Prenatal stress (PNS) has been shown to affect a range of different modalities, like stress responsiveness and affective traits in both animals and humans. Previously, Dr Paula Brunton’s lab has used a novel model of ethologically relevant prenatal social stress and had shown increased stress responsiveness in both first generation (F1) PNS males and females and increased anxiety-like trait in males, together with corresponding changes in mRNA expression for corticotrophin releasing hormone (Crh) and its receptors. The first aim on this project was to further explore the phenotype of PNS offspring created using this model in social context. F1 PNS females, but not males, displayed an impairment in social memory in comparison to control females, which was supported by lower vasopressin receptor type 1a (Avpr1a) mRNA expression in the anterior part of lateral septum and bed nucleus of stria terminalis. Acute stress exposure immediately prior to the social memory test, impaired social memory in control males and females, but had no effect in PNS males and markedly improved performance in PNS females. This facilitated learning in the PNS females was supported by the finding of higher Avpr1a mRNA expression in both target regions in the brain. Finally, olfactory memory for social but not non-social odours was also impaired in PNS females, compared to control females, indicating that deficits in social memory in PNS females are specific to social odours and not in the detection and/or processing of all odours. It has been shown previously that phenotypes observed in PNS animals can also be seen following disrupted maternal care in the early post-partum period and that stress can affect maternal behaviour. To investigate this possibility in the current model a maternal behaviour observation protocol was developed. Dams were observed during the first postnatal week, three times/day in 90 min blocks. Stressed dams showed an increase in pup-directed behaviours, together with an increase in arched back nursing specifically, compared to control dams. Furthermore, studies have shown that maternal behaviour patterns can be transferred from mother to daughters, therefore this possibility was also investigated here. There were no differences in maternal behaviour between F1 control and F1 PNS dams. The maternal behaviour experiment for the F1 PNS dams created a unique opportunity to study their offspring (F2). F2 PNS rats had lower body weights than their control counterparts throughout their lifetimes, while not differing significantly in their calorie intake. Increased anxiety-like behaviour was also observed in both the F2 males and females (but only during proestrous and estrous stages of their cycle). These changes were supported in males by increased Crh and Crh receptor type 1 and decreased Crh receptor type 2 mRNA expression in discrete regions of the amygdala. Furthermore, F2 PNS females exhibited exaggerated, and males attenuated ACTH and corticosterone secretion in response to acute stress, compared with controls. The reduced stress response in F2 PNS males was supported by higher glucocorticoid receptor (GR, Nr3c1) mRNA expression in field CA1 of hippocampus. In F2 PNS females, increased stress responses were associated with increased Crh and Avp mRNA expression in the medial parvocellular division of the paraventricular nucleus of the hypothalamus and lower basal Nr3c1 and mineralocorticoid receptor (MR, Nr3c2) mRNA expression in the hippocampus. As increased stress and anxiety-like responses have been linked to a depressive phenotype that possibility was also investigated. No changes were found in either sucrose preference or floating/swimming behaviour in the forced swim test between the F2 PNS and control rats, in either sex. Finally, the variation in individual stress responsiveness and anxiety-like trait and the relationship between these phenotypes was investigated in an outbred male Sprague Dawley population. It was found that three of the most commonly used anxiety tests: open field test, light dark box and elevated plus maze do not correlate as well with each other as could be expected. Secondly plasma corticosterone concentrations 30min after the onset of acute restraint stress were positively correlated with the amount of time the rats spent in the anxiogenic environments, showing perhaps counter-intuitively, that the higher the stress responses the less anxious the male rat is. The behavioural tests were also used as a selection procedure to compare gene expression by microarray in the amygdala of high and low anxious rats and hypothalamus of high and low stress-responsive rats. To summarise, stress during pregnancy has profound effects on the dams’ immediate maternal behaviour, as well as neuroendocrine and behavioural effects in both the F1 and F2 offspring. Furthermore, there is evidence of inter-individual variation in stress responsiveness and anxiety-like behaviour in an outbred rat population. This data could lead to further understanding of the origins of inter-individual variation and appreciation of the effect of stress throughout the life course.

published_or_final_version / Nursing Studies / Master / Master of Nursing

Before a child is born, parents might have a general (e.g., happy and healthy) or particular vision for their child (e.g., become a doctor). Parents’ ability to focus on their child’s needs and interests (child-oriented goals) above their own self-interests (parent-oriented goals) has been found to predict their sensitivity to their children in the moment (Dix, 1991; 2000). In this study, 126 mothers and fathers, during the mother’s third trimester of pregnancy with both parents’ first child, were asked to verbally report three wishes for their future child. Content analyses of parents’ transcripts revealed eight wish categories: 1) well-being, 2) personal relationships, 3) particular characteristics, 4) particular goals, 5) personal achievement and responsibility, 6) personal fulfillment, 7) protection, and 8) dependence on the parent. Mothers reported more wishes that their future children would be happy and emotionally fulfilled (child-oriented), and fathers reported more wishes that their future children would have a particular characteristic or achieve a particular goal (parent-oriented). Whether mothers wished for their children to have a particular characteristic and whether fathers wished for their children to achieve a particular goal, were negatively associated with their parenting sensitivity (for both fathers and mothers) and children’s developmental outcomes (for mothers only) at 24 months. Linear regression analysis revealed that parenting sensitivity at 24 months acted as a partial mediator among whether mothers reported a prenatal particular characteristic wish and their children’s autonomy at 24 months. Similar mediation analyses were performed with fathers’ prenatal wishes, parenting sensitivity, and children’s developmental outcomes; however, none of the results were significant. / text

No description available.

