Pathways to health : Determinants of health, health behaviour and health inequalities in early adulthood

There is increasing evidence that the origins of poor adult health and health inequalities can be traced back to circumstances preceding current socioeconomic position and living conditions. The life-course approach to examining the determinants of health has emphasised that exposure to adverse social and economic circumstances in earlier life or concurrent adverse circumstances due to unfavourable living conditions in earlier life may lead to poor health, health-damaging behaviour, disease or even premature death in adulthood. There is, however, still a lack of knowledge about the contribution of social and economic circumstances in childhood and youth to adult health and health inequalities, and even less is known about how environmental and behavioural factors in adulthood mediate the effects of earlier adverse experiences. The main purpose of this study was to deepen our understanding of the development of poor health, health-damaging behaviours and health inequalities during the life-course. Its aim was to find out which factors in earlier and current circumstances determine health, the most detrimental indicators of health behaviour (smoking, heavy drinking and obesity as a proxy for the balance between nutrition and exercise), and educational health differences in young adults in Finland. Following the ideas of the social pathway theory, it was assumed that childhood environment affects adult health and its proximal determinants via different pathways, including educational, work and family careers. Early adulthood was studied as a significant phase of life when many behavioural patterns and living conditions relevant to health are established. In addition, socioeconomic health inequalities seem to emerge rapidly when moving into adulthood; they are very small or non-existent in childhood and adolescence, but very marked by early middle age. The data of this study were collected in 2000 2001 as part of the Health 2000 Survey (N = 9,922), a cross-sectional and nationally representative health interview and examination survey. The main subset of data used in this thesis was the one comprising the age group 18 29 years (N = 1,894), which included information collected by standardised structured computer-aided interviews and self-administered questionnaires. The survey had a very high participation rate at almost 90% for the core questions. According to the results of this study, childhood circumstances predict the health of young adults. Almost all the childhood adversities studied were found to be associated with poor self-rated health and psychological distress in early adulthood, although fewer associations were found with the somatic morbidity typical of young adults. These effects seemed to be more or less independent of the young adult s own education. Childhood circumstances also had a strong effect on smoking and heavy drinking, although current circumstances and education in particular, played a role in mediating this effect. Parental smoking and alcohol abuse had an influence on the corresponding behaviours of offspring. Childhood circumstances had a role in the development of obesity and, to a lesser extent, overweight, particularly in women. The findings support the notion that parental education has a strong effect on early adult obesity, even independently of the young adult s own educational level. There were marked educational differences in self-rated health in early adulthood: those in the lowest educational category were most likely to have average or poorer health. Childhood social circumstances seemed to explain a substantial part of these educational differences. In addition, daily smoking and heavy drinking contributed substantially to educational health differences. However, the contribution of childhood circumstances was largely shared with health behaviours adopted by early adulthood. Employment also shared the effects of childhood circumstances on educational health differences. The results indicate that childhood circumstances are important in determining health, health behaviour and health inequalities in early adulthood. Early recognition of childhood adversities followed by relevant support measures may play an important role in preventing the unfortunate pathways leading to the development of poor health, health-damaging behaviour and health inequalities. It is crucially important to recognise the needs of children living in adverse circumstances as well as children of substance abusing parents. In addition, single-parent families would benefit from support. Differences in health and health behaviours between different sub-groups of the population mean that we can expect to see ever greater health differences when today s generation of young adults grows older. This presents a formidable challenge to national health and social policy as well as health promotion. Young adults with no more than primary level education are at greatest risk of poor health. Preventive policies should emphasise the role of low educational level as a key determinant of health-damaging behaviours and poor health. Keywords: health, health behaviour, health inequalities, life-course, socioeconomic position, education, childhood circumstances, self-rated health, psychological distress, somatic morbidity, smoking, heavy drinking, BMI, early adulthood

Evolution, Homology Conservation, and Identification of Unique Sequence Signatures in GH19 Family Chitinases

