The Relationship Between Non-Consensual Sex and Risk of Depression in Female Undergraduates at Universities in Maritime Canada.

Sexual victimization and depression are common on university campuses, especially among females. Both are associated with negative health outcomes and efforts are made to minimize these as much as possible on university campuses. The current study examines the prevalence of, and independent association between, non-consensual sex and current risk of depression after controlling for related factors. The primary study question is as follows: Are female undergraduate students who have been sexually victimized while attending university at an increased risk of depression compared with those who have not been victimized? Cross-sectional data collected online from female students below the age of 30 at eight universities in Maritime Canada were analyzed. Non-consensual sex while at university was measured using one dichotomous item and current risk of depression was measured using the validated Center for Epidemiologic Studies Depression (CES-D) Scale. All analyses were weighted and data were imputed using the sequential regression multiple imputation (SRMI) method. Analyses involved basic descriptive statistics, a series of unadjusted logistic regressions, and an adjusted multiple logistic regression. A total of 36.7% of female undergraduate students were found to be at risk of depression and 6.8% have been victim of non-consensual sex while attending university. After adjusting for covariates, females who were victimized were 2.11 times more likely to be at risk of depression than females who were not victimized (p < .0001). This study points to the possible unmet need for more mental health support for victims of sexual victimization and more efforts to prevent sexual violence on Canadian campuses. These findings can help to inform university mental health services such as mental health support for victims of sexual assault and can also be used to inform prevention and health promotion activities.

Sexual orientation and alcohol-related harms in Canadian youth.

OBJECTIVES: To determine associations between experiencing alcohol-related harm, sex, and sexual orientation among Canadian high school students. METHODS: We used data from the 2012 Atlantic Student Drug Use Survey (ASDUS), including a comprehensive six-category measure of sexual orientation and nine different alcohol-related harms for analyses. Simple logistic regression was used to determine the association between experiencing any of the nine harms and each specific alcohol-related harm and sexual orientation, stratified by sex. Analysis was limited to those who indicated they had consumed alcohol in the year prior to the survey. RESULTS: High rates of having any alcohol-related harm were seen among both males (41.7%) and females (46.0%) attending Atlantic Canadian high schools. Mostly heterosexual males had a lower odds ratio for experiencing any alcohol-related harm compared to heterosexual males. Mostly heterosexual females and bisexual females had higher odds ratios for experiencing any alcohol-related harm than heterosexual females. CONCLUSIONS: High rates of alcohol-related harm in this population suggest that youth may benefit from a harm reduction approach to alcohol use. While we found that mostly heterosexual and bisexual female youth experience higher levels of alcohol-related harm than heterosexual females, further research is required to confirm this association and to determine its relevance to harm reduction strategies.

School Connectedness and Protection From Symptoms of Depression in Sexual Minority Adolescents Attending School in Atlantic Canada.

BACKGROUND: In examining associations of sexual orientation, school connectedness (SC), and depression, no studies have used a continuum of sexual orientation. Additionally, no study has examined whether individuals with higher SC within subgroups of the continuum of sexual orientation are protected from symptoms of depression when compared to others within their own group. Our study aimed to address these deficiencies. METHODS: Data were from a cross-sectional survey of 6643 public high school students. Logistic regression was used to determine if higher SC was associated with protection from symptoms of depression comparing students with minority sexual orientations to heterosexual students, and whether SC was protective within subgroups of orientation. RESULTS: Mean SC scores were higher in heterosexuals than in all other orientation subgroups. Except for bisexual boys, compared with being heterosexual, being in other subgroups of orientation was associated with symptoms of depression, independent of SC. In both sexes SC was protective against depression risk within all categories of orientation except mostly/100% homosexual girls. CONCLUSIONS: Within all subgroups of sexual orientation except mostly/completely homosexual girls, SC was protective for symptoms of depression, indicating its potential importance for prevention of depression in all students, including perhaps particularly those with minority orientation.

