This thesis examines the well-being of Kenyan-Canadian parents and youth living in ethnically- and racially-mixed families in Montreal. The objectives of the thesis are to determine whether there are challenges unique to immigrants belonging to small ethnic communities and living in racially- and ethnically-mixed families, and to educate policy makers and health practitioners as to needs that may be specific to this understudied group. The participants generally seem to be adapting well to life in Montreal, although the experience of racism and difficult y with language policies do generate some stress. Notably, the parents have taken advantage of possibilities afforded by other immigrant communities with greater institutional completeness to promote the well-being of their children. This suggests that an important role can be played by established immigrant communities in welcoming and assisting individual migrants without a receiving community, even when ethnic affiliation may be lacking. / Cette thèse s'intéresse au bien-être de parents et d'enfants canadiens originaires du Kenya et vivant à Montréal dans une famille mixte sur le plan ethnique et racial. L'objectif de la thèse est de déterminer si les immigrants appartenant à une communauté immigrante de petite taille et vivant dans un contexte de famille culturellement mixte font face à des défis particuliers. Les retombées permettront de sensibiliser les décideurs politiques et les professionnels de la santé aux besoins particuliers de cette population encore peu étudiée. Les participants à l'étude ont, de façon générale, réussi à bien s'adapter à leur vie Montréalaise et ce, malgré un certain stress associé à des expériences de racisme et aux difficultés inhérentes aux politiques linguistiques. Les parents vivant en famille mixte ont quant à eux pu profiter des possibilités offertes par la communauté du conjoint, et ainsi eu accès à une plus grande complétude institutionnelle ce qui a favorisé le bien-être de leurs enfants. Ce constat met en lumière le rôle important qui peut être joué par les communautés immigrantes bien établies dans l'accueil et le soutien des immigrants qui ne peuvent compter sur une communauté d'accueil et ce, même si l'affiliation ethnique s'avère inexistante.

Background. Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by impulsivity, hyperactivity, and inattention, which affects 5-10% of school-age children. The first-line treatment for ADHD is stimulant medication, which increase levels dopamine (DA) and norepinephrine (NE). These medications are highly effective, but not always tolerated. Sleep side effects, such as insomnia, are reported for both stimulant classes and are usually, but not always, mild and transitory, which can lead to treatment discontinuation. Poor tolerability may limit efficacy by compromising the ability to prescribe effective doses. Few studies have assessed the comparative effectiveness of long-acting methylphenidate and amphetamine formulations in youth with ADHD, and it is unclear if there are differential effects of drug and/or dose on sleep. MAS increase NE and DA levels more than d-MPH and hence could be affecting sleep differently. Objectives. We sought to determine if there are significant differences in the dose-response effects of ER D-MPH and ER MAS on objective measures of sleep. Methods. Children, aged 10-17 (n=37), participated in a double-blind crossover study comparing two stimulants (extended release DMPH, MAS) at three doses (10, 20, 30 mg) and placebo. Each treatment session lasted one week, for a total protocol duration of eight weeks. Sleep was assessed in all conditions using actigraphy and questionnaires. Results. Sleep schedule measures showed a significant effect for dosage on sleep start time (F(1,36)=6.284, p<0.05), with a significantly later sleep start time when children were on 20mg or 30mg dosages, compared to placebo (p<0.05). Sleep duration revealed a significant dose effect on actual sleep duration (F(1,36)=8.112, p<0.05), with significantly shorter actual sleep duration for subjects receiving 30mg compared to those on placebo (p<0.05). There were no significant differences between medications. Conclusion. Higher dosages reduce sleep duration and lead to later sleep start times, regardless of medication. / Contexte. Le Trouble Déficitaire de l'Attention et de l'Hyperactivité (TDAH) est caractérisé par l'impulsivité, l'hyperactivité, et l'inattention. Le TDAH se produit dans 5-10% des enfants scolaires. Le traitement de première ligne pour le TDAH sont les stimulants. Les stimulants augmentent les niveaux de dopamine (DA) et de norépinephrine (NE). Ces médicaments sont hautement efficaces, mais ne sont pas tolérés par tous les enfants. Les effets indésirables, comme l'insomnie, sont souvent reportés pour ces stimulants. Par contre, leurs effets sont habituellement, mais pas toujours, bénins et transitoires. En général, les enfants souffrant d'insomnie sévère cessent le traitment. La faible tolérance peut limiter l'efficacité en compromettant la possibilité de prescrire des doses plus efficaces. Peu d'études ont mesuré l'efficacité comparative du methylphenidate á action prolongée et de l'amphétamine á action prolongée chez les enfants avec un TDAH. De plus, il n'est pas clair s'il y a un effet différentiel de médicament et/ou de dose sur le sommeil. Les MAS augmentent les niveaux de NE et DA plus que les d-MPH, et donc pourraient avoir une incidence sur le sommeil d'une manière différente. Objectifs. Nous cherchons à déterminer s'il existe des différences significatives dans les effets de dose-réponse des d-MPH et MAS á actions prolongées sur des mesures objectives du sommeil. Méthodes. Les enfants, âgés 10-17 (n=37), ont participé dans une étude croisée à double insu comparant trois doses (10, 20, et 30mg) de d-MPH ou MAS au placebo. Chaque séance de traitement a duré une semaine, pour une durée totale de protocole de huit semaines. Le sommeil a été mesuré dans toutes les conditions avec actimétrie et questionnaires. Résultats. Les mesures d'horaire du sommeil ont montré un effet significatif de dose à l'heure de début de sommeil (F(1,36)=6.284, p<0.05); les enfants recevant 20mg ou 30mg on débuté leur sommeil significativement plus tard que ceux qui ont reçu le placebo (p<0.05). Un effet significatif de dose sur la durée réelle du sommeil (F(1,36)=8.112, p<0.05) a été découverte, avec une durée de sommeil plus courte quand les sujets ont reçu 30 mg comparé au placebo (p<0.05). Aucune différence entre les deux médicaments n'a été trouvée. Conclusion. Des doses plus élevées réduisent la durée du sommeil et conduisent à dormir plus tard, indépendamment de médicaments.

