to prevent mental illnesses and personalized treatments to ensure better outcomes. Research is vital to our success and we look forward to driving change and gathering again for the next CAMH womenmind^TMConference.

rominagdl Fri, 05/10/2024 - 09:30

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Romina Garcia de leon

Behind the Science: Indigenous practices at WISE Women’s College

rominagdl — Fri, 19 Apr 2024 20:30:57 +0000

Behind the Science: Indigenous practices at WISE Women’s College

Interviewee: Lisa Richardson | Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators)

Published: April 19th, 2024

What was the motivation to get the Centre for Wise Practises in Indigenous Health started at Women’s College?

The initial motivation was based on observing the experiences of Indigenous peoples in the healthcare system, both those seeking care and Indigenous learners being trained as healthcare professionals. There was a desire to have a place where people would feel supported and not have to deny their Indigeneity but be in a place where that's valued and seen. We wanted to create a place where one can have access to traditional cultural supports if needed and where they can be supported as a whole person – mind, body, spirit, and emotion in that model of care and well-being.

Additionally, the Centre emerged at the time that it did because the Truth and Reconciliation Commission of Canada (TRC) had come up with specific health-related Calls to Action. I had been involved in writing a report around how healthcare institutions could incorporate those calls to action specifically, and so we sought to do that at Women's College Hospital.

How are healthcare providers educated on Indigenous health?

We have some amazing online modules that exist for cultural safety. But there is also a need to come together in small groups and talk through some of what was heard. We sometimes debrief provider and patient interactions. For instance, if there was an incident where a patient felt uncomfortable, we want to ensure that the patient is supported but also consider how to make things better for next time. This might include a specific healing session, facilitated by an Elder, where a provider and a patient come together and try to emerge from it in a restorative way. We also have speakers for important events like the Missing and Murdered Indigenous Women and Girls annual day of recognition and the National Day for Truth and Reconciliation. Through dialogue, small groups, and one-on-one conversations we try to educate healthcare providers on indigenous health.

Since its opening in 2018, what have been the major outcomes of this initiative?

One of the teachings that I had from an Elder on our Decision-Making Council was “Lisa, build a small fire and people will want to come.” I interpreted it as “don't start by wanting to build this great big program. Just start by doing the work within Women's College and eventually, people will want to participate if it’s done in a good way.” We have very strong community partnerships. We have an Elder-in-Residence who has a Traditional Medicine clinic. We have hired a Patient Relations advocate–an Indigenous peer support and a patient and relations advocate who will sit with patients to accompany them on their journey and connect them to resources both within and outside the hospital. We additionally have a team that goes into community organizations, meets with individuals and tells them about what we’re doing. I feel very strongly about recruiting and supporting the next generation of Indigenous people in health care–advocates, leaders, providers, and scientists, and so we have a lot of Indigenous learners who do their placements or work on projects with us. We have a collaboration with the medical school, which means that Indigenous medical students come and hang out in our space where they can be surrounded by Indigenous peoples, and connect with community members and Elders. We also have an amazing summer camp program for grades 9-10 Indigenous learners. Beyond the hospital, we have worked on outreach programs to help support Indigenous primary care practitioners who are working in isolation and on the reserves. We have specialists who are going out to the reserves to provide consultations as needed.

When incorporating indigenous voices, how do initiatives and foundations avoid non-meaningful engagement and prevent tokenism?

I think building something slowly and carefully and led by Indigenous peoples has been important for us as well. This is the opposite of having a single person in a single role and on their own trying to transform a whole institution, which is generally not successful. Importantly, we have Indigenous people in senior leadership roles overseeing everything we do for accountability purposes. I think one important structural aspect of the Centre is the dual accountability within my role. I report both to the CEO and to our Decision-Making Elders. I do my check-ins with both and thus am held accountable by leaders in our community who can advise me on what would and wouldn’t be appropriate. This is essential for me because it helps ensure that the work is grounded in the needs of our people.

Why the focus on women’s health?

There's a reason why we're centred at Women's College Hospital. It's a hospital that cares for all people but understands some of the specific needs of women and gender-diverse peoples in healthcare. At our Centre, we understand that for our communities and for the future generations to be healthy, we need women, children and families to be healthy.

rominagdl Fri, 04/19/2024 - 13:30

advocacy
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Lisa Richardson

2024 Women's Health Research Symposium: Advancing Women's Health Through Menopause Research

rominagdl — Thu, 04 Apr 2024 17:00:00 +0000

2024 Women's Health Research Symposium: Advancing Women's Health Through Menopause Research

Author: Shayda Swann | Editors: Romina Garcia de leon (Blog Co-coordinator) and Katherine Moore (Director of Operations)

Published: April 4, 2024

On International Women’s Day (March 8th 2024), the Women’s Health Research Institute hosted the 9th annual Women’s Health Research Symposium, titled Midlife Women’s Health Research: Unpacking the Science of the Menopause Journey and its Health Impacts. In this blog, we’ll be highlighting the work shared by the keynote speaker, Dr. Susan Reed (MD, MPH).