Driving under the influence behaviours among high school students who mix alcohol with energy drinks.

Alcohol and energy drinks are commonly used substances by youth in Canada, and are often mixed (AmED). While several studies have shown that AmED can have dangerous effects, less well understood is how AmED is associated with driving under the influence of either alcohol or drugs. This study sought to determine whether youth who use AmED were more likely to engage in driving, or being a passenger of a driver, under the influence of alcohol or cannabis compared to youth who use either alcohol or energy drinks alone. This study used data from grade 10-12 students who took part in the 2014/2015 Canadian Student Tobacco, Alcohol and Drugs Survey (N=17,450). The association of past-year AmED use with past-30day: driving under the influence of alcohol or cannabis, and riding with an alcohol- or cannabis-influenced driver, was assessed using logistic regression. One in four youth had consumed AmED in the previous 12months. AmED users were more likely to engage in all risk behaviours except riding with a drinking driver, relative to youth who only consumed alcohol. No association was observed for youth who consumed alcohol and energy drinks on separate occasions. Youth who use AmED demonstrate a higher risk profile for driving under the influence of alcohol or cannabis, than youth who use alcohol alone. Future research should explore the biopsychosocial pathways that may explain why using energy drinks enhances the already heightened risk posed by alcohol on other health-related behaviours such as driving under the influence.

When parents supply alcohol to their children: Exploring associations with drinking frequency, alcohol-related harms, and the role of parental monitoring.

BACKGROUND: Youth obtain alcohol from many sources, including friends, siblings, parents and other adults. Whether parental supply, relative to other sources, is associated with experiencing a negative alcohol-related outcome is an area of considerable debate. Less well understood is whether the observed association is further contextualized by level of parental monitoring of the child. OBJECTIVES: This study has two main objectives: 1) determine if there is a relationship between parental supply, drinking frequency, and alcohol-related harms among youth; and 2) assess whether parental monitoring moderates this relationship. METHODS: Participants were drawn from the 2012 Student Drug Use Survey in Canada's Atlantic Provinces, an anonymous cross-sectional survey of high school students (ages 15-19 years). Adjusted regression models assessed the association between drinking frequency, experiencing alcohol-related harms, and four different sources of supply. Additional analyses stratified on levels of parental monitoring. RESULTS: Relative to receiving alcohol from friends, parental supply was associated with lower odds of experiencing any alcohol-related harm (AOR 0.42; 95% CI 0.28-0.61) and loss of control (AOR = 0.42; 95% CI 0.29-0.62). Drinking frequency did not differ by source of supply. Associations between parental supply and harm were absent among youth reporting low levels of parental monitoring. CONCLUSIONS: Youth who receive alcohol from parents' report fewer alcohol-related harms relative to those who obtain their alcohol from friends, despite no observed differences in drinking frequency. Understanding how parents may help to minimize experiences of alcohol-related harm among youth beyond the simple promotion of abstinence from drinking is warranted.

Cord blood vitamin D status and neonatal outcomes in a birth cohort in Quebec, Canada.

PURPOSE: Some evidence suggests that low maternal vitamin D status adversely affects perinatal health but few studies have examined cord blood vitamin D status. This project aimed to determine the association between the cord blood concentration of 25-hydroxyvitamin D [25(OH)D] and neonatal outcomes. METHODS: A nested case-control study was conducted in Quebec City, Canada from 2005 to 2010. Included were 83 cases of low birthweight (LBW; <2500 g), 301 cases of small for gestational age (SGA; <10th percentile), 223 cases of preterm birth (PTB; <37 weeks' gestation), and 1027 controls. Levels of 25(OH)D were determined by chemiluminescence immunoassay. Adjusted odds ratios (OR) and 95 % confidence intervals (CI) were estimated with logistic regression. RESULTS: Cord blood [25(OH)D] <50 nmol/L was associated with a lower risk of LBW compared to [25(OH)D] ≥75 nmol/L (OR 0.47 95 % CI 0.23-0.97). For 25(OH)D levels 50-75 nmol/L, a significant association was not demonstrated (OR 0.58, 95 % CI 0.34-1.01). No significant associations were observed between [25(OH)D] and either SGA or PTB after adjustment. CONCLUSIONS: Although our findings suggest that [25(OH)D] <50 nmol/L is associated with reduced risk of having a LBW infant, prenatal vitamin D recommendations require an examination of the literature that considers the full spectrum of maternal and neonatal outcomes.