Purpose: The main purpose of this study was to explore ED nurses' experiences in caring for individuals with mental health concerns and their thoughts of what contributes to or inhibits their ability to care for this patient population. Methodology: A qualitative study using a descriptive phenomenological tradition was guided by the following research questions: a) What are the participants' experiences of the care that is provided to the individual experiencing mental health issues in the ED?, b) What are the participants’ descriptions of elements that contribute to or inhibit their ability to effectively care for individuals with mental health issues in the ED?, c) What are the participants’ educational experiences related to mental health issues?, and d) What are the participants’ recommendations for the enhancement of mental health nursing care in the ED? Conclusion: Nurses practicing in the ED stated they lack psychiatric knowledge related to theory, and skills in assessment and least restraint interventions which are often utilized when providing care to mental health patients in the ED. Mental health education at the undergraduate and practical level relevant for practice in non-psychiatric settings needs to be enhanced and supported at an organizational level. The use of control interventions such as restraints and seclusion pose significant ethical issues for nurses. Interventions are often chosen based on the need to ensure the perceived safety for the patient and those within the ED and not necessarily on least restraint practices. Further barriers include a lack of time, role and responsibility confusion and a fast-paced environment that was not conducive to provide quality care for those with mental health issues. These factors detracted from care practices, and ED nurses thought their care did not meet the needs of the mental health patient. These findings will provide a platform for education and organizational efforts that support the ED nurse and optimize care of individuals with mental health issues seeking care in the ED. / Thesis (Ph.D, Nursing) -- Queen's University, 2014-05-27 16:58:25.387

Research has shown that adult attachment mediates the relationship between child sexual abuse and mental health functioning in adulthood. However, there is great variability across these projects as to the operational definition of attachment. Hence, the primary goal of this project was to clarify the literature by providing a comprehensive definition of attachment which would allow for the translation of research findings into a treatment application for child sexual abuse. The second goal of this project was to update the child sexual abuse and attachment research bases by providing a complete definition of mental health outcome. That is, rather than defining mental health solely as the absence of psychopathology, it was defined both as the absence of psychopathology and the presence of psychological wellbeing. From these goals it was hypothesized that child sexual abuse would be positively related to adult psychopathology and negatively related to adult psychological wellbeing. The relationships were expected to be mediated by both adult attachment anxiety and attachment avoidance. To test the hypotheses a total of 421 men and women undergraduate students were sampled and completed numerous questionnaires. The analyses revealed a significant positive relationship between child sexual abuse and adult psychopathology and this relationship was found to be completely mediated by adult attachment anxiety and partially mediated by attachment avoidance. Contrary to prediction, the inverse relationship found between child sexual abuse and psychological wellbeing was not statistically significant. Unfortunately, all supportive findings had to be nullified because the size of the relationship between child sexual abuse and psychopathology was exceptionally small and post-hoc corrections were unable to increase the size of the effect. A considerable investigation was undertaken to identify potential sources of this apparent error and the relationships between the attachment and complete mental health variables were explored further. The most impressive finding of the exploratory analyses was that nearly one quarter of the variation of complete mental health was accounted for by adult attachment. Taken together, although this project did not unfold as predicted, it did partially satisfy its secondary goal and hence it remains an interesting and viable contribution to the literature.

