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NEXUS portal, Vol. 2, issue 4 Coen, Stephanie; University of British Columbia. NEXUS Research Unit Oct 31, 2008

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such as craving to smoke cigarettes and feeling mentally and physically addicted to cigarettes. This relationship held even after accounting for parental smoking, sibling smok- ing, and the children’s own susceptibility to smoking. The findings of the present study build upon previous research by Becklake and colleagues which demonstrated that non-smoking children who had biological markers of tobacco exposure (having been exposed to parental smoking via secondhand tobacco smoke) were more likely to become what is striking is the mechanism identified by this study through which this process can occur: tobacco smoke exposure. Okoli and colleagues found that children who had never even puffed a cigarette and reported being exposed to someone smoking in the car were more likely to endorse nicotine dependence symptoms, NEXUS Portal Volume 2, Issue 4 October 31, 2008 U n i v e r s i t y  o f  B r i t i s h  C o l u m b i a  -  3 0 2 ,  6 1 9 0  A g r o n o m y  R o a d  -  V a n c o u v e r,  B C  V 6 T  1 Z 3 Pregnancy and Substance Use Resource Launched Joan Bottorff (NEXUS Co-Director), Director of the Centre for Healthy Living and Chronic Dis- ease Preven- tion at UBC Okanagan and Nancy Poole (NEX- US Doctoral Trainee) and Dr. Lorraine Greaves (NEXUS Lead Investigator), Executive Director of the Brit- ish Columbia Centre of Excellence for Women’s Health; Practitioners: Cristine Urquhart, Provincial Training Consultant with ActNow BC, Healthy Choices in Pregnancy and Chi Cejalvo, Execu- tive Director of the BC Association of Pregnancy Outreach Programs; and Women Advocates: Michelle Sherbuck, Advisory Committee Member for the development of the women and alcohol resource. The resources launched were all representative of new ways of promoting women’s health through complex knowledge translation processes. These included: 1. Double Exposure: A Better Practices Review on Alcohol Interventions in Pregnancy – A review of effective interventions to support women to reduce alcohol use in the childbear- ing years. This booklet provides best practice guidelines, including contextualized program components, approaches, and recommendations for practice, research, knowledge translation and policy. 2. Couples and Smoking: What you Need to Know When You are Pregnant – A booklet for couples on the dynamics of managing tobacco reduction in pregnancy. Unlike standard smoking cessation resources for pregnant women, this new information booklet, developed by NEXUS re- searchers, situates women’s smoking and tobacco reduction in the context of realistic everyday in- teractions and relationships with intimate partners, and helps women realize that smoking is influenced by others and is embedded in everyday routines. The booklet takes a women-centred approach, addressing smoking in the context of women’s lives and their relationships (rather than focusing on fetal health), and avoids stigmatizing women’s smoking. A harm reduc- The knowledge translation team working on the ActNow BC Healthy Choices in Pregnancy (HCIP) initiative col- laborated with NEXUS research- ers to launch four new print and DVD resources designed to support change in substance use by pregnant women and their partners. The launch took place on September 11, 2008 and utilized a new virtual mechanism, LiveStream video, to reach participants in BC, across Canada, and internationally. One of the resources, a booklet on couples and smoking, was a product of the Fami- lies Controlling and Eliminating Tobacco (FACET) research program, led by NEXUS Co-Director Dr. Joan Bottorff. The speakers who launched the materials represented four key sectors and collaborations that have been demonstrated as foundational to successful research and knowledge translation: Health system planners: Grant Main, Deputy Minister, BC Ministry of Healthy Living and Sport and Dr. Elizabeth Whynot, President of BC Wom- en’s Hospital and Health Centre; Researchers: Dr. NEXUS Trainee Makes International Headlines NEXUS researchers Nancy Poole and Dr. Joan Bottorff with the Couples and Smoking booklet [Photo: J. Bottorff] - continued on page 4 - Trainee Spotlight    2 New at NEXUS      3 Honourable Mentions               3 Resource Launch (Continued)           4 International Head- lines (Continued)   4 Upcoming Events   5 In this issue - continued on page 4 - “The Couples and Smoking booklet helps women to realize that smoking...is embedded in everyday routines.” “What is striking is the mechanism by which parental smoking affects kids’ tobacco uptake: tobacco smoke exposure.” Through his work with NEXUS, Post-doctoral Fellow Dr. Chizimuzo Okoli published an article in the December 2008 issue of the journal Addictive Behaviors (1) that has made headlines in at least seven countries, including Canada, South Africa, Italy, Germany, Thai- land, Australia, and the US. The article sends a powerful warning: parents who smoke may influence their children’s subsequent smoking behaviour. Although the finding that parental (and peer and sibling) smoking behaviour can influence children’s tobacco uptake is not in itself novel, Angela with partner Blair and daughter Miranda [Photo: A. Wolff] Angela Wolff is the Director of Clinical Education, Professional Practice and Integration, Fraser Health Authority. She is completing the doctoral program in the UBC School of Nursing under the supervision of Dr. Pamela Ratner. Angela’s dissertation examines the complex linkages between diversity among nursing workgroups, professional burnout, and the mediating effects of conflict (relationship and task). Currently, she is working on the final stages of data analysis and writing her dissertation. Her program of research, in the field of health services and policy, focuses on the sustainability of the nursing workforce, the quality of work life/work environment for nurses, and the factors that affect the work performance and preparedness of new RN graduates. She has been a NEXUS trainee since 2004, and is originally from Liberty, Saskatchewan. If  you had a motto, what would it be? My vision “leading, learning, inspiring . . . living” provides guidance in my professional and personal life. How did you initially become interested in social contexts of health behaviour? I initially became interested in the social contexts of health behaviour (and nurses’ workplaces) because of the insights gained through the lenses of gender, diversity, and place. How would you describe your involvement with NEXUS? As a NEXUS trainee, my involvement has been the learning opportunities, poster presentations, and the Spring Institute, as well as the networking opportunities. What are some of  your recent professional accomplishments that you are most proud of? My recent professional accomplishments, to name a few, have been my perseverance in the PhD program, achieving an 82% response rate for the questionnaire used in my dissertation research, providing survey development expertise, and attaining my current position as Director of Clinical Education for Fraser Health Authority. NEXUS Trainee Spotlight Each issue, different NEXUS trainees take the spotlight and share a bit about their academic lives and beyond. What profession other than your own would you like to attempt? I love nursing and cannot think of a profession that I would rather pursue. If  you could pursue any research topic outside your field, what would it be? If I could pursue a research topic outside my current field it would most likely continue in the direction of research informed by organizational behaviour and explore the use of mathematical modelling involving social systems. Perhaps these may be new directions for my current program of research. If  you had to choose a favourite paper/publication of  yours, what would it be and why? My favourite publication is Wolff, A.C., & Rideout, L. (2001). The faculty role in problem-based learning. In L. Rideout (Ed.), Transforming nursing education through problem-based learning (pp. 193-213). Toronto: Jones & Bartlett. I had the opportunity to write this chapter with a former professor from my undergraduate nursing program at McMaster University. Learning in this environment captivated my interest in assisting others to teach, using PBL, and foster study learning. What are some of  your totally unprofessional accomplishments that you are most proud of? I am most proud of being a mom. What attributes, habits, or likes/dislikes would someone be surprised to learn about you? People may be surprised to learn that I am from a small town in rural Saskatchewan that had a population of 150 people, that I joined the Naval Reserve while living in Saskatchewan (prairie people make the best sailors), and that I am a big fan of the Survivor television show. I also enjoy activities with my daughter such as Irish dancing (that is, watching