Sexual health among female Aboriginal university students in the Maritime Provinces of Canada: risk behaviours and health services use.

UNLABELLED: Background Young Aboriginal Canadian people are at increased risk of negative sexual health outcomes, including sexually transmissible infections (STIs) and unplanned pregnancy. Associations between Aboriginal ethnicity and sexual risk behaviours and related health services use among sexually active female university students in eastern Canada were examined. METHODS: A secondary analysis of online survey data collected from sexually active female university students under age 30 years from eight post-secondary institutions in the Maritime Provinces of Canada was carried out (N=5010). Students were asked about their ethnic backgrounds, health services use and sexual health behaviours. Logistic regressions were used to compare Aboriginal students to Caucasian students regarding their sexual health behaviours and services use. RESULTS: In adjusted analyses, Aboriginal students were seen to be more likely to not have used a condom (OR 2.37; 95% CI 1.34-4.18) or any form of effective contraception (OR 3.05; 95% CI 1.75-5.31) at last intercourse. They also were more likely to report any lifetime testing for pregnancy (OR 5.81; 95% CI 3.07-10.99) and STIs (OR 2.95; 95% CI 1.11-7.82). Aboriginal students accessed university health services as often as their Caucasian counterparts. CONCLUSIONS: Aboriginal women attending university in the Maritime Provinces of Canada engage in greater sexual risk taking than Caucasian women and report more related testing. Health services providers working with university students should be aware of these lower rates of barrier protection and use of contraception among Aboriginal women, and use healthcare visits as opportunities to engage these women in reducing their sexual risk taking.

Associations of School Connectedness With Adolescent Suicidality: Gender Differences and the Role of Risk of Depression.

OBJECTIVE: Previous studies have not examined associations of school connectedness with adolescent suicidal behaviours stratified by gender, while including a measure of depression. We analyzed survey data to determine whether there are independent protective associations of higher school connectedness with suicidal behaviours in Canadian adolescents, while controlling for potential confounders, including risk of depression; and whether such associations differ by gender. METHOD: Using data from a stratified cluster sample of randomly selected classes of students in schools in 3 of Canada's Atlantic provinces, we used multiple logistic regression to examine whether associations of risk of depression, measured using the 12-item Center for Epidemiologic Studies-Depression scale, lessened protective associations of higher school connectedness with suicidal behaviours in grades 10 and 12 students, while stratifying by gender. RESULTS: After adjusting for risk of depression, higher school connectedness was independently associated with decreased suicidal ideation in both genders and with suicidal attempt in females. In males, higher connectedness was no longer protective for suicide attempt when risk of depression was included in the model. CONCLUSIONS: School connectedness, which is felt to have positive influences on many types of adolescent behaviour, appears to also be both directly and indirectly protective for suicidality. These effects may occur through different pathways in females and males. Given the protection it offers both genders, including those at risk and not at risk of depression, increasing school connectedness should be considered as a universal adolescent mental health strategy. Studies that examine school connectedness should include analyses that examine potential differences between males and females.

Knowledge and practice of childhood motor vehicle restraint use in Nova Scotia: phase II.

