SRHR Aspiration Research Cluster Publications

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A lipidomics-based method to eliminate negative urine culture in general population
(Journal of Clinical Microbiology, 2024) Nartey, Linda K.; Mikhael, Abanoub; P?trošová, Helena; Yuen, Victor; Kibsey, Pamela; Pekcan, Mert; Ernst, Robert K.; Chen, Michael X.; Goodlett, David R.
Urinary tract infections (UTIs) pose a significant challenge to human health. Accurate and timely detection remains pivotal for effective intervention. Current urine culture techniques, while essential, often encounter challenges where urinalysis yields positive results, but subsequent culture testing produces a negative result. This highlights potential discrepancies between the two methods and emphasizes the need for improved correlation in urinary tract infection (UTI) detection. Employing advanced lipidomics techniques, we deployed the fast lipid analysis technique (FLAT) on a clinical cohort suspected of having UTIs. Lipid fingerprinting by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), directly from urine samples without ex vivo growth, correctly identified the common uropathogens within a 1 hour timeframe when compared to urine culture. FLAT analysis also identified urine samples without culturable pathogens (negative UTIs) with 99% microbial identification (ID) agreement, whereas urinalysis showed 37% ID agreement with the gold standard urine culture. In 402 urine samples suspected for UTI from outpatients, FLAT assay rapidly ruled out negative urines without the need for culture in 77% of all cases. The potential impact of this innovative lipidomic-based approach extends beyond conventional diagnostic limitations, offering new avenues for early detection and targeted management of urinary tract infections. This research marks a paradigm shift in urine culture methodology, paving the way for improved clinical outcomes and public health interventions.
Anxiety and related disorders during the perinatal and postpartum periods
(Annual Review of Clinical Psychology, 2025) Fairbrother, Nichole; Challacombe, Fiona L.; Green, Sheryl M.; O'Mahen, Heather A.
Anxiety and anxiety-related disorders are, as a group, the most common mental health conditions and are more common among women compared with among men. It is now evident that these disorders affect one in five pregnant and postpartum people and are more common than depression. For some disorders (e.g., obsessive–compulsive disorder), there is also evidence of an elevated risk for their development and exacerbation during perinatal periods. In this article, we review the literature pertaining to anxiety and anxiety-related disorders during the perinatal period. We also provide information related to pregnancy-specific anxiety and fear of childbirth constructs that exist outside of diagnostic classification but are particularly important in the perinatal context. We review the scope, prevalence, and etiology of these disorders as well as comorbidity, screening, assessment, and treatment. We conclude with an overview of some of the key gaps in knowledge and recommendations for future research.
Associations between extreme weather events and resource insecurities with HIV vulnerabilities and biomedical HIV prevention outcomes among adolescent girls and young women in Kenya: A cross-sectional analysis
(Journal of the International Association of Providers of AIDS Care, 2025) Logie, Carmen H.; Admassu, Zerihun; Hasham, Aryssa; Evelia, Humphres; Kagunda, Julia; Omondi, Beldine; Gachoki, Clara; Chege, Mercy; Gittings, Lesley; Dorea, Caetano; Turan, Janet M.; Mwangi, Mumbi; Mbuagbaw, Lawrence
Objectives: We examined associations between extreme weather events (EWE), resource insecurities, and HIV vulnerabilities among a purposive sample of adolescent girls and young women (AGYW) aged 16 to 24 in Nairobi and Kisumu, Kenya.Methods: We conducted multivariable logistic/linear regression on cross-sectional survey data to assess associations between EWE exposure, food insecurity (FI), water insecurity (WI), and sanitation insecurity (SI) with HIV vulnerabilities (transactional sex [TS], intimate partner violence [IPV], sexual relationship power [SRP], and preexposure prophylaxis [PrEP] awareness and acceptability).Results: Among participants (n?=?597; mean age: 20.13 years; standard deviation?=?2.5), in adjusted analyses, SI and WI were associated with increased TS. Increased cumulative EWEs and eco-anxiety were associated with increased IPV. EWE frequency, FI, and SI were associated with reduced SRP. EWE frequency and SI were associated with reduced, and WI with increased, PrEP awareness. EWE frequency and SI were associated with PrEP acceptability.Conclusion: Resource scarcities and EWEs were associated with HIV vulnerabilities and PrEP acceptability among AGYW.
