Moms in motion: Predicting healthcare utilization patterns among mothers in Newfoundland and Labrador.

Mothers have a significant influence on family dynamics, child development, and access to family services. There is a lack of literature on the typical Canadian maternal experience and its influence on access to services for mothers despite recognizing the importance of mothers. A cross-sectional study was conducted to address this research gap that employed Andersen's Behavioral Model of Health Service Use in conjunction with a feminist lens. A total of 1,082 mothers who resided in Newfoundland and Labrador (NL) participated in a province-wide survey in 2017 and reported on their wellbeing, family life, and healthcare utilization. Stepwise binomial logistic regressions and linear regressions were used to predict initiation and continued service utilization within the preceding 12 months, respectively. Mothers who participated in this survey were older, and were more likely to be in a relationship than those in the Canadian census, while no difference was observed in annual income. Approximately half of mothers accessed services for themselves over the previous 12-months, with the overwhelming majority accessing services for their children. Medical services were the most likely to be utilized, and mental health and behavioural services were the most likely services to be needed, but not available. Sociodemographic (e.g., age, education attainment), familial relationships and role satisfaction, health need, and health practices predicted maternal initiation and continued use of services, with a larger number of variables influencing maternal service initiation as compared to continuous use of services. Sociodemographic (e.g., maternal age, community population), maternal social support, health need, and maternal health practices predicted maternal access of at least one child service while family relationships, health need, and maternal health practices predicted maternal use of a range of child services conditional on initial access. These results can support the provincial health system to better support access to care by acknowledging the interdependent nature of maternal and child health care utilization. They also highlight the importance of equitable healthcare access in rural locations. Results are discussed in terms of their clinical relevance to health policy.

Obsessive-Compulsive Disorder: A Medical School Curriculum and Textbook Review.

OBJECTIVES: We conducted a curriculum review of Canadian undergraduate medical programs to identify why aggressive obsessions (among those with obsessive-compulsive disorder [OCD]) are so often misidentified by primary care physicians and professional students. METHODS: This study involved standardized interviews with representatives from Canadian medical schools regarding the content, time, and teaching styles used to deliver curricula related to OCD. Further, we utilized a set of standardized criteria to assess the OCD content of recommended textbooks from these schools. RESULTS: Canadian medical curricula failed to provide a comprehensive picture of OCD. One-third of medical programs did not provide an example of aggressive obsessions to students, with textbook case examples centered heavily (70%) on contamination or symmetry. Only 25% of programs (and 60% of textbooks) discussed the composition of the Unacceptable Thought Domain to include aggressive, sexual, and religious obsessions. Finally, over half of medical programs failed to indicate that aggressive obsessions are ego-dystonic and do not lead people to harm themselves or others. CONCLUSION: A series of recommendations are provided for medical schools intended to improve the comprehensiveness of OCD-related training.

Item-method directed forgetting is (usually) impaired in clinical populations: A meta-analysis.

The item-method directed forgetting paradigm is a common laboratory task used to measure memory control. While impaired memory control may contribute to the development and/or maintenance of a variety of psychological disorders, comparisons between clinical and nonclinical groups using this paradigm have been inconsistent-even within the same disorder. A systematic search for related articles utilizing clinical populations was conducted revealing 823 articles of which 36 met inclusion criteria. Raw mean differences were calculated and aggregated using Bayesian multilevel random-effects models. These models revealed a significant difference in the magnitude of directed forgetting between clinical and control populations, such that clinical populations (collapsing across all disorders or combining only the critical anxiety and depression clusters) exhibited a reduced directed forgetting effect. This difference tended to be larger in clinical (as opposed to clinical-analog) populations and in older samples. These results support the notion that item-method directed forgetting provides a suitable measure of memory control sensitive to real-world control deficits and further implies that memory control deficits may contribute to mental illness (although causality remains to be determined). (PsycInfo Database Record (c) 2023 APA, all rights reserved).