OBJECTIVE: To examine changes to knowledge and practice of childhood motor vehicle restraint (CMVR) use in Nova Scotia after the implementation of stricter car seat and new booster seat (BS) legislation in 2007. METHODS: A random telephone survey of households (at least one child <12 years) was performed in 2004 and 2010. Logistic regression determined variables independently associated with correct knowledge and/or practice of CMVR use. RESULTS: Families were surveyed in the pre- (N=426 families, 728 children) and post- (N=453 families, 723 children) legislative periods. Reported appropriate use of forward-facing car seats (FFCSs) and BSs increased significantly (74-92% and 58-95%, respectively). After adjusting for covariates, the post-law period remained a significant predictor of increased knowledge of when to graduate to a BS or a seat belt alone (SB) (OR:1.4(95% CI:1.0-2.0) and 1.9(1.4-2.7), respectively), which was significantly associated with correct use. The strongest independent predictor of the correct use of FFCSs and BSs was the post-law period (OR:14(3.0-68) and 43(17-114), respectively). With regards to rear-facing car seats (RFCSs), new legislation and associated social marketing on graduating from a rear-facing car seat was not associated with increases in correct practice. CONCLUSIONS: Legislation, combined with social marketing at the time of introduction, is an effective means to educate parents on when to graduate from a FFCS and the importance of BSs while also influencing parents to use them, though not for RFCS graduation. The known protective effect of BSs dictates the need for all regions in Canada to adopt comprehensive BS legislation.

Is religiosity positively associated with school connectedness: evidence from high school students in Atlantic Canada?

School connectedness (SC) is associated with decreased student risk behavior and better health and social outcomes. While a considerable body of research has examined the factors associated with SC, there is limited evidence about the particular role of religiosity in shaping levels of SC. Employing data reported by junior and senior high school students from Atlantic Canada, this study examines whether religiosity is positively associated with SC and whether such associations differ by gender. We tested the association between SC and religiosity using a random intercept multilevel logistic regression. The between-school variability in SC was first determined by our estimating a null or empty model; three different model specifications that included covariates were estimated: in Model 1 we adjusted for gender, age, academic performance, parental education, and living arrangement; in Model 2 for sensation seeking and subjective social status in addition to Model 1 variables; and in Model 3 we added substance use to the analysis. Our multilevel regression analyses showed that religiosity was protectively associated with lower SC across the three model specifications when both genders were examined together. In gender-stratified analyses we found similar protective associations of religiosity, with lower SC for both males and females in all three models. Given the overwhelming positive impact of SC on a range of health, social and school outcomes, it is important to understand the role of religiosity, among other factors, that may be modified to enhance student's connectedness to school.

Sex differences in associations of school connectedness with adolescent sexual risk-taking in Nova Scotia, Canada.

BACKGROUND: Associations of lower school connectedness have been seen with adolescent sexual risk behaviors, but little is known about gender differences with respect to these relationships. Understanding any such differences could contribute to better supporting the school environment to promote youth sexual health. METHODS: We used provincially representative cross-sectional data from 1415 sexually active students in grades 10 to 12 in Nova Scotia, Canada, to determine whether lower school connectedness was associated with students' sexual risk behaviors using multivariate logistic regression, stratifying by sex. RESULTS: In boys, lower connectedness was associated with three risk behaviors, having ≥ 2 partners in the previous year (odds ratio [OR] 1.07; 95% confidence interval [CI] 1.01-1.13), no condom use at last intercourse (OR 1.06; 95% CI 1.01-1.12), and having unplanned intercourse due to substance use (OR 1.09; 95% CI 1.03-1.15). No such associations were seen in girls. CONCLUSIONS: These results demonstrate that gender differences may exist for associations of school connectedness and sexual risk behaviors; connectedness may be more important for boys than for girls in this area of adolescent health. Educators should consider gender differences when designing interventions to maximize youth sexual health through school-based interventions. Further research on school connectedness and risk-taking should examine genders separately.

Elevated depressive symptoms and adolescent injury: examining associations by injury frequency, injury type, and gender.