on the sidelines, not dancing) as well as attending clay art classes and events such as the kids program with the Vancouver Symphony Orchestra. Which talent would you most like to possess? I would like to play a musical instrument flawlessly! What human quality do you most admire? Genuineness and transparency. “My motto is leading, learning, inspiring... living.” ANGELA WOLFF Page 2NEXUS: Researching the social contexts of health behaviour NEXUS Portal Volume 2, Issue 4 Rick Sawatzky Awarded Top Prize At the15th Annual Conference of the International Society for Quality of Life Research in Montevideo, Uruguay, October 22-25, 2008, NEXUS Co-Investigator, Dr. Rick Sawatzky was awarded the Early Career Investigators’ Award for his oral presentation ‘Latent class factor analysis of SF-36 physical function indicates lack of invariance of discrimination and difficulty parameters’, co-authored with Dr. Pamela Ratner (abstract published in Quality of Life Resarch (2008), (suppl.), A-27-A28). This honour recognizes the best overall oral presentation made by researchers having received their doctorates within the last five years, as well as full time students. Rick was presented with a cash prize at the conference banquet. Slides of the presentation are available at www.ricksawatzky.com. Joan Bottorff Honoured with CNA Centenial Award To commemorate its 100th anniversary, the Canadian Nurses Association has selected 100 registered nurses across Canada whose personal and professional contributions have significantly impacted the nursing profession to receive a one-time award. NEXUS Co-Director Dr. Joan Bottorff is recipient of this prestigous honour. Pamela Ratner Appointed to CIHR Institute Advisory Board NEXUS Co-Director Dr. Pamela Ratner has been appointed to the Institute Advisory Board of the Institute of Circulatory and Respiratory Health. This body provides support and guidance to the Scientific Director on strategic directives and links between the Institute and stakeholders. Elaine Chong Makes Career Move Elaine Chong – NEXUS Trainee Affiliate since September 2007 – has accepted a position as an acting director in the Drug Use Optimization (DUO) Branch of the BC Ministry of Health Services’ Pharmaceutical Services Division. DUO’s mandate is to facilitate quality use of medicines through education, drug use evaluations, and other initiatives. She completed her post-doctoral training jointly with Nursing and CHSPR. New at NEXUS NEXUS Welcomes New Trainees! In September 2008, six new trainees joined NEXUS, and we are very happy to have them on board! Cindy Masaro, Mi-Yeon Kim, and Katie Baines, are working towards their PhDs under the supervision of Dr. Joy Johnson. Erin Ptolemy is a Master’s of Social Work student, supervised by Dr. Joan Bottorff. Jennifer Bell is a PhD student supervised by Dr. Lynda Balneaves, and Sienna Caspar is a PhD student under the supervision of Dr. Pamela Ratner. NEXUS PIs Receive 2 Out of 5 CIHR Team Grants In the recently announced results of the CIHR Emerging Team Grant: Gender, Sex and Health competition, NEXUS investigators were the principal investigators on two of the five projects that received funds. Grants were awarded to Dr. Joan Bottorff and Dr. John Oliffe for Gender Based Tobacco Reduction Interventions, and to Dr. Lorraine Greaves and colleagues for Sex, Gender and Health Promotion: Building Evidence for Effective Health Promotion for Women. NEXUS Holds Safer Crack Use Meeting NEXUS will hold a pan-Canadian meeting, funded by the Canadian Institutes of Health Research, to facilitate knowledge exchange among key stakeholders in research, policy, and program delivery pertaining to the safer use of crack cocaine. This meeting will be a vital opportunity to build collaborations and new networks across different settings within Canada and to exchange and collate information in order to develop evidence-based recommendations for improvements in policy and practice. In addition to enabling the sharing of research knowledge and program initiatives, the meeting aims to move forward a national policy agenda and to begin to develop comprehensive best practice guidelines for harm reduction in crack use. The event is organized by NEXUS Lead Investigator Dr. Jane Buxton, and will take place in Toronto, Ontario, winter 2009. Dr. Lisa Maher, Program Head of the National Centre in HIV Epidemiology and Clinical Research and Associate Professor in the School of Public Health and Community Medicine at the University of New South Wales, Australia, will