Canadian network for mood and anxiety treatments 2024 clinical practice guideline for the management of perinatal mood, anxiety and related disorders
(Canadian Journal of Psychiatry, 2025) Vigod, Simone N.; Frey, Benicio; Clark, Crystal T.; Grigoriadis, Sophie; Barker, Lucy C.; Brown, Hilary K.; Charlebois, Jaime; Dennis, Cindy Lee; Fairbrother, Nichole; Green, Sheryl; Letourneau, Nicole L.; Oberlander, Tim F.; Sharma, Verinder; Singla, Daisy R.; Stewart, Donna E; Tomasi, Patricia; Ellington, Brittany D.; Fleury, Cathleen; Tarasoff, Lesley A.; Tomfohr-Madsen, Lianne; Da Costa, Deborah; Beaulieu, Serge; Brietzke, Elisa; Kennedy, Sidney H.; Lam, Raymond W.; Milev, Roumen V.; Parikh, Sagar V.; Ravindran, Arun V.; Samaan, Zainab; Schaffer, Ayal; Taylor, Valerie H.; Tourjman, Smadar V.; Van Ameringen, Michael; Yatham, Lakshmi N.; Van Lieshout, Ryan J.
Background The Canadian Network for Mood and Anxiety Treatments (CANMAT) publishes clinical practice guidelines for mood and anxiety disorders. This CANMAT guideline aims to provide comprehensive clinical guidance for the pregnancy and postpartum (perinatal) management of mood, anxiety and related disorders. Methods CANMAT convened a core editorial group of interdisciplinary academic clinicians and persons with lived experience (PWLE), and 3 advisory panels of PWLE and perinatal health and perinatal mental health clinicians. We searched for systematic reviews of prevention and treatment interventions for perinatal depressive, bipolar, anxiety, obsessive–compulsive and post-traumatic stress disorders (January 2013–October 2023). We prioritized evidence from reviews of randomized controlled trials (RCTs), except for the perinatal safety of medications where reviews of large high-quality observational studies were prioritized due to the absence of RCT data. Targeted searches for individual studies were conducted when systematic reviews were limited or absent. Recommendations were organized by lines of treatment based on CANMAT-defined levels of evidence quality, supplemented by editorial group consensus to balance efficacy, safety, tolerability and feasibility considerations. Results The guideline covers 10 clinical sections in a question-and-answer format that maps onto the patient care journey: case identification; organization and delivery of care; non-pharmacological (lifestyle, psychosocial, psychological), pharmacological, neuromodulation and complementary and alternative medicine interventions; high-risk clinical situations; and mental health of the father or co-parent. Equity, diversity and inclusion considerations are provided. Conclusions This guideline's detailed evidence-based recommendations provide clinicians with key information to promote the delivery of effective and safe perinatal mental healthcare. It is hoped that the guideline will serve as a valuable tool for clinicians in Canada and around the world to help optimize clinical outcomes in the area of perinatal mental health.
Comparing impacts of donor human milk to formula supplementation on the gut microbiome of full-term infants born via cesarean section: Protocol for a pilot randomized controlled trial
(Journal of Human Lactation, 2025) Brockway, Meredith; Khalid, Maria; Khalil, Yasmeen; Rusi, Heather; Asbury, Michelle R.; Arrieta, Marie-Claire; Keys, Elizabeth; Ou, Christine; Festival, Jannette
Background: A disrupted gut microbiome during an infant’s first 1000?days of life can lead to long-lasting negative effects on child health. Cesarean delivery and formula feeding are two factors that can detrimentally impact infant microbiome development as well as maternal mental health. Donor human milk may be a superior supplementation alternative to formula. Research Aim: To examine donor human milk supplementation compared to formula supplementation in full-term infants born via Cesarean section and the impact on the infant gut microbiome, infant health outcomes, breastfeeding outcomes, and maternal mental health. Methods and Planned Analyses: We are conducting a pilot clinical randomized controlled trial, comparing donor human milk to formula supplementation for 187 full-term infants born via Cesarean section who are breastfeeding and require supplementation in the first postnatal week of life. Infant stool samples, breastfeeding outcomes, maternal mental health, and child health outcomes will be measured at 1-week, 3-, 6-, and 12-months postpartum. Additionally, child health and maternal mental health are being assessed at 18- and 36-months postpartum. Discussion: This study will generate essential data on the association between supplementation types and the full-term infant microbiome, breastfeeding exclusivity and duration, and infant health. It will also provide preliminary data to inform a multi-site, longitudinal mixed-methods randomized controlled trial that will assess longer term child health outcomes. This evidence may be used to inform guidelines and policies that will increase accessibility to and raise awareness of donor human milk as a supplementation option in this population
Complex role of digital health literacy in awareness and use of digital sexually transmitted and blood-borne infections testing: A structural equation modelling analysis of the 2022 GetCheckedOnline survey
(Sexually Transmitted Infections, 2025) Iyamu, Ihoghosa; Gorun, Pierce; Bartlett, Sofia; McKee, Geoffrey; Donelle, Lorie; Chang, Hsiu-Ju; Sierra-Rosales, Rodrigo; Haag, Devon; Pedersen, Heather Nicole; Lachowsky, Nathan John; Worthington, Catherine; Grennan, Troy; Grace, Daniel; Gilbert, Mark