BACKGROUND: Key risk factors for adolescent injury have been well documented, and include structural, behavioural, and psychosocial indicators. While psychiatric distress has been associated with suicidal behaviour and related self-harm, very little research has examined the role of depression in shaping adolescent injury. This study examines the association of elevated depressive symptoms with injury, including total number of injuries and injury type. Gender differences are also considered. METHODS: Data were drawn in 2010-11 from a representative sample of 2,989 high school students (14 to18 years of age) from Nova Scotia, Canada. Self-reported injury outcomes were examined using the 17-item Adolescent Injury Checklist, which captures past six-month injuries. Elevated depressive symptoms were assessed using the Centers for Epidemiological Studies Depression scale. Associations of elevated depressive symptoms with total number of injuries were estimated with negative binomial regression, while associations with specific injury types were estimated with logistic regression. Analyses were conducted in 2012. RESULTS: Adolescents with elevated depressive symptoms experienced a 40% increase in the total number of injury events occurring in the past six months. The association of elevated depressive symptoms with injury was consistent across injury type; violence-related (OR 2.21, 95% CI 1.61 to 3.03), transport-related (OR 1.53, 95% CI 1.10 to 2.13), and unintentional injuries (OR 1.65, 95% CI 1.20 to 2.27). Gender differences were also observed. CONCLUSION: Elevated depressive symptoms play a role in shaping adolescent injury. Interventions aimed at reducing adolescent injury should look to minimize psychosocial antecedents, such as poor mental health, that put adolescents at an elevated risk.

Nova Scotia pharmacists' knowledge of, experiences with and perception of factors interfering with their ability to provide emergency contraceptive pill consultations.

OBJECTIVE: The objective of this research was to explore pharmacists' knowledge of, experiences with and perception of factors interfering with their ability to provide non-prescription emergency contraceptive pill consultations in the Canadian province of Nova Scotia. METHODS: A self-administered paper questionnaire was mailed, using Dillman's tailored design method, to all pharmacists (n = 1123) registered with the Nova Scotia College of Pharmacists. KEY FINDINGS: The response rate was 53.0% (595/1123), with 451 respondents working in community practice. Most respondents reported that they had provided consultations for the emergency contraceptive product Plan B since it became available without a prescription (93.6%), and that Plan B is kept behind the pharmacy counter (83.6%). Pharmacists most frequently (47.8%) reported spending 6-10 min providing Plan B consultations. Respondents were generally knowledgeable about Plan B; however, only 39.2% knew that it can be effective for up to 5 days and 69.3% knew that the incidence of vomiting is less than 50%. The factors interfering the most with providing Plan B consultations were lack of privacy (46.1%) and lack of staff to cover during the consultation (50.9%). CONCLUSIONS: In general, Nova Scotia pharmacists are knowledgeable about emergency contraceptive pills; however, education regarding effective timing for use of such pills would be helpful. Private areas for counselling and consideration of pharmacy staffing schedules in community pharmacies may help address pharmacist concerns regarding their ability to provide Plan B consultations.

Longitudinal associations of cannabis and illicit drug use with depression, suicidal ideation and suicidal attempts among Nova Scotia high school students.

OBJECTIVE: To examine associations of cannabis and other illicit drug use with depression, suicidal ideation and suicidal attempts over a two year period during adolescence. METHODS: Nine hundred and seventy-six school students in four high schools in northern Nova Scotia, Canada, were surveyed in grade 10 and followed up in grade 12. Assessments of past 30 day cannabis and illicit drug use as well as mental health variables (risk of depression, suicidal ideation and suicide attempts) were obtained at baseline (2000 and 2001) and follow-up two years later (2002 and 2003). Generalized estimating equations modelled depression, suicidal ideation and attempts among illicit drug users and non-users. RESULTS: Illicit drug use with or without cannabis use was significantly associated with higher odds of depression, suicidal ideation and suicide attempt. Heavy cannabis use alone predicted depression but not suicidal ideation or attempt. CONCLUSIONS: Illicit drug use, with and without accompanying cannabis use, among high school students increases the risk of depression, suicidal ideation and suicidal attempts. Heavy cannabis use alone predicts depression but not suicidal ideation or attempts.