deliver a keynote address on gendered policy regarding safer crack use. Honourable Mentions Mathematical model to examine sample heterogene- ity with respect to the measurement of physical function by R. Sawatzky and P.A. Ratner. Page 3NEXUS: Researching the social contexts of health behaviour NEXUS Portal Volume 2, Issue 4 tion approach guides the presentation of options to address tobacco use. 3. Women and Alcohol: A Women’s Health Resource – This booklet is another example of putting comprehensive evidence-based resources in the hands of health care providers, so they can create an effective context of support for women and their families. This text helps practitioners broaden the discussion to women’s alcohol use beyond pregnancy, and to re- lated concerns which might make it difficult for them to make a change in their drinking. It was devel- oped collaboratively by mothers, service providers, researchers and educators to respond to the needs of women who are often missed in alcohol use screening and support interventions before, during, and after pregnancy. 4. Supporting Change: Preventing FASD – A DVD illustrating an evidence-based practice framework that supports change in alcohol use and related health and social areas by women of child bearing years who use substances. This resource grew out of requests from service providers to see evidence-based practice in action, and to have a reference for answering common clinical questions. This process of moving knowledge from research, to print and media resources, and ensuring that these resources are effectively incorporated into practice, requires ongoing collaboration. For example, to test Couples and Smoking: What You Need to Know, the research team and the HCIP educators worked with the BC Association of Pregnancy Outreach Programs (www.bcapop.ca) to pilot-test the booklet with 49 female smokers and 50 service providers in 11 communities throughout British Columbia. Their Resource Launch (continued from page 1) Nancy Poole preparing for the launch [Photo: J. Bottorff] International Headlines (continued from page 1) NEXUS Portal Volume 2, Issue 4 Page 4 smokers at a follow-up point (2). This recent study by Okoli and col- laborators was the first of its kind to show that children who had never smoked were more likely to experience nicotine dependence symp- toms, after exposure to secondhand tobacco smoke (SHS). In conjunc- tion with this finding, a few recent studies have also demonstrated that SHS exposure is independently associated with smoking cessation and nicotine dependence among smoking adults (3); and that adult non-smokers with high SHS exposure (or biomarkers) are more likely to endorse symptoms reported by smokers who are withdrawing from cigarette use (namely, irritability, poor concentration, anxiety, restless- ness) (4). These studies strengthen the plausibility that SHS exposure, as an important source of nicotine exposure (5), increases the susceptibili- ty of non-smokers to tobacco use and subsequent nicotine dependence. In conclusion, the take home message is that in addition to placing in- dividuals at risk for heart disease, respiratory illness, and cancer, SHS exposure can also increase children’s risk of initiating and becoming dependent on cigarettes. Although no causal inferences between SHS exposure and tobacco use uptake can be made because of the design of the current study, it provides a strong basis for future studies to explore these associations. In the meantime, the study findings provide the basis for a precaution for parents to avoid smoking near their kids, and for advocating and strengthening policies that restrict tobacco smoke exposure in public spaces, motor vehicles, and in public housing. References 1. Bélanger, M., O’Loughlin, J.L., Okoli, C.T.C., McGrath, J., Setia, M., Guyon, L., & Gervais, A. (2008). Nicotine dependence symptoms among young never-smokers exposed to secondhand tobacco smoke. Addictive Behaviors, 33, 1557–1563. 2. Becklake, M.R., Ghezzo, H., &d Ernst, P. (2005). Childhood predic- tors of smoking in adolescence: A follow-up study of Montréal school- children. Canadian Medical Association Journal, 173, 377–379. 3. Okoli, C.T.C., Browning, S., Rayens, M.K., & Hahn, E.J. (2008). Sec- ondhand tobacco smoke exposure, nicotine dependence, and smoking cessation. Public Health Nursing, 25, 46–56. 4. Okoli, C.T.C, Rayens, M.K., & Hahn, E.J. (2007). Behavioral effects of nicotine exposure from secondhand tobacco smoke among bar and restaurant workers. Addictive Behaviors, 32, 1922–1928. 