Why menopause matters

Perhaps the most obvious reason why menopause matters is because half of the world’s population will experience it. This ubiquitous experience brings bothersome symptoms that can reduce women’s quality of life, lead to work absences, and reduce overall productivity. Despite this, only a fraction of health funding goes towards menopause research. For instance, of the ~9,000 grants funded by the Canadian Institutes of Health Research from 2009-2020, only 5.9% evaluated female specific outcomes, let alone menopause-focused work. We encourage readers to review our three-part menopause series where we cover many of these topics in depth (Part 1, Part 2, and Part 3).

Reviewing landmark studies in menopause research

The Study of Women’s Health Across the Nation (SWAN) began in 1994 and was a US-based cohort of 3,000 women aged 42-52. They identified that “menopause transition symptoms”, such as menstrual irregularity and vasomotor symptoms (i.e., hot flushes and night sweats) peaked between ages 46-56 and that most people experience menopausal symptoms for up to 10 years. They also reported that symptoms were typically most bothersome in the two years before and after the final menstrual period. Additionally, the SWAN study identified important predictors of vasomotor symptoms, such as adiposity (body fat), having less than a college education, stress, depression, and anxiety. The SWAN study also reported key findings around sleep, mood, cognition, cardiovascular disease, metabolic health, bone health, and sexual health. For instance, they found that low libido was associated with vasomotor symptoms and that bone loss is most rapid in the year preceding the final menstrual period.

Another study, called MsFLASH, further advanced our understanding of this important phase in women’s lives, with a focus on alleviating menopause symptoms. First, they found that selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrin reuptake inhibitors (SNRIs) have a modest benefit of reducing vasomotor symptoms in women who cannot or prefer not to take hormonal therapies. Unfortunately, exercise, omega-3s, and yoga were not found to be beneficial therapies. Similarly, they found that neither vaginal estrogen nor vaginal moisturizer decreased the number of moderate-to-severe vulvovaginal discomfort episodes compared to placebo.

What do we know about treating menopause?

From the studies cited above and others, Dr. Reed shared the current evidence for menopause treatment options. This is a very brief overview and we encourage all women to discuss specific treatment approaches with a trusted health care provider. First, menopause hormone therapy can be initiated in most women with symptoms between ages 50-59 who are 1) low risk for cardiovascular disease, breast cancer, or venothromboembolism (blood clots) or 2) moderate risk based on informed decision-making. Treatments should be initiated within 10 years of the final menstrual period or before age 60.

Knowledge translation

Dr. Reed also shared several useful patient-centred resources to help women navigate the menopause transition. For instance, the Menopause Priority Setting Partnership has a survey where women can share their priorities for future menopause research projects. The MsFLASH study also developed a fantastic website which includes a primer on menopause, an overview of treatment options, and a tool to build a personalized “menoplan”.

Thanks to the organizers of the Women’s Health Research Symposium for another excellent meeting and for prioritizing mid-life women’s health!

rominagdl Thu, 04/04/2024 - 10:00

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Shayda Swann

The Faces of Women’s Health: Women’s Health Trailblazers

rominagdl — Mon, 18 Mar 2024 23:54:02 +0000

The Faces of Women’s Health: Women’s Health Trailblazers

Authors: Shayda Swann & Romina Garcia de leon

Published: March 22, 2024

In honour of Women’s History Month, this blog will focus on prominent women who shaped the future of women’s health. We are honoured to benefit from the impacts of these remarkable women!

Dr. Susan La Flesche Picotte

Dr. Picotte, born in 1865 as a member of the Omaha tribe in Nebraska, USA, was the first Indigenous woman to receive a medical degree. As someone deeply committed to the health of her community, she was inspired to pursue medicine after witnessing the death of an Indigenous women who was refused care by a white physician. Dr. Picotte applied to attend the Women’s Medical College of Pennsylvania in 1886, which at the time was one of the only medical schools to train women. Following her graduation in 1889, where she was honoured as valedictorian of her class, Dr. Picotte returned to her home community to provide medical care to members of the Omaha reserve. In addition to her medical practice, Dr. Picotte was a strong advocate for public health and preventative medicine, focusing specifically on reducing alcoholism, improving hygiene and food sanitation, and combating tuberculosis.