Emergency contraception: knowledge and attitudes of Nova Scotian family physicians.

OBJECTIVE: To determine the extent to which Nova Scotian FPs prescribe and provide emergency contraceptive pills (ECPs) and to explore their knowledge of and attitudes toward ECPs. DESIGN: Survey of Nova Scotian FPs using a modified Dillman method. SETTING: All regions of Nova Scotia. PARTICIPANTS: Family physicians registered with Dalhousie University's Division of Continuing Medical Education. MAIN OUTCOME MEASURES: Sex differences in the provision of ECPs and knowledge and attitudes about the ECP Plan B. RESULTS: Of 913 eligible FPs, 155 (17.0%) participated in the survey. Respondents resembled the sampling frame closely. Most physicians (64.0%) had prescribed ECPs in the previous year (mean number of prescriptions, 4.92); only 12.9% provided ECPs in advance of need. Knowledge about Plan B was quite good, except for knowledge of the time frame for potential effectiveness; only 29.2% of respondents answered that question correctly. Respondents generally supported nonprescription availability of ECPs, but 25.0% of FPs were concerned that this could lead to less use of more effective methods of contraception, and 39.2% believed that it would encourage repeat use. Younger FPs provided ECPs more often than their older colleagues, while female respondents had better knowledge about Plan B. In multivariate analysis being younger than 40 years was marginally associated with prescribing Plan B and with prescribing any form of ECP. CONCLUSION: Most Nova Scotian FPs provided ECPs and had generally good knowledge about and attitudes toward providing such contraception without prescription. However, FPs were poorly informed about the length of time that Plan B can be effective, which could potentially affect use when patients consult several days after unprotected sex. There were some concerns about nonprescription availability of ECPs, which could have implications for recommending it to patients. Rarely were ECPs prescribed for advance use, which might represent a lost prevention opportunity, especially for adolescents who often do not use effective contraception.

Discrepancies between knowledge and practice of childhood motor vehicle occupant safety in Nova Scotia--a population-based study.

OBJECTIVES: To determine discrepancies between knowledge and practice of childhood motor vehicle restraints (CMVRs) and vehicle seating position amongst parents within the province of Nova Scotia. DESIGN: Random telephone survey. SETTING: The Canadian province of Nova Scotia. SUBJECTS: Four hundred and twenty-six households with at least one child under the age of 12 years, totaling 723 children. MAIN OUTCOME MEASURES: The proportion of parents whose children who should be in a specific stage of CMVR and sitting in the rear seat of the vehicle, and who demonstrate correct knowledge of that restraint system and seating position, yet do not use that restraint system/seating position for their child (demonstrate practice discrepant from their knowledge). RESULTS: Awareness of what restraint system to use is good (>80%). However, knowledge of when it is safe to graduate to the next stage is low (30-55%), most marked for when to use a seatbelt alone. Awareness of the importance of sitting in the rear seat of a vehicle was universal. Discrepancies between knowledge and practice were most marked with booster seats and rear-seating of older children. Factors influencing incorrect practice (prematurely graduated to a higher-level restraint system than what is appropriate for age and weight) included lower household income, caregiver education level, and knowledge of when to graduate from forward-facing car seats and booster seats. Incorrect practice was also more commonly observed amongst children of weight and/or age approaching (but not yet reaching) recommended graduation parameters of the appropriate CMVR. CONCLUSIONS: Discrepancies between knowledge and practice are evident through all stages of CMVRs, but most marked with booster seats. The roles of lower socioeconomic status and gaps in CMVR legislation, in influencing discrepant practice, must be acknowledged and suggest the need for targeted education concurrent with development of comprehensive all-stages CMVR policies.