Objectives: A community dental public health program in Vancouver has been providing clinical hygiene services and oral health counseling to a limited number of high-risk, low income pregnant women for over 20 years. To enable future program decision-making, a program evaluation was undertaken with the following objectives: 1) to describe program, clients, and their oral health needs; 2) to determine whether program activities have been implemented as intended; and 3) to assess program's effectiveness in improving oral health status of clients and in improving their knowledge and behavior in relation to their own health and those of their children. Methods: The evaluation, undertaken by the resident dental hygienist, had two phases. Phase 1: Evaluability assessment, descriptive and process evaluation (retrospective and concurrent chart reviews, semi-structured interviews, appointment monitoring, and field observations). Phase 2: A short- and medium-term outcome evaluation with a convenience sample who attended over a 1-year period. Data, collected by questionnaires, interviews, clinical indices, chart review, field observations, and appointment statistics, was analyzed with a combination of univariate and bivariate analyses. Results: Phase 1: Stakeholders' goals were identified; a logic model and organizational flowchart were developed. Chart review (N=123) revealed mean client age of 27 years; 28% Canadian-born; 48% had other children; 78% were concerned about "bleeding gums"; and 63% had visible tooth decay. 28% of women referred to the program never attended. Unfamiliarity of clients with the dental "experience", language barriers, and clinic operation and time restraints affected implementation of program's activities. Phase 2: Outcomes in clients (N=61) demonstrated significant improvements (P<0.05) in clinical indices, oral health knowledge and tooth brushing skills, and dental care for clients' children. A positive program experience was reported from all the women. However, 79% (48/61) of clients never obtained the "outside" dental services that they needed. Conclusions: Evaluation revealed positive changes, extending into the postnatal period in knowledge, behaviors and clinical outcomes despite language barriers, insufficient resources, and ill-defined program goals. Identified program limitations need to be addressed to further improve outcomes of this promising intervention. Research was partially supported by a grant from the British Columbia Dental Hygienists Association.

Adolescent pregnancy is an important public health issue. The purpose of this mixed-methods study was to examine factors related to inadequate use of prenatal care (PNC) among adolescents living in inner-city Winnipeg. The quantitative component consisted of a secondary analysis of data from 92 adolescents (<20 years of age) who participated in a larger case-control study. Adolescents who were of First Nations ethnicity, single, multiparous, and who had low interpersonal support were more likely to receive inadequate PNC. Barriers, facilitators and motivators to PNC utilization were also identified. The qualitative component consisted of open-ended interviews with ten inner-city pregnant adolescents to examine how social support affected their use of PNC. Results showed that material, emotional and informational support were important factors affecting use of PNC. The most important source of material and emotional support was the adolescent’s mother, and the main source of informational support was the PNC provider.

Adolescent pregnancy is an important public health issue. The purpose of this mixed-methods study was to examine factors related to inadequate use of prenatal care (PNC) among adolescents living in inner-city Winnipeg. The quantitative component consisted of a secondary analysis of data from 92 adolescents (<20 years of age) who participated in a larger case-control study. Adolescents who were of First Nations ethnicity, single, multiparous, and who had low interpersonal support were more likely to receive inadequate PNC. Barriers, facilitators and motivators to PNC utilization were also identified. The qualitative component consisted of open-ended interviews with ten inner-city pregnant adolescents to examine how social support affected their use of PNC. Results showed that material, emotional and informational support were important factors affecting use of PNC. The most important source of material and emotional support was the adolescent’s mother, and the main source of informational support was the PNC provider.

The optimisation of a simple, reliable and practical method of interphase FISH which allows prenatal diagnosis of major chromosome aneuploidies using a minimum volume of amniotic fluid sample was the overall objective of this study. When all the probes required were available, the study continued by developing the technique of ratio-mixing FISH for simultaneous detection of the five major chromosome aneuploidies. The technique of five-colour ratio mixing FISH which has been presented here is simple and straightforward, since only two haptenisation and detection systems have been employed to visualise simultaneously five different targets in five distinguishable colours. The steps of denaturation, hybridisation and detection are the same as those used in a uni-colour FISH experiment. The results obtained from hybridisation of an unselected series of 20 uncultured lymphocytes and 27 uncultured amniocytes indicate that the technique is reliable and can be used for simultaneous detection of major chromosome aneuploidies. In order to provide a practical strategy for clinical diagnostic purposes, the use of a three colour ratio-mixing FISH and a dual colour was investigated to visualise the five probe sets on two slides from the same sample. A total unselected series of 45 uncultured lymphocytes and 60 uncultured aminocytes were hybridised with different probe combinations using three colour ratio-mixing FISH. The results indicate that the major chromosome aneuploidies can be simply and reliably identified on two slides from the same sample, using a three colour ratio-mixing FISH to detect the chromosomes X, Y and 21 and a dual colour to detect chromosomes 13 and 18. The failure rate was reduced to 4 per cent using this approach.