Background Although digital health literacy (DHL) is recognised as a determinant of access to digital sexually transmitted and blood-borne infection (STBBI) testing, empirical evidence about its contribution to access disparities remains limited. We applied multidimensional DHL measures to examine inequities in awareness and use of GetCheckedOnline, British Columbia’s (BC) publicly funded digital STBBI testing service. Methods We analysed data from GetCheckedOnline’s 2022 community survey of English-speaking BC residents aged ?16 years who were sexually active in the past year. Outcomes were awareness and use of GetCheckedOnline (yes/no). DHL was measured using latent factors from the eHealth Literacy Scale: Information Navigation, Resource Appraisal and Confidence in Use. Structural equation modelling (SEM) was used to estimate associations and mediation pathways between DHL, sociodemographic characteristics and service outcomes. Model fit was assessed using standard SEM indices. Results Among 1657 respondents (mean age 33 years, SD 11.77), Information Navigation was positively associated with awareness (?=0.162, p<0.001) and use (?=0.063, p=0.020) of GetCheckedOnline. Confidence in Use was positively associated with awareness (?=0.206, p=0.014) and use (?=0.115, p=0.020). In contrast, Resource Appraisal was negatively associated with awareness (?=?0.263, p=0.006) and use (?=?0.150, p=0.010). DHL factors mediated the effects of age, income, education and digital access on both outcomes. Conclusions DHL operates as a multidimensional and socially patterned determinant of access to digital STBBI testing services. While information navigation and confidence in use facilitate access, higher resource appraisal may reduce use, potentially reflecting concerns about service fit, privacy or trust. Findings highlight the need for digital interventions that are not only accessible but also contextually relevant, trusted and responsive to the needs of diverse users.
Determinants of equitable data governance for African, Caribbean, and Black communities in health research in high income countries: Protocol for a scoping review
(JMIR Research Protocols, 2026) Etowa, Josephine; Baidoobonso, Shamara; Kakuru, Doris; Dryden, OmiSoore; Oraka, Chinedu; Etowa, Egbe; Farrell, Peter; Mba, Sandra; Gebremeskel, Akalewold; Fantaye, Arone Wondwossen
Background: African, Caribbean, and Black (ACB) communities in high-income countries continue to experience persistent health inequities, driven by systemic anti-Black racism, socioeconomic disadvantage, and exclusion from health decision-making. Historically, data have been extracted from ACB communities without transparency, accountability, or community ownership. These inequitable practices have produced data systems that reinforce harm rather than promote equity. Equitable data governance, which promotes community ownership over data collection, access, and use, is increasingly recognized as a critical but underresearched determinant of health equity. Objective: This protocol outlines the methodology of a scoping review to identify and synthesize evidence on the determinants of equitable data governance in health research involving ACB communities in high-income countries. Methods: The review follows the 6-stage Arksey and O’Malley methodological framework, supplemented with updated guidance from the Joanna Briggs Institute. The searches were conducted in the Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, APA PsycInfo, and Scopus databases. Peer-reviewed articles are considered, with no limits placed on study design, publication type, or date. Multiple reviewers will independently extract data by using a standardized form. A 3-phase thematic mapping process, conceptually informed by critical race theory, intersectionality, and community-based participatory research principles, will be conducted to analyze the data, generate themes, and interpret findings. Results: The final comprehensive database searches were completed on December 17, 2024. The search strategy targeted literature on data management, governance, sharing, security, and ethical principles in relation to ACB populations in high-income countries. A total of 4365 records were screened at the title and abstract level, after deduplication, of which 247 studies were deemed potentially relevant and advanced to full-text screening. Following full-text screening and reference list searching a total of 15 articles were deemed eligible for analysis. The data extraction stage is scheduled to overlap and occur between November 2025 and February 2026. The thematic mapping and stakeholder consultations processes are scheduled between December 2025 and February 2026. The final review and manuscript submission are expected by March 2026, with dissemination activities planned for mid-2026. Conclusions: This review will synthesize existing information on key pillars, barriers, facilitators, promising data governance policies and practices, and recommendations relevant to ACB communities. The findings may inform the expansion of Ontario’s Engagement, Governance, Access, and Protection guidelines and support tailored research and national data governance frameworks. The review is expected to contribute to policy, research, and community-led data initiatives. Dissemination will occur through academic publications, conferences, and community-based knowledge-sharing events. As the review relies solely on publicly available data, ethics approval is not required.