Suicidal behaviours in adolescents in Nova Scotia, Canada: protective associations with measures of social capital.

PURPOSE: Few studies of adolescent suicidality have examined its associations with social capital. We explored associations of measures of individual level social capital with self-reported suicide ideation and suicide attempt in adolescents in Cape Breton, Nova Scotia, Canada, controlling for other factors known to be associated with adolescent suicidality. METHODS: We surveyed 1,597 grade 10-12 students at three high schools in 2006 using self-completion questionnaires. Both sexes were combined for analysis. Outcome measures were suicidal ideation and attempt in the previous year. Measures of social capital included perceptions of trustworthiness and helpfulness of others at school, frequency of religious attendance and participation in extracurricular activities. Logistic regressions were carried out to determine associations of social capital with suicidality while controlling for other factors. RESULTS: Perceived trustworthiness and helpfulness were protective for suicidal ideation and suicide attempt in the previous year. In adjusted analyses, there were interactions of gender and social capital-females reporting more social capital were more protected from suicide attempt relative to males with similar levels of social capital. CONCLUSIONS: This study provides initial evidence of protective associations of individual level social capital with adolescent suicidality. Our findings suggest that among adolescents low social capital as measured by perceptions of trust and helpfulness of others at school may be a warning sign for suicidality, particularly for females. It may be helpful to inquire of young people how they perceive the trustworthiness and helpfulness of their school environment as a measure of how supportive that environment might be to them when they are facing challenges to their mental health.

Knowledge of, beliefs about, and perceived barriers to the use of the emergency contraception pill among women aged 18-51 in Nova Scotia / Conocimiento, creencias y barreras percibidas sobre el uso de contracepción de emergencia entre mujeres de 18-51 años en Nueva Escocia

Objectives: To investigate women in Nova Scotia (NS), Canada with respect to their knowledge of, beliefs about, and perceptions of barriers to accessing emergency contraception pills (ECP). Methods: A random digit dialing approach was used to survey a representative sample of NS women aged 18-51. Analyses described the knowledge, beliefs, and perceived barriers associated with ECP access among participants. Particular focus was given to differences between younger (age 18-31) and older (age 32-51) women. Results: The survey response rate of 49% achieved the desired sample size of 770. Overall, women in NS appeared to be poorly informed about ECP with regards to effectiveness, proper timing of administration, how it works, as well as how to access Plan B®. Younger women (age 18-31) were significantly more likely than older women (age 32- 51) to know that ECP does not always prevent pregnancy (p<0.01), that it can be taken more than 12 hours after unprotected intercourse (p<0.01), and that it is available without a prescription in pharmacies (p<0.01). Thirty percent of women agreed that ECP will cause an abortion, with older women (p<0.01) being more likely than younger women to agree. Cost and lack of privacy in pharmacies were identified as potential barriers to access. Conclusions: Lack of knowledge and the perception that ECP causes an abortion may influence a woman’s ability to consider ECP as an option should she find herself at risk of an unplanned pregnancy. To address this, efforts should be made to educate women (including older women) about ECP and its availability in pharmacies (AU)