Objectives: A community dental public health program in Vancouver has been providing clinical hygiene services and oral health counseling to a limited number of high-risk, low income pregnant women for over 20 years. To enable future program decision-making, a program evaluation was undertaken with the following objectives: 1) to describe program, clients, and their oral health needs; 2) to determine whether program activities have been implemented as intended; and 3) to assess program's effectiveness in improving oral health status of clients and in improving their knowledge and behavior in relation to their own health and those of their children. Methods: The evaluation, undertaken by the resident dental hygienist, had two phases. Phase 1: Evaluability assessment, descriptive and process evaluation (retrospective and concurrent chart reviews, semi-structured interviews, appointment monitoring, and field observations). Phase 2: A short- and medium-term outcome evaluation with a convenience sample who attended over a 1-year period. Data, collected by questionnaires, interviews, clinical indices, chart review, field observations, and appointment statistics, was analyzed with a combination of univariate and bivariate analyses. Results: Phase 1: Stakeholders' goals were identified; a logic model and organizational flowchart were developed. Chart review (N=123) revealed mean client age of 27 years; 28% Canadian-born; 48% had other children; 78% were concerned about "bleeding gums"; and 63% had visible tooth decay. 28% of women referred to the program never attended. Unfamiliarity of clients with the dental "experience", language barriers, and clinic operation and time restraints affected implementation of program's activities. Phase 2: Outcomes in clients (N=61) demonstrated significant improvements (P<0.05) in clinical indices, oral health knowledge and tooth brushing skills, and dental care for clients' children. A positive program experience was reported from all the women. However, 79% (48/61) of clients never obtained the "outside" dental services that they needed. Conclusions: Evaluation revealed positive changes, extending into the postnatal period in knowledge, behaviors and clinical outcomes despite language barriers, insufficient resources, and ill-defined program goals. Identified program limitations need to be addressed to further improve outcomes of this promising intervention. Research was partially supported by a grant from the British Columbia Dental Hygienists Association.

This study examined the effects of prenatal exposure to methadone on clinical and neurobehavioural outcomes of infants between 40 and 42 weeks gestation. The aims of this study were: (a) to describe clinical and neurobehavioural outcomes of infants exposed to methadone during pregnancy, (b) to examine the effects of maternal methadone dose during pregnancy on infant clinical and neurobehavioural measures, and (c) to examine the extent to which associations between exposure to methadone during pregnancy and infant outcomes persisted after statistical control for a range of confounding variables. Two groups of study infants were recruited. These consisted of 51 consecutively recruited infants born to mothers maintained on methadone during their pregnancy and 42 randomly identified non-methadone exposed comparison infants. Prior to her child's birth, each pregnant woman completed a comprehensive maternal interview. At birth and during the infant's hospital stay a broad perinatal data-base was collected. At 42 weeks gestation infants underwent a neurobehavioural assessment including the NICU Network Neurobehavioural Scale (NNNS; Lester & Tronick, 2004) and infant cry analysis. Study results showed significant differences across several clinical and neurobehavioural measures. Infants exposed to methadone in utero were found to be significantly lighter, have smaller head circumferences, and spend longer in hospital. Neurobehaviourally, they were significantly less well regulated, less attentive, more easily aroused, more excitable, and more hypertonic. In addition, they exhibited less motor maturity, displayed more stress abstinence symptomatology, and required more support from the assessor in order to remain in an appropriate state. Concurrent analysis of infant cry characteristics revealed no significant differences between the fundamental frequencies or the melody contours of the two groups. However, infants prenatally exposed to methadone did display higher levels of frequency perturbation in their cries, as evidenced by analysis of their jitter factor and percentage of directional jitter. Analysis of the effects of maternal dose during pregnancy suggested that maternal dose levels above 60mg/day were general indicative of poorer infant outcomes than those below 60mg/day, with significant linear trends occurring across a number of measures. The extent to which associations between methadone exposure during pregnancy and infant outcomes reflected either a) the direct effects of methadone exposure and/or b) the effects of confounding factors correlated with maternal methadone use was examined using regression analysis. The results of this analysis for infant clinical outcomes showed confounding variables attenuated the effects of methadone exposure on infant birth length and, to some degree, infant head circumference. In contrast, associations between methadone exposure during pregnancy and most neurobehavioural outcomes remained significant, suggesting that maternal methadone use during pregnancy is an important, independent predictor of infant neurobehavioural functioning. These findings support the view that prenatal exposure to methadone has at least short term impacts on the infant's central nervous system (CNS) development. Important implications of possible vulnerabilities faced by these infants and their families are discussed.