The discovery of GH (Glycoside Hydrolase) 19 chitinases in Streptomyces sp. raises the possibility of the presence of these proteins in other bacterial species, since they were initially thought to be confined to higher plants. The present study mainly concentrates on the phylogenetic distribution and homology conservation in GH19 family chitinases. Extensive database searches are performed to identify the presence of GH19 family chitinases in the three major super kingdoms of life. Multiple sequence alignment of all the identified GH19 chitinase family members resulted in the identification of globally conserved residues. We further identified conserved sequence motifs across the major sub groups within the family. Estimation of evolutionary distance between the various bacterial and plant chitinases are carried out to better understand the pattern of evolution. Our study also supports the horizontal gene transfer theory, which states that GH19 chitinase genes are transferred from higher plants to bacteria. Further, the present study sheds light on the phylogenetic distribution and identifies unique sequence signatures that define GH19 chitinase family of proteins. The identified motifs could be used as markers to delineate uncharacterized GH19 family chitinases. The estimation of evolutionary distance between chitinase identified in plants and bacteria shows that the flowering plants are more related to chitinase in actinobacteria than that of identified in purple bacteria. We propose a model to elucidate the natural history of GH19 family chitinases.

Measurement of the band bending and surface dipole at chemically functionalized Si(111)/vacuum interfaces

The core-level energy shifts observed using X-ray photoelectron spectroscopy (XPS) have been used to determine the band bending at Si(111) surfaces terminated with Si-Br, Si-H, and Si-CH₃ groups, respectively. The surface termination influenced the band bending, with the Si 2p_3/2 binding energy affected more by the surface chemistry than by the dopant type. The highest binding energies were measured on Si(111)-Br (whose Fermi level was positioned near the conduction band at the surface), followed by Si(111)-H, followed by Si(111)-CH₃ (whose Fermi level was positioned near mid-gap at the surface). Si(111)-CH₃ surfaces exposed to Br₂(g) yielded the lowest binding energies, with the Fermi level positioned between mid-gap and the valence band. The Fermi level position of Br₂(g)-exposed Si(111)-CH₃ was consistent with the presence of negatively charged bromine-containing ions on such surfaces. The binding energies of all of the species detected on the surface (C, O, Br) shifted with the band bending, illustrating the importance of isolating the effects of band bending when measuring chemical shifts on semiconductor surfaces. The influence of band bending was confirmed by surface photovoltage (SPV) measurements, which showed that the core levels shifted toward their flat-band values upon illumination. Where applicable, the contribution from the X-ray source to the SPV was isolated and quantified. Work functions were measured by ultraviolet photoelectron spectroscopy (UPS), allowing for calculation of the sign and magnitude of the surface dipole in such systems. The values of the surface dipoles were in good agreement with previous measurements as well as with electronegativity considerations. The binding energies of the adventitious carbon signals were affected by band bending as well as by the surface dipole. A model of band bending in which charged surface states are located exterior to the surface dipole is consistent with the XPS and UPS behavior of the chemically functionalized Si(111) surfaces investigated herein.

Avaliação difratográfica da microestrutura de três resinas compostas submetidas à aplicação de um agente clareador a base de peróxido de hidrogênio