5. Okoli, C.T., Kelly, T., & Hahn, E.J. (2007). Secondhand smoke and nicotine exposure: A brief review. Addictive Behaviors, 32, 1977– 1988. feedback, gathered through individual interviews and focus groups, helped to improve the usability of the booklet and the clarity of its messages. The ActNow BC HCIP team is currently working with Health Authorities, the BC Association of Pregnancy Outreach Programs, the Centre for Addiction Research of BC and other organizations to make the resources available to service providers to use in their discussions with women and their support networks. They are also working to develop approaches for implementing these multi-faceted health promotion resources in different settings, and for evaluating their implementation, again involving government policy makers, health system planners, health care workers and women. For more information, to view a live recording of the launch, or to order these health promotion resources please visit www.hcip-bc.org/hcip_re- sources.htm 1. Parkes, T., Poole, N., Salmon, A., Greaves, L., & Urquhart, C. (2008). Dou- ble exposure: a better practices review on alcohol interventions in pregnancy. Vancouver, BC: British Columbia Centre of Excellence for Women’s Health 2. Bottorff, J. L., Carey, J., Poole, N., Greaves, L., & Urquhart, C. (2008). Couples and smoking: what you need to know when you are pregnant. Van- couvr BC: British Columbia Centre of Excellence for Women’s Health and the Centre for Healthy Living and Chronic Disease Prevention, University of British Columbia Okanagan. 3. Poole, N., Urquhart, C., Pitman, L., & Advisory Committee. (2008). Women and alcohol: a women’s health resource. Vancouver, BC: British Columbia Cen- tre of Excellence for Women’s Health 4. Urquhart, C., & Poole, N. (Writers) (2008). Supporting change: preventing fetal alcohol spectrum disorder [DVD]. 2C Visual Communications (Producer). Vancouver, BC Canada: British Columbia Centre of Excellence for Women’s Health. NEXUS: Researching the social contexts of health behaviour NEXUS is funded byNEXUS is a community of academic and clinical researchers and graduate students pursuing health behaviour research from a variety of perspectives including Nursing, Public Health, Epidemiology, Health Promotion, Sociology, Pharmaceutical Sciences, and Geography. Its mission is to develop knowledge, interventions, and policy recommendations based on a critical analysis of the social contexts that 1) create barriers to health, 2) affect health seeking, and 3) influence system responses. NEXUS is building expanded research  programs related to these three themes in health behaviour using the analytical lenses of gender, diversity, and place. Dr. Lynda Balneaves Dr. Joan Bottorff Dr. Jane Buxton Dr. Lorraine Greaves Dr. Joy Johnson Dr. John Oliffe Dr. Aleck Ostry Dr. Ric M. Procyshyn Dr. Pamela Ratner Dr. Jean Shoveller Dr. Judith Soon Dr. Annette Browne Dr. Joyce Davison Dr. Paul Galdas Ms. Sukhdev Grewal Dr. Su-Er Guo Dr. T. Gregory Hislop Dr. Mieke Koehoorn Ms. Martha Mackay Ms. Mary McCullum Dr. John Ogrodniczuk Dr. Birgit Reime Dr. Chris Richardson Dr. Carole A. Robinson Dr. Rick Sawatzky Ms. Tracy Truant Dr. Helen Ward Dr. Sabrina Wong Dr. Mary Lynn Young NEXUS Lead Investigators NEXUS Co-Investigators NEXUS Poster Session & Holiday Party November 26, 2008 TEF III, 2nd Floor Boardroom (#203) 6190 Agronomy Road Vancouver, BC V6T 1Z3 NEXUS Seminar Series 2008-09 Join us for the continution of the 2008-09 NEXUS seminar series. Seminars are presented at the UBC Vancouver and Okanagan campuses and are broadcast online via WebEx. January 21, 2009 ~ Does an Historical Overview Have Anything to Offer 21st Century Policy Makers?    Aleck Ostry, NEXUS Lead Investigator February 25, 2009 ~ Diversity in the Nursing Workforce: The Key to Success or a Source of Tension?    Angela Wolff, NEXUS PhD Trainee March 25, 2009 ~ Complementary Medicine Education and Outcomes    Lynda Balneaves, NEXUS Lead Investigator; Tracy Truant, NEXUS Co-Investigator;    Alison Brazier, NEXUS Alumna NEXUS Spring Institute 2009 Knowledge Exchange: From Research to Social Action and Back April 16 & 17, 2009 St. John’s College 2111 Lower Mall, UBC Vancouver, BC V6T 1Z4 Upcoming Events For more information on NEXUS events please visit www.nexus.ubc.ca/opportunities/learning/learning.htm Page 5NEXUS: Researching the social contexts of health behaviour NEXUS Portal Volume 2, Issue 4


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