This research implements advanced statistical techniques to examine the relationship between spirituality and mental health among Canadians 25 years of age and older in 2002. Using ordinary least squares regression and logistic regression to analyze data from the Canadian Community Health Survey, this study attempts to contribute to the emerging body of research surrounding mental health and spirituality. The quantitative results indicate that the strength, meaning and understanding that spiritual values provide respondents in their everyday lives significantly affect mental health. These results are integrated and discussed in the context of the study’s theoretical and methodological contributions to the sociological study spirituality and mental health. / Graduate

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Rheological behavior and flow induced fiber orientation in simple flows of short glass fiber reinforced polypropylene melts were studied. Transient and steady state properties and in situ fiber orientation distribution were measured in simple shear flow, poiseuille flow, small amplitude oscillatory shear and uni-axial extensional flow. Strong correlation is found between the flow induced changes in fiber orientation distribution and measured bulk rheological properties. / An extension of suspension theories for dilute systems is proposed, where multi-particle interactions are modeled as a randomizing process. The effect of non-Newtonian fluid properties is incorporated at the slow flow limit through its effect on the fiber orientation only. Model predictions for simple shear demonstrate the strong correlation between the changes in fiber orientation and bulk rheological properties. Model predictions are in qualitative agreement with experimental observations in simple shear flow.

Background: The question whether certain cognitive domains in schizophrenia qualify as disproportionate/core impairments against a back-drop of generalized deficits remains unresolved. Investigating more homogeneous subgroups of patients may enhance our understanding of the exact nature of disproportionate deficits. / Method: One-hundred and twenty-one patients attending an early psychosis program completed a neuropsychological battery comprising of six cognitive domains and IQ. Symptom severity and pre-morbid adjustment were also assessed. / Results: Early psychosis patients with high levels of negative symptoms and "stable-poor" pre-morbid functioning have severe generalized cognitive impairment. Patients with low levels of negative symptoms and "stable-good" pre-morbid adjustment present with milder generalized impairments. / Conclusion: Contrary to our hypothesis, visual memory appears to be disproportionally impaired against a back-drop of severe generalized cognitive deficits in early psychosis patients. Patients who have a consistently poor (stable-poor) course pre-morbid adjustment and those with high levels of negative symptoms are more impaired. / Contexte: Les déficits cognitifs sont hétérogènes chez les schizophrènes. La question reliée à la présence de certains déficits cognitifs disproportionnés par rapport à un déficit généralisé reste non-résolue. L`étude de sous-groupes de patients plus homogènes au niveau de la sévérité des symptômes et du fonctionnement prémorbide pourrait éclairer notre compréhension entourant la nature exacte des déficits disproportionnés. / Méthode : Cent-vingt et un patients suivis dans un programme de premier épisode psychotique ont complété une batterie neuropsychologique complète évaluant cinq domaines cognitifs et le QI global. La sévérité des symptômes et le fonctionnement prémorbide ont aussi été évalués. / Résultats : Dans un échantillon hétérogène de premier épisode de psychose, les patients présentent des déficits cognitifs généralisés sévères. En classifiant les patients en sous-groupes, ceux avec de hauts niveaux de symptômes négatifs et un fonctionnement prémorbide «stable-pauvre » présentent des déficits cognitifs généralisés sévères. Les patients avec peu de symptômes négatifs et un fonctionnement prémorbide « stable-bon » démontrent des déficits généralisés plus modérés. / Conclusion: Nos résultats indiquent la présence de sévères déficits cognitifs au niveau de la mémoire visuelle et de la vitesse de traitement de l`information chez les jeunes souffrant d`un premier épisode de psychose. De plus, il semble plus prononcés chez les patients avec un fonctionnement prémorbide «stable-pauvre ».

We examined the effects of bright light on social interaction and mood in healthy individuals with mild seasonality. In a cross-over design, 38 mildly seasonal individuals received three weeks of bright light and three weeks of placebo (low-density negative ions). Using an event-contingent method participants recorded their mood and behaviours during social interactions and wore a light-sensor actigraphy at the wrist to monitor adherence to home based light exposure. During light administration, 23 participants adhered to the light protocol and exhibited more quarrelsome behaviours and no change in mood. Participants who provided no evidence of adherence had similar mood and social behaviour during both interventions. The results indicate the need for effective methods for determining adherence to the protocol in light studies. Furthermore, in individuals with mild seasonality light administration may not improve mood and may have adverse effects on social behaviour. / Nous avons examiné les effets de la lumière forte sur les interactions sociales et l'humeur chez des individus sains avec un caractère saisonnier léger. En utilisant un plan d'étude croisé, 38 individus légèrement saisonniers ont été exposés à trois semaines de lumière forte et trois semaines d'un placebo (ions négatifs à intensité basse). En utilisant la méthode des événements liés (les participants ont enregistré leur humeur et comportement durant leurs interactions sociales et ont porté un détecteur de lumière au poignet pour vérifier leur adhérence à l'exposition à la lumière à la maison. Durant l'administration de la lumière, 23 participants ont adhéré au protocole de lumière et exhibé plus de comportements querelleurs et aucun changement d'humeur. Parmi les autres participants qui n'ont fourni aucune preuve d'adhérence, et leur humeur et comportement social étaient semblables pendant les deux interventions. Les résultats indiquent un besoin de méthodes efficaces pour déterminer l'adhérence au protocole de lumière. Qui plus est, chez les individus avec caractère saisonnier léger, il est possible que l'administration de lumière n'améliore pas l'humeur et exerce des effets adverses sur le comportement social. fr