Professor Tu Youyou

Professor Tu was born in 1930 and trained in pharmaceutical chemistry at the Beijing Medical College. During the Vietnam War, the Chinese government tasked Professor Tu with searching for a treatment for malaria, which was killing thousands of soldiers. With her background in both Chinese and Western medicine, Professor Tu travelled around China to gather teachings from Traditional Chinese Medicine practitioners. Her findings were collected in a journal called A Collection of Single Practical Prescriptions for Anti-Malaria, which summarized 640 prescriptions. Based on these, she evaluated 2,000 recipes and eventually discovered the anti-malaria properties of a compound called artemisinin or qinghaosu, extracted from sweet wormwood plant. As the first person to isolate this compound, she insisted that the first human clinical trial was done on herself. Fortunately, the treatment proved to be both safe and effective, leading to her publishing her findings in 1977 after nearly a decade of work. To this day, artemisinin-based compounds continue to be first-line therapy for malaria, thanks to Professor Tu’s innovative approach to pharmaceutical discovery. Professor Tu received the Nobel Prize for Physiology or Medicine in 2015 for her groundbreaking work that has saved millions of lives. She continues to lead the field of science as the Chief Scientist of the China Academy of Chinese Medical Sciences.

Dr. Flossie Wong-Staal (Wong Yee Ching)

Dr. Flossie Wong-Staal born in 1946 in Guangzhou, China was the first scientist to clone human immunodeficiency viruses (HIV) and determine the function of its genes. It was this pivotal work that led to the conclusion that HIV was the cause of acquired immunodeficiency syndrome (AIDS). High rates of AIDS became rampant in the 1970s disproportionately affecting gay men, this led to a harmful stigmatization of HIV, and towards the gay community. The advancement in research by scientists like Dr. Wong-Staal contributed to the destigmatization of AIDS. Dr. Wong-Staal had conducted her Ph.D. in molecular biology at UCLA and was working on her postdoctoral fellowship at the National Cancer Institute (NCI) where she studied retroviruses. Through her work at the NCI, she cloned HIV and completed its entire genetic mapping. These specific discoveries led to the development of blood testing for HIV, and later segwayed into her work of repressing HIV in stem cells to function as a treatment for AIDS. However, her research also aided in the advancement of Hepatitis C, cancers, and even COVID-19. It was how she approached HIV that changed how virologists study viruses today. She continued her research to find a cure for AIDS through gene therapy and became the chief scientific officer of the biotechnology firm, Immunosol.

Eunice Newton Foote

Born in 1819, Eunice Newton Foote became the first scientist to discover the greenhouse effect. The greenhouse effect was coined decades after Newton Foote discovered the interaction of carbon dioxide (CO2) and heat. In 1856, Eunice Netwon Foote placed a series of glass cylinders full of different gases and gaseous mixtures next to sunlight and found that the glass cylinder filled with moist air and CO2 warmed the most. Newton Foote concluded in a paper that this CO2 could be a contributor to a heating planet. This foundation became a cornerstone in climate science. Three years later, an Irish scientist, John Tyndall concluded similar findings and was coined the discoverer of the greenhouse effect and father of climate science. The overlooked findings of Newton Foote are an example of how female scientists have remained in the shadows of history.

rominagdl Mon, 03/18/2024 - 16:54

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Unveiling the Gap: Understanding Heart Disease in Women

rominagdl — Fri, 16 Feb 2024 02:12:11 +0000

Unveiling the Gap: Understanding Heart Disease in Women

Authors: Najah Adreak, MD, MSc in Surgery, University of British Columbia | Editors: Romina Garcia de leon and Shayda Swann

Published: February 16th, 2024

Have you heard that heart disease is a man's disease? In fact, heart disease is the leading cause of death for women worldwide. Since 2015, Canada and other nations have reported an increase in female deaths from heart disease, highlighting the urgent need for comprehensive understanding and targeted interventions. In Canada, every 20 minutes, one woman dies from a heart attack, every 7 minutes one woman is diagnosed with heart disease, and women are 7x more likely to die of cardiovascular disease than breast cancer. Heart and vascular disease stand as the leading causes of hospitalization and premature death among women in Canada, affecting one in three women globally. Despite these alarming figures, women remain understudied, underdiagnosed, and under-treated, with healthcare providers often unaware of their unique risk factors and atypical presentation of heart and vascular disease.

How Heart Disease Differs in Women: Unveiling the Discrepancies

The distinct nature of heart disease in women compared to men emphasizes the need for specialized attention. Factors such as different symptoms, risk factors, and causes necessitate unique diagnostic and treatment approaches.