A odontologia moderna utiliza métodos e técnicas ultraconservadores no intuito de corrigir os diversos tipos de alterações cromáticas observadas clinicamente. Os meios empregados baseiam-se na utilização de substâncias químicas à base de peróxidos presentes em diversas concentrações. O presente estudo objetivou avaliar a microestrutura de três resinas compostas fotossensíveis submetidas à aplicação de um agente clareador a base de peróxido de hidrogênio a 35% (Whiteness HP Maxx - fabricante: FGM), ativado por uma fonte híbrida de energia luminosa (Aparelho de Laser-Led Whitening Lase, fabricante: DMC). Para isso, foram confeccionados 30 corpos de prova (CDP) 10 para cada grupo, no formato de discos, com 13 mm de diâmetro e 2,0 mm de espessura em uma matriz de teflon e aço inox, fotoativados por um aparelho de luz halógena convencional (Optilux 401 - Demetron/UR) por 40 segundos com densidade de potência média igual a 450 mW/cm2. Os grupos foram dispostos da seguinte forma: Grupo 1 - resina microparticulada (Durafill VS - fabricante: Heraeus Kulzer); Grupo 2 - resina micro-híbrida (Esthet-X - fabricante: Dentsply); e Grupo 3 resina nanoparticulada (Filtek Supreme XT fabricante: 3M ESPE). Todos os materiais restauradores utilizados eram da cor A2. Após serem submetidos à sequência de acabamento e polimento os CDP foram armazenados por sete dias em saliva artificial, limpos em ultra-som, envelhecidos artificialmente de acordo com a norma ASTM G 154. Os CDP dos três grupos foram aleatoriamente divididos em 2 subgrupos (ST sem tratamento e CT com tratamento) e finalmente submetidos aos experimentos. Os CDP dos subgrupos 1-ST, 2- ST e 3-ST foram triturados (SPEX SamplePrep 8000-series, marca: Mixer/Mills) seguido pela verificação dos materiais por meio de um espectrômetro (marca/modelo: Shimadzu EDX 720) para certificação da ausência de elementos pertencentes ao meio de moagem e por fim foram levados a um difrator de raios-X (marca / modelo: Philips -PW 3040 -X'Celerator- 40kV; 30mA; (λ): CuKα; 0,6; 0,2mm; 0,05 (2θ); 2s; 10-90 (2θ). Em seguida os CDP dos subgrupos 1-CT, 2- CT e 3-CT foram tratados com o peróxido de hidrogênio de acordo com o protocolo do fabricante para a fonte híbrida luminosa de energia selecionada, totalizando 9 aplicações de 10 minutos, onde eram respeitados os tempos de 3 minutos de ativação por 20 segundos de descanso, finalizando 10 minutos em cada aplicação. Mediante a este tratamento, os CDP dos subgrupos CT eram verificados e avaliados pelo mesmo método descrito anteriormente. Após interpretação gráfica, análise comparativa por meio do processamento digital das imagens no programa KS400 3.0 (Carl Zeiss Vision) e análise de concordância por cinco avaliadores calibrados utilizando um escore, pôde-se concluir que houve degradação estrutural e que as estruturas cristalinas das resinas estudadas foram afetadas de forma distinta quando tratadas pelo peróxido de hidrogênio; onde observou-se que: Grupo 1 > Grupo 3 > Grupo 2. Foi sugerido a realização de novos estudos, relacionados à interação do peróxido de hidrogênio às resinas compostas.

Análise da variabilidade gênica de antígenos de T. cruzi com aplicação para o diagnóstico sorológico da doença de Chagas