Objetivos: Investigar a las mujeres de Nueva Escocia (NS), Canadá sobre sus conocimientos, creencias y percepciones de las barreras de acceso a las píldoras de contracepción de emergencia (PCE). Métodos: Se utilizó una selección aleatoria de números para encuestar a una muestra representativa de mujeres de NS entre 18-51 años. El análisis describió el conocimiento, creencias y barreras percibidas asociadas con el acceso a PCE entre las participantes. Se prestó especial atención a las diferencias entre mujeres jóvenes (edad 18-31) y mayores (edad 32-51). Resultados: La tasa de respuesta de la encuesta fue del 49%, alcanzando el tamaño deseado de 770. En general, las mujeres en NS parecían poco informadas sobre la PCE en relación a su efectividad, tiempo apropiado de la administración, como funciona, asi como del acceso al Plan B®. Las más jóvenes (edad 18-31) tenían significativamente más probabilidad de saber que las PCE no siempre previenen del embarazo (p<0,001), que pueden tomarse más tarde de las 12 horas de la relación no protegida (p<0,001), y que están disponibles sin receta en las farmacias (p<0,001). El 30% de las mujeres afirmó quie las PCE producían un aborto, siendo las mujeres mayores las que más probablemente afirmaban eso (p<0,001). El coste y la falta de privacidad en las farmacias fueron las potenciales barreras identificadas para el acceso. Conclusiones: La falta de conocimiento y la percepción de que las PCE producen un aborto pueden influir en la capacidad de considerar las PEC como una opción si la mujer se encuentra en riesgo de embarazo no planeado. Para resolver esto, deben realizarse esfuerzos para educar a las mujeres (incluyendo a las mujeres mayores) sobre las PCE y su disponibilidad en las farmacias (AU)

Protective associations of importance of religion and frequency of service attendance with depression risk, suicidal behaviours and substance use in adolescents in Nova Scotia, Canada.

PURPOSE: We examined relationships of measures of personal importance of religion and frequency of attendance at religious services with risk of depression and risk behaviours in high school students in Cape Breton, Canada. We examined the impact of confounding and explanatory factors on these relationships. METHODS: Data were drawn from self-report surveys of adolescents aged 15-19 (N=1615) at three high schools in May, 2006. We used logistic regression to assess associations of religious importance and religious service attendance with risk of depression, suicidal behaviour, binge drinking and frequent marijuana use, controlling in multivariate models for sociodemographic factors, family structure and social capital. RESULTS: Among females, higher personal importance of religion was associated with decreased odds of depression, suicidal ideation, drinking and marijuana use, while more religious attendance was protective for substance use behaviours and suicidal ideation. In males, both measures of religiosity were associated with decreased substance use. In multivariate models, religious importance had weak protective effects for depression and suicidal thinking in females, which were respectively modified by social trust and substance use. Attendance was protective for suicidal thinking in females, and was modified by depression. These associations were not seen in males. Attendance was consistently associated with less substance use in females, while importance was not. Importance was consistently protective for marijuana use and attendance was protective for binge drinking in males. LIMITATIONS: This was a cross-sectional self-report survey and causality cannot be inferred. CONCLUSION: Protective associations of measures of religiosity are seen in Canadian adolescents, as they are elsewhere.

Knowledge of, beliefs about, and perceived barriers to the use of the emergency contraception pill among women aged 18-51 in Nova Scotia.

OBJECTIVE: To investigate women in Nova Scotia (NS), Canada with respect to their knowledge of, beliefs about, and perceptions of barriers to accessing emergency contraception pills (ECP). METHODS: A random digit dialing approach was used to survey a representative sample of NS women aged 18-51. Analyses described the knowledge, beliefs, and perceived barriers associated with ECP access among participants. Particular focus was given to differences between younger (age 18-31) and older (age 32-51) women. RESULTS: The survey response rate of 49% achieved the desired sample size of 770. Overall, women in NS appeared to be poorly informed about ECP with regards to effectiveness, proper timing of administration, how it works, as well as how to access Plan B®. Younger women (age 18-31) were significantly more likely than older women (age 32-51) to know that ECP does not always prevent pregnancy (p<0.01), that it can be taken more than 12 hours after unprotected intercourse (p<0.01), and that it is available without a prescription in pharmacies (p<0.01). Thirty percent of women agreed that ECP will cause an abortion, with older women (p<0.01) being more likely than younger women to agree. Cost and lack of privacy in pharmacies were identified as potential barriers to access. CONCLUSIONS: Lack of knowledge and the perception that ECP causes an abortion may influence a woman's ability to consider ECP as an option should she find herself at risk of an unplanned pregnancy. To address this, efforts should be made to educate women (including older women) about ECP and its availability in pharmacies.