Heart attacks in women often go unrecognized. The Hollywood-style chest pain:” Chest-clutching, crushing pain’’ may not be the predominant symptom, with women more likely to present with 3+ symptoms, including jaw, neck, arm, or back pain, excessive sweating, shortness of breath, stomach discomfort, and more. Downplaying symptoms and attributing them to non-heart-related issues can lead to misdiagnosis or underdiagnosis. Proactively seeking medical help is important to ensure proper diagnosis and treatment.

Did you know that the early signs of heart attack are missed in 78% of women, especially if they are young or come with less common symptoms? Women and their doctors can be slow to identify the signs and symptoms of a heart event. According to a study published in The New England Journal of Medicine in 2000, women are 7 times more likely to be sent back home from the ER while having a heart attack, when compared to men.

It is imperative to also acknowledge the often overlooked burden placed on women due to caregiver responsibilities and the strain arising from juggling work and household duties. Women — particularly younger women — may have their signs attributed to anxiety, heartburn, or other “female” issues and are less likely to get immediate treatment.

Causes of Heart Disease in Women: Beyond the Basics

Heart disease can manifest differently in women and men, presenting with various types.

Women, in particular, are more susceptible to distinct conditions, such as a tear in the large blood vessels of the heart (spontaneous coronary artery dissection, SCAD), tightening of the large heart blood vessels that restrict blood flow (coronary vasospasm), small vessel disease (microvascular dysfunction), weakened heart due to a stressful event (Takotsubo cardiomyopathy), and weakened heart during or after pregnancy (peripartum cardiomyopathy). The prevalence of SCAD, for instance, is notably higher in women, making up to 35% of heart attacks in women under 50. Notably, smoking, diabetes, high blood pressure, and a family history of heart disease serve as notable warning signs specifically for women. For instance, women living with diabetes are 3x more likely to die from heart disease compared to men.

Several unique risk factors contribute to an elevated risk of heart disease in women, including specific pregnancy complications such as premature birth, diabetes or hypertension during pregnancy, and preeclampsia. Additionally, early menopause, polycystic ovary syndrome, and systemic inflammatory and autoimmune disorders like rheumatoid arthritis and lupus can increase the risk. Indigenous women in Canada and those from particular racial and ethnic groups such as South Asian, Chinese, black and Afro-Caribbean descent experience higher rates of heart disease and poorer outcomes compared to Caucasian Canadians. They are also at a higher risk of cardiovascular disease.

Empowering Women: Mitigating Heart Disease Risks

Despite the concerning statistics, more than 80% of risk factors for heart and vascular diseases can be prevented through proactive measures:

Be Active and Keep Moving: Regular physical activity is crucial for maintaining heart health. Check this guideline for more
Eat a Variety of Nutritious Foods
Manage Stress
Live Free from Commercial Tobacco and Vaping
Limit Alcohol and Substance Misuse
Get Regular Health Checkups

Wear Red Canada: A Collective Effort for Women's Heart Health

In 2018, the Canadian Women’s Heart Health Alliance was established to transform clinical practice and enhance collaborative action on women’s cardiovascular health in Canada. The annual Wear Red Canada awareness campaign, set on February 13, aims to improve heart health for women of all ages.

Participation in Wear Red Canada is open to all, with activities ranging from wearing red to sharing key messages on social media using hashtags #HerHeartMatters and #WearRedCanada. Participating in virtual movement challenge events, attending webinars, and engaging with the Wear Red Canada community on Facebook are impactful ways to support women's heart health.

Understanding the nuances of heart disease in women is essential for effective prevention and treatment strategies. By acknowledging the differences and taking proactive steps, we can work together to reduce the prevalence of heart and vascular diseases in women.

rominagdl Thu, 02/15/2024 - 18:12

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Najah Adreak

Behind the Science: Women’s Health and Forced Migration

rominagdl — Thu, 08 Feb 2024 01:41:28 +0000

Behind the Science: Women’s Health and Forced Migration

Interviewee: Dr. Shahin Kassam, RN, PhD, Postdoctoral Research Fellow, University of British Columbia School of Nursing, Capacity Research Unit

Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators)

Published: February 9th, 2024

This week we talk to Shahin Kassam who tells us about her work on forced migration, specifically how displacement (for reasons such as climate instability, political conflict, coercion and human trafficking) impacts local and international intersections where gender, race, class and migrant status converge to shape women’s health and access to health and social services.

Can you tell us a bit more about your research?

My doctoral research looked at how public health nurses located here in British Columbia support women living with refugee status while also transitioning into parenthood. This intersectionality-framed research identified fragmented pathways women have to self-navigate to access health and social systems while also living with the impacts of gender-based violence, discrimination, and fear stemming from migration policies.