A doença de Chagas é uma zoonose causada pelo protozoário flagelado Trypanosoma cruzi. Estima-se que 8 milhões de pessoas estão infectadas com o T. cruzi em todo o mundo, principalmente na América Latina. Testes tradicionais de diagnóstico estão sendo gradualmente substituídos por métodos inovadores. A utilização de antígenos recombinantes foi proposta nos anos 90, e várias combinações foram testadas com soros de pacientes com diferentes formas clínicas de diferentes regiões da América Latina. Apesar do ganho em especificidade, estes testes apresentaram menor sensibilidade, frustrando expectativas. Este estudo objetivou analisar a variabilidade genética dos genes KMP11 e 1F8 que codificam antígenos comumente utilizados em diagnóstico experimental. Cepas de T. cruzi pertencentes a diferentes sub-grupos taxonômicos e de diferentes regiões foram analisadas para avaliar o impacto da variação antigênica em testes de diagnóstico. Maximizando a sensibilidade, evitar reatividade cruzada com epítopos de outros agentes patogênicos deve permitir a concepção de melhores testes rápidos. Num primeiro passo, DNA genômico foi extraído das seguintes cepas: Dm28c, Colombiana, Y, 3663, 4167, LL014 e CL Brener e foi realizada a amplificação dos genes 1F8 e KMP11 que codificam antígenos a partir destas cepas. Em seguida foram realizadas a clonagem, sequenciamento, expressão e detecção dos antígenos recombinantes. Na etapa final, análises de estruturas secundárias e terciárias, a última apenas para o antígeno 1F8, visualizaram as diferenças nas sequências de aminoácidos obtidas a partir de sequenciamento de DNA. Os resultados apresentados neste estudo mostram que o antígeno KMP11 de T. cruzi possui uma similaridade na sequência de aminoácidos muito elevada com o T. rangeli, mostrando a necessidade de um mapeamento antigênico desta proteína em todos os tripanosomatídeos que apresentaram alta similaridade com o antígeno de T. cruzi, como o T. rangeli, para verificar a presença de epítopos específicos de T. cruzi. O antígeno 1F8 pode ser uma ferramenta útil no diagnóstico da doença de Chagas e que será necessário aprofundar os conhecimentos sobre os determinantes antigênicos para futuramente elaborar poli-epítopos sintéticos adaptados de um maior número possível de antígenos, obtendo a maior especificidade e sensibilidade nos testes de diagnóstico sorológico e de teste rápido da doença de Chagas. Este estudo representa um passo crucial para a otimização de antígenos recombinantes para o diagnóstico da doença de Chagas.

BioHackathon series in 2011 and 2012: penetration of ontology and linked data in life science domains.

The application of semantic technologies to the integration of biological data and the interoperability of bioinformatics analysis and visualization tools has been the common theme of a series of annual BioHackathons hosted in Japan for the past five years. Here we provide a review of the activities and outcomes from the BioHackathons held in 2011 in Kyoto and 2012 in Toyama. In order to efficiently implement semantic technologies in the life sciences, participants formed various sub-groups and worked on the following topics: Resource Description Framework (RDF) models for specific domains, text mining of the literature, ontology development, essential metadata for biological databases, platforms to enable efficient Semantic Web technology development and interoperability, and the development of applications for Semantic Web data. In this review, we briefly introduce the themes covered by these sub-groups. The observations made, conclusions drawn, and software development projects that emerged from these activities are discussed.

Identification of gene networks associated with acute myeloid leukemia by comparative molecular methylation and expression profiling

Around 80% of acute myeloid leukemia (AML) patients achieve a complete remission, however many will relapse and ultimately die of their disease. The association between karyotype and prognosis has been studied extensively and identified patient cohorts as having favourable [e.g. t(8; 21), inv (16)/t(16; 16), t(15; 17)], intermediate [e.g. cytogenetically normal (NK-AML)] or adverse risk [e.g. complex karyotypes]. Previous studies have shown that gene expression profiling signatures can classify the sub-types of AML, although few reports have shown a similar feature by using methylation markers. The global methylation patterns in 19 diagnostic AML samples were investigated using the Methylated CpG Island Amplification Microarray (MCAM) method and CpG island microarrays containing 12,000 CpG sites. The first analysis, comparing favourable and intermediate cytogenetic risk groups, revealed significantly differentially methylated CpG sites (594 CpG islands) between the two subgroups. Mutations in the NPM1 gene occur at a high frequency (40%) within the NK-AML subgroup and are associated with a more favourable prognosis in these patients. A second analysis comparing the NPM1 mutant and wild-type research study subjects again identified distinct methylation profiles between these two subgroups. Network and pathway analysis revealed possible molecular mechanisms associated with the different risk and/or mutation sub-groups. This may result in a better classification of the risk groups, improved monitoring targets, or the identification of novel molecular therapies.