Development and validation of a revised multidimensional digital health literacy scale: Secondary analysis using cross-sectional data from the 2022 GetCheckedOnline community survey in British Columbia, Canada.
(Journal of Medical Internet Research, 2025) Iyamu, Ihogosa; Gorun, Pierce; Chang, Hsiu-Ju; Sierra-Rosales, Rodrigo; Haag, Devon; Pedersen, Heather; Bartlett, Sofia; Lachowsky, Nathan; McKee, Geoffrey; Worthington, Catherine; Grennan, Troy; Donelle, Lorie; Grace, Daniel; Gilbert, Mark
Background: Digital technologies are reshaping health care, making digital health literacy (DHL) a critical competency for navigating online health information. Although widely conceived and measured as a unidimensional measure of DHL, the literature increasingly supports a multidimensional framing of the eHealth Literacy Scale (eHEALS). Studies propose alternative factor structures that can better inform population-level interventions, but these studies have not accounted for the ordinal nature of eHEALS response data. Objective: This study aimed to identify and validate an alternate multidimensional structure of eHEALS accounting for its ordinal response scale. Methods: Data were drawn from the 2022 GetCheckedOnline community survey of consenting English-speaking British Columbia residents aged ?16 years who reported sexual activity in the past 12 months. Participants were recruited through geo-targeted digital advertisements, community outreach, and in-person recruitment at public events, and community locations. DHL was measured using eHEALS, with responses collected on a 5-point Likert scale. Descriptive statistics summarized eHEALS responses using means, medians, and IQRs. Exploratory and confirmatory factor analyses were used to assess the scale’s structure using polychoric correlations and standard model fit indices. Reliability and validity were evaluated using polychoric ordinal alpha, average variance extracted, and composite reliability, with missing data addressed via multiple imputation. Results: Overall, 1657 participants met inclusion criteria with a mean age of 33.0 (SD 11.77, 95% CI 32.4-33.6) years. Among these 47.3% (95% CI 44.9%-49.7%) identified as women, 30.4% (95% CI 28.1%-32.6%) identified as racialized minorities, 80.5% (95% CI 78.5%–82.3%) reported easy internet access, and 32.2% (95% CI 30.0%-34.5%) had a bachelor’s degree or higher. Across eHEALS items, median scores were 4.0 (IQR 1.0-2.0) with excellent internal consistency (polychoric ordinal ?=.92). Exploratory factor analysis supported a 3-factor solution explaining 65.7% of the variance, demonstrated through confirmatory factor analysis (?²17=71.7, P<.001, root-mean-square error of approximation=0.059, standardized root-mean-square residual=0.026, comparative fit index=0.969, Tucker-Lewis Index=0.948). The final model included Information Navigation (standardized loadings=0.765-0.917), Resource Appraisal (0.825-0.892), and Confidence in Use (0.803 for both items), with composite reliability (0.784-0.900), and average variance extracted (0.503-0.738) supporting construct validity. Conclusions: This study confirms a multidimensional structure of eHEALS, identifying Information Navigation, Resource Appraisal, and Confidence in Use as key dimensions of DHL. This revised model enhances measurement precision, enabling more accurate identification of populations with limited DHL and informing the development of targeted, equity-oriented interventions. Future research should aim to confirm this multidimensional structure in more diverse populations and explore how distinct DHL domains influence access to digital health services in various contexts. Additionally, ongoing scale development must adapt to account for the role of emerging technologies, including artificial intelligence and social media algorithms in health care.