This doctoral work opened up more questions for me to further understand women’s experiences of accessing systems of health and social well-being and how they are shaped by these conjoint experiences of racial discrimination, gender-based violence, and their migrant status. To specify “forced migration” in this work is important because when we talk about migration it is often in binaries, either voluntary or involuntary. Experiences of being forced can be about being categorized by policy as a refugee, or as seeking asylum. But it can also be categorizations where women are rendered dependent and socially disconnected thereby increasing their risk for gender-based violence exposure and consequential chronic and acute health problems such as post-traumatic stress disorder, depression, hypertension, diabetes, and asthma. Rather than systems deciding whether a woman migrates forcibly or not, why are we not letting women’s experiences shape the narrative?

Essentially the research I'm doing just really intentionally ensures that we place women and their experiences at the forefront of understanding forced migration.

What drew you to this work?

I come from a clinical public health nursing background. My research took off from the stories and experiences that I had with varying women with different backgrounds who experienced marginalization or disadvantages such as poverty or lack of support, literacy skills, and limited education. I constantly saw the inequities that these women faced and couldn’t let go of how that deserved more attention. So I think that just really propelled me into doing more.

Can you share any findings from this work?

As a Postdoctoral Research Fellow, I’m working with my supervisor Dr. Vicky Bungay who is the Scientific Director of the Capacity Research Unit and professor at the UBC School of Nursing, to build my program of research involving the development of non-profit community partnerships with sectors that are really integral to the safe settlement of women. So the research being done is informed by community-based participatory research principles where the community drives the research process. The overarching goal is to inform the enhancement of access to health and social services with the experiences of women impacted by gender-based violence, racism, and forced migration.

Through a SSHRC Partnership Engagement Grant, our community co-lead, Diana Ospina from DIVERSEcity Community Resources Society (DCRS) and I convened a group of leaders from three additional non-profit organizations focused on settlement service delivery. Together we met often and shaped the research process. We recruited nine women who had been in Canada from 0-5 years across varying races, migrant statuses, and languages such as Spanish, Ukrainian, Dhari, and Tigrinya.

Some of the key findings that we found through these women’s stories were that women need support in their pursuit of meaningful employment and integration into the labor market sector. Loss of financial independence and dealing with poverty is very challenging. Language barriers continue and language classes are often inaccessible because of the lack of affordable childcare. Another finding is housing that is safe from forms of violence or exploitation. The need for social growth and connections is another finding. When women arrive in Canada, often their only connection is their partner or their partner's family/friends, creating dependency.

To further understand the experiences of women impacted by forced migration, we are hoping to grow through further funding opportunities to delve deeper into this work.

Given the lack of attention to forced migration, and women’s health, what keeps you moving forward?

A big part of doing this work is grit and tenacity and simply not giving up. I think that if you are passionate about something, and you're surrounded by support, that I think those are two big key ingredients to doing the work. For me, it's the applied experiences as a nurse that continue to just really propel me in this direction. And then I think it's the pragmatic and inclusive pillars and the values that align my work with the Capacity Research Unit and the School of Nursing that have promoted building and weaving together this program of research.

How can people learn more about your work?

Website: Shahin Kassam’s website

Research Unit: Capacity Research Unit, Women’s Stories of Forced Migration

More information:

Funder: SSHRC Partnership Engagement Grant

Principle Investigator: Dr. Vicky Bungay, UBC School of Nursing, Capacity Research Unit

Community Co-Applicant: Ms. Diana Ospina, DIVERSEcity Community Resources Society

Academic Co-Applicant: Dr. Shahin Kassam, Postdoctoral Research Fellow

Community Collaborators:

rominagdl Wed, 02/07/2024 - 17:41

advocacy
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forced migration
gender-based violence
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Shahin Kassam

Personality and Sex Differences in Depressive Symptomatology

rominagdl — Fri, 19 Jan 2024 17:30:00 +0000

Personality and Sex Differences in Depressive Symptomatology

Authors: Jessica Stewart, PhD Candidate, Health Psychology, University of British Columbia | Editors: Romina Garcia de leon and Shayda Swann

Published: January 19, 2024

It’s not hard to believe that people with tendencies toward anger or aggression will end up with more health problems than those who have a positive outlook. Many studies have shown that personality traits are associated with physical health and mortality.

Personality traits can be identified as patterns of feelings, thoughts, and behaviours that take shape in one’s childhood and become consistent throughout one’s life.

The Five-Factor Model of personality is a common method of describing personality traits and separates the traits into agreeableness, conscientiousness, extraversion, neuroticism and openness to experience.