Biomarkers of fruit and vegetable intake in Human intervention studies a systematic review

Observational evidence consistently shows that consumption of a diet rich in fruit and vegetables may offer protection against diseases such as cardiovascular disease and cancer. Assessment of dietary intake is complex and prone to many sources of error. More objective biomarkers of fruit and vegetable intake are therefore of interest. The aim of this review is to examine the usefulness of the main biomarkers of fruit and vegetable intake to act as objective indicators of compliance in dietary intervention studies. A comprehensive search of the literature was conducted using six databases. Suitable papers were selected and relevant data extracted. The papers were categorized into 3 sub-groups: whole diet interventions; mixed fruit and vegetable interventions; and studies involving individual varieties of fruits or vegetables. Ninety-six studies were included in the review. Overall, the most commonly measured, and most consistently responsive, biomarkers were the carotenoids and vitamin C. Based on the results of this systematic review, it remains prudent to measure a panel of biomarkers in fruit and vegetable intervention studies. The only possible exception to this is “fruit only” intervention studies where assessment of vitamin C alone may suffice.

A sibling-controlled, prospective study of outcomes at home and school in children with severe congenital heart disease

Objectives: The objectives of this study were to compare behaviour problems and competencies, at home and school, in 7-year-old children with congenital heart disease with a sibling control group, to examine the prospective determinants of outcome from infancy, and to explore whether any gains were maintained in our sub-group of children who had participated in a previous trial of psychological interventions in infancy.
Methods: A total of 40 children who had undergone surgery to correct or palliate a significant congenital heart defect in infancy were compared (Child Behavior Checklist) with a nearest-age sibling control group (18 participants). Comparisons were made between sub-groups of children and families who had and had not participated in an early intervention trial.
Results: Problems with attention, thought and social problems, and limitations in activity and school competencies, were found in comparison with siblings. Teacher reports were consistent with parents, although problems were of a lower magnitude. Disease, surgical, and neurodevelopmental functioning in infancy were related to competence outcomes but not behaviour problems. The latter were mediated by family and maternal mental health profiles from infancy. Limited, but encouraging, gains were maintained in the sub-group that had participated in the early intervention programme.
Conclusions: The present study is strengthened by its longitudinal design, use of teacher informants, and sibling control group. The patterns of problems and limitations discerned, and differential determinants thereof, have clear implications for interventions. We consider these in the light of our previously reported intervention trial with this sample and current outcomes at the 7-year follow-up.

Multi-Dimensional Deprivation in Ireland Among 9-Year-Olds in Ireland:An Analysis of the Growing Up in Ireland Survey’

In this paper we make use of the 9-year old wave of the Growing Up in Ireland study to analyse multidimensional deprivation in Ireland. The Alkire and Foster adjusted head count ratio approach (AHCR; 2007, 2011a, 2011b) applied here constitutes a significant improvement on union and intersection approaches and allows for the decomposition of multidimensional poverty in terms of dimensions and sub-groups. The approach involves a censoring of data such that deprivations count only for those above the specified multidimensional threshold leading to a stronger set of interrelationships between deprivation dimensions. Our analysis shows that the composition of the adjusted head ratio is influenced by a range of socio-economic factors. For less-favoured socio-economic groups dimensions relating to material deprivation are disproportionately represented while for the more advantaged groups, those relating to behavioral and emotional issues and social interaction play a greater role. Notwithstanding such variation in composition, our analysis showed that the AHCR varied systematically across categories of household type, and the social class, education and age group of the primary care giver. Furthermore, these variables combined in a cumulative manner. The most systematic variation was in relation to the head count of those above the multidimensional threshold rather than intensity, conditional on being above that cut-off point. Without seeking to arbitrate on the relative value of composite indices versus disaggregated profiles, our analysis demonstrates that there is much to be gained from adopting an approach with clearly understood axiomatic properties. Doing so allows one to evaluate the consequences of the measurement strategy employed for the understanding of levels of multidimensional deprivation, the nature of such deprivation profiles and socio-economic risk patterns. Ultimately it permits an informed assessment of the strengths and weaknesses of the particular choices made.