Diagnostic classification of fear of childbirth: Why specific phobia may not be enough
(Behavioural and Cognitive Psychotherapy, 2025) Fairbrother, Nichole; Keeney, Cora
Background: Fear of childbirth (FoB) is a common experience during pregnancy which can cause clinically significant distress and impairment. To date, a number of investigations of FoB have assumed that clinically significant FoB is best understood as a type of specific phobia. However, preliminary evidence suggests that specific phobia may not be the only diagnostic category under which clinically significant symptoms of FoB are best described. Aim: The current study is the first to investigate which DSM-5 diagnostic categories best describe clinically significant symptoms of FoB. Method: Pregnant people reporting high levels of FoB (n = 18) were administered diagnostic interviews related to their experience of FoB. Results: Participants (n = 18) were predominantly nulliparous (73.3%), cisgender women (83.3%). Of these, 14 (77.8%) met criteria for one or more DSM-5 anxiety-related disorders. Preliminary findings suggest that primary FoB may align with specific phobia criteria, whereas secondary FoB (following a traumatic birth) may be better classified under post-traumatic stress disorder (PTSD). FoB also featured in other anxiety-related disorders but was not the primary focus (e.g. obsessive-compulsive disorder). Four participants did not meet criteria for any DSM-5 disorder. Conclusions: Findings provide preliminary evidence that clinically significant FoB fits within existing DSM-5 categories, in particular specific phobia and PTSD. Although FoB-related concerns appears in other anxiety-related disorder categories, it does not appear as the primary focus. Although informative, due to the small sample employed in this research, replication in larger and more diverse samples is needed.
DMEM and EMEM are suitable surrogate media to mimic host environment and expand leptospiral pathogenesis studies using in vitro tools
(bioRxiv, 2025) Garcia, Leandro E.; Lin, Zitong; Culos, Sophie; Muenker, M Catherine; Johnson, Emily E.; Wang, Zheng; Lopez-Giraldez, Francesc; Giraud-Gatineau, Alexandre; Jackson, Angela; Picardeau, Mathieu; Goodlett, David R.; Townsend, Jeffrey P.; Pětrošová, Helena; Wunder, Elsio A., Jr.
Pathogenic Leptospira species can survive and thrive in a wide range of environments. Distinct environments expose the bacteria to different temperatures, osmolarities, and amounts and sources of nutrition. However, leptospires are mostly cultured, in a laboratory setting under in vitro conditions that do not reflect natural environments. This constraint on laboratory cultures limits the applicability of in vitro studies to the understanding of even simple pathogenic processes. Here we report, investigate, and identify a medium and conditions that mimic the host environment during leptospirosis infection, expanding the available in vitro tools to evaluate leptospiral pathogenesis. We quantified genome-wide gene expression of pathogenic Leptospira interrogans cultured in different in vitro media compositions (EMJH, DMEM, EMEM, and HAN). Using EMJH as standard, we compared gene expression in these compositions to genome-wide gene expression gathered in a host environment: whole blood (WB) of hamsters after infection with pathogenic leptospires. Leptospires cultured in DMEM and EMEM media shared 40% and 47% of all differentially expressed genes (DEGs) of leptospires present within WB (FDR<0.01), while leptospires cultured in HAN media only shared 20% of DEGs with those from WB. Furthermore, gene and pathway expression of leptospires cultured on DMEM and EMEM media exhibited a better correlation with leptospires grown in WB, including promoting expression of a similar leptospiral lipid A profile to the one identified directly in host tissues. Taken together, these results indicate that commercial cell-culture media EMEM or DMEM are better surrogates for in vivo pathogenic studies than EMJH or HAN media in Leptospira. These alternative culture conditions, using media that are a standard supply worldwide, provide a reproducible and cost-effective approach that can accelerate research investigation and reduce the number of animal infections necessary for basic research of leptospirosis.
Examining the influence of pre-HAART experiences on older, self-identifying gay men’s contemporary constructions of quality of life (QOL)
(Journal of Homosexuality, 2024) Handlovsky, Ingrid; Amato, Anthony T.; Ferlatte, Oliver; Kia, Hannah; Gagnon, Marilou; Worthington Catherine
Some older gay men (50+) experience diminished quality of life (QOL) due to historical and ongoing discrimination in addition to living through a collective trauma—the pre-HAART era of the HIV/AIDS epidemic—characterized by the absence of treatment and rampant discrimination targeting gay men. A growing body of literature, however, illustrates that older gay men demonstrate remarkable resilience but little is known about how QOL is conceptualized and how these conceptualizations are potentially shaped by pre-HAART experiences. The current study drew on constructivist grounded theory methods to examine how QOL is conceptualized in light of the sociohistorical relevance of pre-HAART. Twenty Canadian based gay men aged 50+ participated in semi-structured interviews via Zoom. Ultimately, QOL is understood as experiencing contentment, which is made possible by the development and implementation of three key processes: (1) developing and cultivating meaningful connections, (2) growing into and embracing identity, and (3) appreciating the capacity to do what brings joy. QOL for this group is greatly informed by a context of disadvantage, and the demonstrated resilience warrants further investigation to meaningfully support the overall well-being of older gay men.