Hostility, which is an attribute of neuroticism, is associated with coronary heart disease and mortality, while conscientiousness predicts longevity.

Depressive symptoms, which approximately 350 million people around the world currently experience, have been linked to personality traits. A 2023 study showed that all five dimensions of personality were linked to changes in depressive symptoms but neuroticism has the strongest association with depressive symptoms, with people who are high in neuroticism being more likely to experience depressive symptoms.

Personality traits may also be a cause of the considerable sex difference in depressive disorders that exists between males and females across sociocultural contexts. This difference exists across the lifespan, with females around twice as likely as men to experience depressive disorders from adolescence to late adulthood.

Neuroticism and depression in women

In a 2022 study, neuroticism was correlated with the prevalence of probable major depressive episodes for both men and women. Still, the effect of neuroticism in the incidence and persistence-recurrence of probable major depressive episodes was only found in females. In other words, the study found a neuroticism-related vulnerability in women for the incidence or persistence-recurrence of a major depressive episode.

Past research has suggested one neural mechanism between neuroticism and depression found only in women. It has been described as a correlation between neuroticism and resting-state regional cerebral blood flow in the hippocampus and midbrain, and neuroticism predicted depressive symptoms through greater activity of these regions, which are used in emotional processing and regulation.

Conscientiousness and depression in women

Conscientiousness affects men and women differently as well. In the same 2022 study, the interaction found between gender and conscientiousness for the incidence of depressive symptomatology demonstrated a larger protective effect of conscientiousness for men compared to women. In other words, being high in conscientiousness helps men prevent depressive symptoms more than it does for women.

Considering the impact of personality traits and gender on depressive symptoms, researchers recommend including personality and gender-specific strategies in mental health and depression intervention or prevention programs.

rominagdl Fri, 01/19/2024 - 09:30

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Jessica Stewart

Brain Health in Pregnancy, Menopause, and Beyond - Is There a Link with Alzheimer’s disease?

rominagdl — Tue, 02 Jan 2024 20:03:06 +0000

Brain Health in Pregnancy, Menopause, and Beyond - Is There a Link with Alzheimer’s disease?

Interviewee: Alesia V. Prakapenka, Assistant Professor, Biomedical Sciences, College of Graduate Studies, Midwestern University Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators)

Published: January 5, 2024

Could you tell us more about the work you do in women’s health?

In my lab, we use animal models to understand how hormones impact brain and behavioral health within females and we take on a lifespan approach. We recently were awarded a grant from the Alzheimer's Association to investigate the relationship between pregnancy, age, and menopause on healthy aging and Alzheimer's disease progression in female rodent models. We're very excited to get that work started. Primary outcomes include both short-term and long-term memory measures, as well as evaluation of memory types that engage different brain regions, including hippocampus, frontal cortex, and striatum. We're also interested in anxiety-like and depressive-like behaviors as these are modulated by hormones and are associated with Alzheimer’s disease.

How did you become involved in this field?

I'm fascinated by how learning, memory, and the brain works in general. When I was in high school, I took a psychology class and one of the units was on the brain. That sparked my interest, and I really wanted to learn more about what we know and what we don't know about the brain. As an undergraduate, I got involved in research in a lab that used animal models to study learning and memory, and one interesting aspect of it was that the lab only worked with male animals. That got me thinking and looking more into the research on how learning and memory works in males versus females. To me, it seemed like there was a gap in understanding female learning, memory, and brain functions compared to males. So, for graduate school, I pursued research that focused specifically on female learning and memory with my co-mentors, Drs. Heather Bimonte-Nelson and Rachael Sirianni. Specifically, I worked on developing strategies to target the delivery of hormones, such as estrogens, to the brain to optimize their cognitive effects in females. My graduate research led to many more questions than answers regarding hormones and female health, which I am excited to continue to research.

What does a typical day in your field look like?

If we’re working with the animals, the timelines are planned out months in advance. With this new project looking at pregnancy and Alzheimer’s disease, for example, we have a schedule set for 2-3 years because we are working with animals throughout their lifespan. Some days, we’re administering treatments, checking in on the health of animals, or testing behavior and memory tasks. And then other days we’re getting to work with the tissue - process it, tag it with antibodies, and then visualize it. And then other days we’re on a computer looking at lots and lots of spreadsheets, analyzing the data and putting it together to understand and share what we find.

Are there any interesting findings from your work that you'd like to highlight?