A methodological review of the Short Form Health Survey 36 (SF-36) and its derivatives among breast cancer survivors

Purpose: A systematic review of the validity, reliability and sensitivity of the Short Form (SF) health survey measures among breast cancer survivors.
Methods: We searched a number of databases for peer-reviewed papers. The methodological quality of the papers was assessed using the COnsenus-based Standards for the selection of health Measurement INstruments (COSMIN).
Results: The review identified seven papers that assessed the psychometric properties of the SF-36 (n = 5), partial SF-36 (n = 1) and SF-12 (n = 1) among breast cancer survivors. Internal consistency scores for the SF measures ranged from acceptable to good across a range of language and ethnic sub-groups. The SF-36 demonstrated good convergent validity with respective subscales of the Functional Assessment of Cancer Treatment—General scale and two lymphedema-specific measures. Divergent validity between the SF-36 and Lymph-ICF was modest. The SF-36 demonstrated good factor structure in the total breast cancer survivor study samples. However, the factor structure appeared to differ between specific language and ethnic sub-groups. The SF-36 discriminated between survivors who reported or did not report symptoms on the Breast Cancer Prevention Trial Symptom Checklist and SF-36 physical sub-scales, but not mental sub-scales, discriminated between survivors with or without lymphedema. Methodological quality scores varied between and within papers.
Conclusion: Short Form measures appear to provide a reliable and valid indication of general health status among breast cancer survivors though the limited data suggests that particular caution is required when interpreting scores provided by non-English language groups. Further research is required to test the sensitivity or responsiveness of the measure.

FKBPL: a marker of good prognosis in breast cancer

FK506-binding protein-like (FKBPL) has established roles as an anti-tumor protein, with a therapeutic peptide based on this protein, ALM201, shortly entering phase I/II clinical trials. Here, we evaluated FKBPL's prognostic ability in primary breast cancer tissue, represented on tissue microarrays (TMA) from 3277 women recruited into five independent retrospective studies, using immunohistochemistry (IHC). In a meta-analysis, FKBPL levels were a significant predictor of BCSS; low FKBPL levels indicated poorer breast cancer specific survival (BCSS) (hazard ratio (HR) = 1.30, 95% confidence interval (CI) 1.14-1.49, p < 0.001). The prognostic impact of FKBPL remained significant after adjusting for other known prognostic factors (HR = 1.25, 95% CI 1.07-1.45, p = 0.004). For the sub-groups of 2365 estrogen receptor (ER) positive patients and 1649 tamoxifen treated patients, FKBPL was significantly associated with BCSS (HR = 1.34, 95% CI 1.13-1.58, p < 0.001, and HR = 1.25, 95% CI 1.04-1.49, p = 0.02, respectively). A univariate analysis revealed that FKBPL was also a significant predictor of relapse free interval (RFI) within the ER positive patient group, but it was only borderline significant within the smaller tamoxifen treated patient group (HR = 1.32 95% CI 1.05-1.65, p = 0.02 and HR = 1.23 95% CI 0.99-1.54, p = 0.06, respectively). The data suggests a role for FKBPL as a prognostic factor for BCSS, with the potential to be routinely evaluated within the clinic.

The effects of Chronic Lycopene Supplementation on Exercise-Induced Oxidative Stress and Glucose Homeostasis.