Extreme weather events and refugee youths’ experiences of physical health in a Ugandan humanitarian setting: Qualitative insights
(International Journal of Qualitative Studies on Health and Well-being, 2025) Logie, Carmen H.; Leggett, Rachel; Sivan, Ofir; Mackenzie, Frannie; Okumu, Moses; Loutet, Miranda; Lukone, Simon Odong; Kisubi, Nelson; Gittings, Lesley; Otika, Lawrence; Lukwago, Moses; Dorea, Caetano; Hystad, Perry; Kyambadde, Peter
Refugee settlements globally experience increased exposure to extreme weather events (EWE) compared with host national settings; however, refugee youth climate-related health experiences in humanitarian settings are understudied. We explored the lived experiences of climate change and EWE related to physical health among refugee youth aged 16–24 in a Ugandan refugee settlement.
Glucose enrichment accelerates C. elegans reproductive aging via non-autonomous DAF-2/insulin-like receptor signaling in somatic tissues
(bioRxiv, 2025) Athar, Faria; Houston, Emma J.; Jewett, Emily; Templeman, Nicole M.
Detrimental effects of chronic high-sugar overconsumption can extend from molecular and cellular responses to systemic changes. Reproductive systems are particularly sensitive to diet and energetic state, yet the long-term reproductive consequences of overnutrition are poorly defined. Here, we used Caenorhabditis elegans to study the impacts of glucose excess on reproductive aging. Glucose supplementation shortens C. elegans lifespan, and we found that it also hastens age-related reproductive decline, evidenced by a greater deterioration in oocyte quality and lower fertility with age. We next evaluated insulin-like signaling contributions, as this glucose-responsive pathway is well known to regulate both somatic aging and reproductive aging. Intriguingly, while 20 mM glucose enrichment still shortens the lifespan of daf-2(e1370) mutants, we found that it had no detrimental impact on their reproductive aging phenotypes. Using auxin-induced tissue-selective degradation, we discovered that DAF-2/insulin-like receptor signaling in C. elegans intestine and body wall musculature is required for glucose enrichment to exert damaging impacts on the reproductive system. However, suppressing insulin-like signaling in either of these tissues is sufficient to protect C. elegans against glucose-induced reproductive aging. These findings suggest that insulin-like signalling in metabolically active somatic tissues may represent a key link between overnutrition and reproductive aging.
Healthy sleep durations appear to vary across cultures
(Proceedings of the National Academy of Sciences, 2025) Ou, Christine; Lou, Nigel Mantou; Maheshka, Charoul; Shi, Marc; Takemura, Kosuke; Cheung, Benjamin; Heine, Steven J.
Past research finds that sleep duration is reliably linked with health yet sleep durations differ substantially between countries. We investigated whether countries with shorter sleep durations have worse health. Study 1 analyzed national sleep durations from 14 past investigations (k = 353) and found that they were not associated with national health. Study 2 collected sleep duration and health data from people from 20 different countries (N = 4,933). Average sleep durations varied substantially between countries (range = 1.57 h). A quadratic relation between sleep duration and health was found in all countries, although the turning points varied between countries. Individuals whose sleep duration was closer to their country’s perceived ideal reported better health. The results suggest that the amount of sleep associated with optimal health varies across countries.
Identification of antibodies induced by immunization with the syphilis vaccine candidate Tp0751
(Vaccine, 2025) Urselli, Francesca; Gomez, Alloysius; Gray, Matthew D.; Cameron, Caroline E.; Taylor, Justin J.