My lab is in its second year, so our data collection is currently very fresh and ongoing. For example, as we establish our behavior tasks and protocols in the lab, we are finding that dose-dependent effects of 17beta-estradiol on spontaneous alternation behaviors are modulated by specific task parameters in female rats. And although we do not yet have findings from our lab for our recently funded work, I’d love to highlight valuable findings from other labs’ in the field that informed and sparked this research direction. There are multiple findings, for example, showing that pregnancy is neuroprotective and beneficial for female brain health. There's also some evidence to suggest that pregnancy can be associated with increased Alzheimer's disease risk. So, we aim to investigate factors, such as age and menopause type, that may help explain the disparate effects of pregnancy on healthy aging and Alzheimer's disease pathogenesis.

What impact do you hope to see with your work?

The impact I hope to see with my work is rooted in student mentorship. Majority of students that I work with are either on a pre-healthcare career path or in their first or second year of medical or dental school. My approach is to mentor students, most of whom will be future healthcare professionals and inevitably working with the female population, to appreciate the complexity of female health and embrace it. I hope to help them understand the research on female health, critically analyze it, and appreciate it so that when they are forming that medical plan for an individual, they can be comfortable addressing female-specific health aspects.

Look out for Dr. Prakapenka’s upcoming work funded by the Alzheimer's Association, through the Sex and Gender in Alzheimer's Award, titled 'Alzheimer's disease pathogenesis in mothers: a role for age and menopause'.

rominagdl Tue, 01/02/2024 - 12:03

Alzheimer's Disease
brain health
estrogens
hormones
pregnancy

Blog

Blog Author(s)

Alesia Prakapenka

Menopause Hormone Therapy from a Consumer's Point-of-View

rominagdl — Fri, 29 Dec 2023 20:00:00 +0000

Menopause Hormone Therapy from a Consumer's Point-of-View

Authors: Amanda Thebe, Fitness and Nutrition Coach Editors: Romina Garcia de leon, Shayda Swann

Published: December 29, 2023

Women don’t have much agency when it comes to menopause, and that has to change. Historically, menopause has either been demonized or swept under the rug as something women should soldier on with. And this has done women a huge disservice. It has led to a massive knowledge gap that means women aren’t getting access to the help they need, either because they don’t know what is happening to them or where to turn.

We aren’t taught about menopause in school, it is hardly ever discussed in the workplace (thankfully, that is changing), and when it comes to advocating for ourselves within the medical community, women are more likely to have incorrect treatments or be completely dismissed by their GP. Why? Well, we know doctors receive very little medical training unless they opt into take it. And the result of this leaves women floundering.

Women are unfortunately at the receiving end of the WHI Study 2002, which boldly told the world that menopause hormone therapy (MHT) causes breast cancer. Even though those findings have been withdrawn, that statement caused a lot of damage. Doctors became hesitant to prescribe MHT, and that hesitancy still exists today despite the menopause societies recommending MHT as a safe treatment option for some menopause symptoms. And the people that suffer the most because of this are women with symptoms who are desperately looking for help.

Going to the doctors to advocate for yourself during menopause can be a minefield. If women simply don’t know that they're in perimenopause, they may just present with one or two symptoms and be treated for those symptoms without the doctor looking at the full picture. Alternatively, women might go to the doctor asking for help with what they know to be perimenopause, only to be turned away empty-handed or with a referral to a specialist because the doctor feels hesitant or uninformed about providing help. This type of negative experience leaves a lasting mark on a woman, who typically has to build up quite a lot of courage to ask for the help she needs. According to the American Association of Retired Persons (AARP), 80% of medical residents in the United States did not feel competent to discuss or treat women in menopause!

We need to help women know that MHT should be an option open for discussion so that they can see if they can be a candidate for the treatment of their symptoms. The MQ6 is a great tool that doctors can use to screen midlife women for menopause and find appropriate treatments. Many women who start taking MHT really feel the benefit and start to see improvements in their symptoms and, therefore, in their quality of life.

On the flip side of this, there is a pervasive message, especially on social media and within menopause online communities, from women who take MHT successfully to treat their menopause symptoms, and from some “celebrity doctors” that MHT is a panacea. This can lead to many women feeling excluded from the conversation because the truth is not every woman can or should take it. MHT is a powerful drug that doesn’t suit all women, especially those with contraindications. We all have a duty to make sure that the information we share about MHT and non-hormonal alternatives stay within the medical consensus statements.

These same platforms often talk about (peri)menopause as a disease or deficiency that must be treated with hormones and the bizarre idea that we weren’t meant to live past menopause in the past. This type of disinformation is very harmful during a vulnerable time of a woman’s life. It is essential to empower women during this time with accurate knowledge, so that they know that if they are suffering, there is help available to them, and they do not have to suffer. But that this is a life transition (for most women) which is meant to happen and that we can and do thrive in postmenopause.