Lycopene can exert antioxidant effects against peripheral and cellular oxidative stress and may be associated with reduced diabetic risk. Conversely, exercise-induced free radicals are thought to underpin many of the desirable whole-body adaptations following training and the use of antioxidants within the exercise model remains debatable. PURPOSE: To investigate the effect of lycopene supplementation on oxidative stress and glucose homeostasis following acute aerobic exercise. METHOD: Twenty-eight (n=28) apparently healthy male volunteers were recruited (age 24 ± 4 years; weight 78 ± 10 kg; height 178 ± 8 cm; 2max 40 ± 7 ml·kg-1 ·min-1 ) in a randomised, single blind, placebo-controlled study. Participants were required to attend the Laboratory on two occasions: prior to and following 6 weeks of supplementation of either 10mg lycopene (LG; n=15) or placebo (PG; n=13) followed by a bout of acute exercise for one hour at 65% 2max. Exogenous glucose oxidation was then measured on an isotope ratio mass spectrometer in a sub-group of participants (n=14) following exercise, by administration of a standard oral glucose tolerance test (OGTT; 75g glucose). Venous blood samples were drawn for measurement of oxidative stress parameters, plasma glucose and insulin. RESULTS: Plasma lycopene increased in LG only (0.01 ± 0.004 vs.0.02 ± 0.007 µmol/L; P <0.05) following supplementation and remained elevated post exercise compared to PG (0.01 ± 0.004 vs. 0.02 ± 0.009 µmol/L; P <0.05). There were no changes in other markers of oxidative stress (SOD, LOOHs, F2 ISP and Alkoxyl radical) either between or within the trials, (P >0.05, respectively). A main effect for an increase in insulin was observed two hours post OGTT in the sub-groups (Pooled data, P <0.05) but trends in the HOMA scores were evident with a 57% increase for LG (2.20 ± 1.84 vs. 5.14 ± 2.5; P >0.05) and an 11% decrease for PG (2.17 ± 1.06 vs. 1.94 ± 1.53; P >0.05). No change in plasma glucose was detected at any point, or after the OGTT (P >0.05). CONCLUSION: In healthy males, lycopene supplementation had no effect on post exercise levels of ROS or markers of lipid peroxidation, despite an increase in plasma lycopene. However, lycopene supplementation may affect post exercise insulin sensitivity in response to glucose consumption, but further parallel research is required.

The working practices of Birmingham's Centre for Contemporary Cultural Studies

This article offers a history of the working practices of the Birmingham Centre for Contemporary Cultural Studies. Based on extensive interviews with former members and on research into a new archive of the Centre, housed in the Cadbury Research Library, University of Birmingham, it argues that cultural studies as practised in the 1970s was always a heterogeneous subject. The CCCS was heavily influenced by the events of 1968 when it tried to develop a new type of radical and collaborative research and teaching agenda. Despite Stuart Hall's efforts to impose a focused link between politics and academic practice, the agenda soon gave way to a series of diverse and fruitful initiatives associated with the ‘sub-groups’ model of research.

Men’s depression and suicide literacy: A nationally representative Canadian survey

Background: Male suicide prevention strategies include diagnosis and effective management of men’s depression. Fundamental to suicide prevention efforts is public awareness, which in turn, is influenced by literacy levels about men’s depression and suicide.

Aim: To examine sex differences in mental health literacy with respect to men’s depression and suicide among a cohort of Canadian respondents.

Methods: 901 English-speaking Canadian men and women completed online survey questionnaires to evaluate mental health literacy levels using 10-item D-Lit and 8-item LOSS questionnaires, which assess factual knowledge concerning men’s depression and suicide. Statistical tests (chi-square, z-test) were used to identify significant differences between sex sub-groups at 95% confidence.

Results: Overall, respondents correctly identified 67% of questions measuring literacy levels about male depression. Respondents’ male suicide literacy was significantly poorer at 53.7%. Misperceptions were especially evident in terms of differentiating men’s depressive symptoms from other mental illnesses,
estimating prevalence and identifying factors linked to male suicide. Significant sex differences highlighted that females had higher literacy levels than men in regard to male depression.

Conclusions: Implementing gender sensitive and specific programs to target and advance literacy levels about men’s depression may be key to ultimately reducing depression and suicide among men in Canada.