The continued and increasing prevalence of syphilis worldwide highlights the need for an effective syphilis vaccine to complement public health measures. Previous work demonstrated that immunization of the rabbit animal model with vaccine candidates derived from the T. pallidum endothelial cell adhesin Tp0751 could reduce dissemination of T. pallidum to lymph nodes. In those studies, a proportion of animals exhibited complete inhibition of treponemal dissemination and others exhibited partial or no inhibition of treponemal dissemination, consistent with results expected from an outbred animal model. In the current study we further characterized the Tp0751-specific antibody response in immunized animals that showed inhibition of T. pallidum dissemination. To do this, we generated Tp0751 tetramers to identify Tp0751-specific B cells before and after immunization. Using this approach, we found a robust expansion of Tp0751-specific B cells in the blood and spleens of immunized animals compared to unimmunized control animals. Ten antibodies from Tp0751-immunized rabbits were cloned and binding to specific structural regions of the Tp0751 protein was assessed using epitope mapping assays and structural modeling. Importantly, nine out of the ten antibodies cloned from Tp0751 tetramer-binding B cells were able to significantly inhibit T. pallidum attachment to human endothelial cells in vitro, including antibodies exhibiting weaker binding to Tp0751. Combined, our results provide a proof-of-principle that Tp0751-based subunit vaccines can stimulate strong B cell responses resulting in the production of antibodies able to inhibit T. pallidum attachment to endothelial cells.
In-depth proteome coverage of in vitro-cultured Treponema pallidum and quantitative comparison analyses with in vivo-grown treponemes
(Journal of Proteome Research, 2024) Houston, Simon; Gomez, Alloysius; Geppert, Andrew; Goodyear, Mara C.; Cameron, Caroline E.
Previous mass spectrometry (MS)-based global proteomics studies have detected a combined total of 86% of all Treponema pallidum proteins under infection conditions (in vivo-grown T. pallidum). Recently, a method was developed for the long-term culture of T. pallidum under in vitro conditions (in vitro-cultured T. pallidum). Herein, we used our previously reported optimized MS-based proteomics approach to characterize the T. pallidum global protein expression profile under in vitro culture conditions. These analyses provided a proteome coverage of 94%, which extends the combined T. pallidum proteome coverage from the previously reported 86% to a new combined total of 95%. This study provides a more complete understanding of the protein repertoire of T. pallidum. Further, comparison of the in vitro-expressed proteome with the previously determined in vivo-expressed proteome identifies only a few proteomic changes between the two growth conditions, reinforcing the suitability of in vitro-cultured T. pallidum as an alternative to rabbit-based treponemal growth. The MS proteomics data have been deposited in the MassIVE repository with the data set identifier MSV000093603 (ProteomeXchange identifier PXD047625).
Insulin levels early in perimenopause inform vasomotor symptom incidence across the menopausal transition
(Journal of Clinical Endocrinology and Metabolism, 2026) Athar, Faria; Gregory, Sarah; Houston, Emma J.; Templeman, Nicole M.
Context Metabolic health affects the menopausal transition. Metabolic characteristics like body mass index (BMI) affect vasomotor syndrome incidence, but the role of elevated insulin, an early marker of metabolic dysfunction, remains understudied. Objective This work aimed to determine whether midlife insulin levels are associated with vasomotor symptom incidence or reproductive hormone trajectories. Methods Longitudinal analyses of community-based data from the Study of Women's Health Across the Nation (SWAN) were conducted. We analyzed the 704 SWAN participants (of 3302) without oophorectomy or hysterectomy who had metabolic data for age 47 and did not take insulin/medications for hyperglycemia. Mean fasting insulin at age 47 was 10.117?µIU/mL (SD = 6.711), with 27.0 BMI (SD = 6.6); the mean age of the final menstrual period for these participants was 51.0 years (SD = 2.3). Main outcome measures included vasomotor symptom timings and durations, and trajectories of estradiol (E2), follicle-stimulating hormone (FSH), and testosterone (T) across the menopausal transition. Results Higher insulin at age 47 predicted younger onsets of hot flashes and night sweats, longer durations of hot flashes and cold sweats, and greater T rise. BMI associations with vasomotor symptoms paralleled those of insulin, but BMI appeared more closely linked to slower E2 decline and blunted FSH rise. In Cox proportional hazards models, elevated age-47 insulin was associated with increased likelihood of hot flashes; this remained statistically significant with BMI and glucose as covariates. Conclusion Perimenopausal fasting insulin and BMI show complementary but distinct associations with menopausal changes. Elevated insulin predicts earlier and prolonged vasomotor symptoms, and is associated with higher T.