From a personal perspective, I was relieved to be offered MHT by a very progressive doctor, only to have a very negative experience with it. Many years later, when I learned I had a sensitivity to hormones, it all made sense. During those 5 years, I often would flounder into deep depression or struggle with chronic cluster migraines every time I tried MHT. And I know I am not alone. Thankfully for people like me, or for others who can never take MHT, other pharmaceuticals do exist, and women should be given this information.

In an ideal world, if a woman is one of the 75% with moderate symptoms or 25% with life-altering symptoms, and they go to their doctor for help, they should be heard. They should have an assessment to make sure they are in perimenopause and then be offered the most appropriate treatment for them - which may or may not include MHT. Ultimately, menopause is a shared experience amongst all women, but we must be treated on an individual basis for our unique circumstances.

rominagdl Fri, 12/29/2023 - 12:00

advocacy
hormone therapy
hormones
menopause

Blog

Blog Author(s)

Amanda Thebe

Behind the Science: Pregnancy and Multiple Sclerosis – What’s The Link?

rominagdl — Fri, 15 Dec 2023 18:56:00 +0000

Behind the Science: Pregnancy and Multiple Sclerosis – What’s The Link?

Interviewees: Pia Campagna, Postdoctoral Fellow, Monash University, Melbourne, Australia Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators)

Published: December 15th, 2023

When there are clear sex differences in disease prevalence, researchers must question the underlying factors. Women with Multiple Sclerosis (MS) outnumber men 4 to 1. What is being done to understand this statistic? How can we look into female-specific factors to disentangle these questions?

For this month’s Behind the Science, we interviewed Pia Campagna who provided some insight into these questions.

Can you tell us about your research?

Our lab studies Multiple Sclerosis (MS) and other neuro-immunological conditions. Much of my work focuses on incorporating women's health into MS research by looking at pregnancy and menopause. MS affects 2 million people globally, roughly 75% of which are women. Previous work from our group has shown the clinical effect of pregnancy, where a pregnancy before disease onset delays the onset of MS symptoms by 3.4 years. After onset, the effect of pregnancy is more controversial, but work from our group has shown a protective effect of pregnancy on long-term disability accumulation.In my postdoc, I'm seeking to understand the biological mechanisms underpinning these clinical effects via a national multi-site prospective study.

Why did you want to get involved in women's health?

I started research in MS due to the demographic of those affected - women. Because of this, it’s an interesting population to study in light of all of the female-specific experiences that interact with this disease. For example, it’s a disease that’s primarily diagnosed in a woman’s reproductive years (20-40 years old) so there are interactions with pregnancy, and due to the chronic nature, women are living with MS during perimenopause and menopause too.

I started my Ph.D., focused on genomics, prognostic modelling and machine learning in MS. It just so happened that other people in our group were doing this fascinating work on pregnancy. I had the opportunity to delve into the epigenetic impacts of pregnancy in women with MS, which sparked my interest in women's health route MS. I did love the bioinformatic aspects of my Ph.D. work and hope to incorporate that down the line when we have the data available.

Is there anything interesting that you’ve learned from your research findings?

When we compared the whole blood DNA methylation profiles of women with MS who had not given birth, we identified differences in methylation patterns at genes enriched in neurogenesis and axon guidance pathways. After noticing these signals, we hypothesized that the hormonal changes from pregnancy created long-term effects that drive changes to the clinical course of MS. Now, we are collecting blood from women with and without MS before, during and after pregnancy, so eventually we'll be able to look at DNA methylation in these different stages, as well as a range of other -omic profiles.

What impact do you hope to see with this work in the long term?

Not only is the prevalence of MS increasing worldwide but so is the female-to-male ratio. I hope that research focuses more on the female-specific aspects of the disease, which is still very understudied. Although there’s strong evidence that pregnancy is beneficial before onset, and some evidence of a beneficial long-term effect, , it's surprising to me that we still don't know how or why. Detangling this will not only be beneficial to women but also more individualized therapeutic targets benefit men as well. Another frontier in MS research that I would like to see more of is the impact of menopause. For example, we still don't know if the disease gets worse after menopause, how estrogen loss interacts with disease-modifying therapies, or whether they're as effective. Understanding the clinical aspects of menopause and subsequently, the biological aspects of menopause is an important route to take moving forward.

Where can people learn more about your work?

Twitter: @PiaCampagna
Personal website: piacampagna.com
Lab website: Jokubaitis group

rominagdl Fri, 12/15/2023 - 10:56

autoimmune disorders
Behind the Science
biology
birth
menopause
multiple sclerosis
pregnancy

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Blog Author(s)

Pia Campagna