Missed opportunities to provide sexually transmitted and blood-borne infections testing in British Columbia: An interpretive description of users’ experiences of Get Checked Online's design and implementation
(Digital Health, 2024) Iyamu, Ihoghosa; Kassam, Rosemin; Worthington, Catherine; Grace, Daniel; Pedersen, Heather; Haag, Devon; Bondyra, Mark; Salmon, Amy; Koehoorn, Mieke; Gilbert, Mark
Background Digital testing services for sexually transmitted and blood-borne infections (STBBIs), such as GetCheckedOnline, experience significant user drop-offs. For example, 32% of GetCheckedOnline users needing testing at account creation do not test, constituting missed opportunities. We explored the influence of users’ expectations and experiences of GetCheckedOnline's web design and implementation on missed opportunities. Methods This interpretive description purposively sampled 14 GetCheckedOnline users who created accounts between April 2022 and February 2023, indicated needed testing at account creation but did not test. We conducted semi-structured interviews and cognitive walkthroughs of GetCheckedOnline on Zoom, exploring participants’ expectations and experiences, including problems using the service. Interviews were audio recorded, transcribed verbatim, and analyzed using reflexive thematic analyses. Results Three themes were identified: (a) transitioning between GetCheckedOnline and laboratory services is a major testing barrier; (b) users’ appraisal of their health and social contexts is a determinant of testing through GetCheckedOnline; and (c) tailoring GetCheckedOnline's design and implementation to accommodate varying user needs can promote equitable testing. Health equity issues occurred along sociodemographic gradients as the GetCheckedOnline-laboratory transition was more onerous for older users. Users’ appraisal of their testing needs which varied by age and gender, and their assessment of time, and travel requirements for testing in remote communities influenced testing. Learning about GetCheckedOnline from healthcare providers improved testing compared with learning about the service through Google search which raised trust concerns regarding GetCheckedOnline's authenticity. Suggested improvements to promote health equity include personalized education, mail-in testing options, and simpler seamless web experiences. Conclusions To promote equitable access to digital STBBI testing services such as GetCheckedOnline, we can adapt web-design and implementation to suit user needs and contexts, ensuring simplicity and options for testing that reduce user burdens.
Models and key elements of integrated perinatal mental health care: A scoping review
(PLOS Mental Health, 2025) Carter, Michelle; Russolillo, Angela; Ou, Christine; Zusman, Enav Z.; Hall, Wendy A.; Cheung, Iva W.; Jenkins, Emily
Perinatal mental illness is a common and significant complication of pregnancy and childbirth. When left untreated, these illnesses are associated with an increased risk of adverse health outcomes for mothers, infants, and families. While early detection and effective management are essential, less than 15% of affected individuals receive timely and appropriate treatment. Integrated care offers a promising approach to addressing complex treatment barriers; however, the core features of integrated perinatal mental health (PMH) care are not well understood. We conducted a scoping review to identify and synthesize evidence on existing models and key elements of integrated PMH, with data extracted according to PRISMA guidelines. The search was conducted across four databases: Ovid MEDLINE, EMBASE, PsycInfo, and CINAHL. We included peer-reviewed articles, published in English between 1990 and 2024, that described models of integrated PMH care. Three reviewers independently screened 4588 articles by title and abstract, with 153 articles selected for full-text review. A total of 45 peer-reviewed articles were retained for analysis. These articles described a wide range of integrated PMH care models, including specialized inpatient units, intensive hospital day programs, outpatient and community clinics, and collaborative and stepped-care frameworks. An analysis of these models identified seven key elements of integrated care: (1) screening, assessment, and triage; (2) integrated care delivery; (3) patient-centred care; (4) a biopsychosocial approach to treatment; (5) PMH-trained clinicians; (6) health promotion and illness prevention; and (7) transition and discharge planning. This evidence suggests that care integration improves the accessibility, continuity, and quality of PMH care. Integrated models of care can take many forms with positive impacts on perinatal individuals and their families. Research is needed to establish consensus on the key elements of integrated care to support implementation.
Motherhood in adolescence: Voices from the margins
(Centering Marginal Voices Project, University of Victoria, 2024) Kakuru, Doris; Kamusiime, Annah; Kyomuhendo, Grace Bantebya; Mucina, Mandeep Kaur; Nassimbwa, Jacqueline; Nabirye, Jackline; Tumuheise, Phiona; Iganga Youth; Kawempe Youth
This is report presents the results of a survey on the experiences of young mothers in Iganga (rural) and Kawempe (urban low-income locale) in Uganda. The project was implemented between April 2021 and November 2024.

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