Monthly Archives: February 2018

Folic acid awareness and pregnancy

Why you need to take folic acid

Folic acid is vital to the normal growth of your baby’s spine, brain and skull. Taking a daily vitamin supplement that has folic acid can reduce the risk of your baby having a neural tube defect.

The benefits of taking folic acid to reduce the risk of NTDs are highest in the very early weeks of pregnancy. At this stage, most women do not know they are pregnant. For this reason, taking folic acid before you become pregnant and in the early weeks of pregnancy is very important.

It’s never too early to ask your health care provider about folic acid.

About neural tube defects

The neural tube is the part of the developing baby that becomes the brain and spinal cord. NTDs occur when the neural tube does not fully close during the early weeks of pregnancy.

This results in spine, brain and skull defects that can lead to stillbirth or lifelong disability. Spina bifida (when the spine does not close) and anencephaly (when part of the brain and skull are missing) are the most common NTDs.

Proper folic acid dosage

All women who could become pregnant need to take a multivitamin with 0.4 mg of folic acid in it every day. Even if you are not planning to become pregnant, you need to take folic acid because many pregnancies are unplanned.

If you are planning to become pregnant, take the supplement for at least three months before pregnancy.

If you are already pregnant and not taking folic acid, start taking it as soon as possible. During your pregnancy, keep taking your daily folic acid supplement.

Why you may need a higher dose

Some women may need a higher dose of folic acid. This can include women with:

  • a previous pregnancy affected with NTD
  • a family history of other folic acid-related birth defects
  • a family history  of NTD (or a male partner with a family history of NTD)

Women with certain medical conditions and on certain drugs may also need a higher dose of folic acid. These conditions and drugs may include:

  • celiac disease
  • kidney dialysis
  • alcohol overuse
  • advanced liver disease
  • gastric bypass surgery
  • inflammatory bowel disease
  • pre-pregnancy diabetes (type 1 or 2)
  • antiepileptic or other folate inhibiting drugs

Talk to your health care provider to see if you require a higher dose of folic acid.

Dosage limits for folic acid

Do not take more than one daily dose of your supplement as described on the product label. You should not increase your dose of folic acid beyond 1 mg per day without a health care provider’s advice.

Benefits of a healthy diet

Taking a vitamin supplement does not reduce or replace the need for a healthy, well-balanced diet. Some great sources of folate include:

  • corn
  • beans and lentils
  • dark green vegetables
    • peas
    • spinach
    • broccoli
    • Brussels sprouts
  • oranges

Foods fortified with folic acid are also great sources of folate. These foods include:

  • white flour
  • ready-to-eat cereals
  • enriched pasta and cornmeal

However, dietary sources on their own are not enough to reach the required folate level to protect against NTDs. You still need to take a multivitamin with folic acid.

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For more information


What does good health care look like? A positive health care experience can look like many things to different people. It’s not about perfect scripts, it’s about increasing capacity to provide affirming care for diverse people and communities. Although Canada’s health care system is universal, not everyone has equal access to the care they need and deserve, which results in health disparities. When it comes to mental health and sexual health, individuals may feel hesitant to access health care due to concerns around or previous experiences of stigma and discrimination.

This handbook includes scenarios, discussion prompts, and tips for health care professionals to provide comprehensive and affirming care related to mental and sexual health and all the ways they intersect.

This handbook was produced as part of Sexual and Reproductive Health Awareness Week. An annual campaign hosted by Action Canada for Sexual Health and Rights to promote sexual and reproductive health in Canada. For more information visit


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Resource: Healthcare providers and their role in understanding stigma


OTTAWAFeb. 14, 2018 /CNW/ – While we know that people with mental illness and addiction often face stigma in Canadian society, we may be surprised to learn that they face it within healthcare environments as well. Today, the Mental Health Commission of Canada (MHCC) and the Centre for Addiction and Mental Health (CAMH) launched a free online course called Understanding Stigma, designed to help healthcare providers and frontline clinicians develop strategies to improve care for people with mental health and addiction problems.

This self-directed course is available in both official languages and consists of three modules that focus on raising awareness, the impacts of stigma, and challenging stigma and discrimination.

The Understanding Stigma online course is being hosted on CAMH’s website, making it easily accessible to healthcare providers and frontline clinicians Canada-wide. We invite all members from the healthcare sector to complete this free online course, designed to complement their strategies in understanding stigma.


“As a registered psychiatric nurse, if told my interaction with a person with mental health and addiction problems caused them to feel devalued or dismissed, it would feel like a punch in the gut. I recognize that everyone in the system is working at capacity to provide the best possible patient care. To show our support, the Understanding Stigma online course was designed for healthcare providers who wish to develop strategies to better understand and care for people with mental health and addiction problems.”
—Ed Mantler, Vice President, Programs and Priorities, Mental Health Commission of Canada

“CAMH is committed to improving the quality of care and driving mental health advocacy through education. We are delighted to partner with the Mental Health Commission of Canada to adapt and host their successful classroom course as a free, online course—making it even more accessible to professionals across the country. We are making progress on reducing the stigma of mental illness. As healthcare providers, we must continue to challenge our own attitudes and co-create strategies with our patients to address stigma. Together we can make a difference.”
—Dr. Ivan Silver, Vice President, Education, Centre for Addiction and Mental Health

Quick Facts

  • The stigmatization of people living with mental health and addiction problems is all too common in Canada, including within healthcare environments. People with lived experiences of mental health and addiction problems often report feeling devalued, dismissed and dehumanized by many of the healthcare professionals with whom they come into contact.
  • The MHCC and CAMH partnered to develop a web platform to help market and promote efforts to enlist healthcare provider participation.
  • The MHCC will facilitate the evaluation of the online course, as it has done for other healthcare provider programs in the past.
  • Research with healthcare providers suggests that stigma can manifest in subtle and largely unintended ways (Knaak & Patten).
  • The course provides scenarios, interactive questions, personal stories and quizzes intended to help change the attitudes and behaviours of healthcare providers toward people seeking help.

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Associated Links

Alberta Family Wellness Initiative: Research Update


Early Adversity, Toxic Stress, and Resilience: Pediatrics for Today.

Dowd, M. D.

Pediatric Annals46(7), e246–9.

Never before in the history of science have we had better insight into the factors that determine the health and well-being of a person from infancy to adulthood. An expanding body of knowledge is converging from numerous disciplines including neuroscience, education, behavioral science, public health, the social sciences, and medicine. Awareness of the impact of early childhood adversity and toxic stress is growing rapidly among both professionals and the lay public. This calls for a reevaluation of how and what we, as child health care providers, should deliver to maximize our impact on individual health and well-being across the lifespan. This article briefly summarizes the topic and gives examples of how child health care providers are innovatively incorporating the latest science in practice.

Implementation of an Evidence-Based Parenting Program in a Community Mental Health Setting.

Roosa Ordway, M. et al.

Infant Mental Health Journal39(1), 92–105.

The process of mental health intervention implementation with vulnerable populations is not well-described in the literature. The authors worked as a community-partnered team to adapt and pilot an empirically supported intervention program for mothers of infants and toddlers in an outpatient mental health clinic that primarily serves a low-income community. We used qualitative ethnographic methods to document the adaption of an evidence-based intervention, Mothering from the Inside Out, and the pilot implementation in a community mental health clinic.

Mobile Technology-Based Interventions for Adult Users of Alcohol: A Systematic Review of the Literature

Fowler, L. A. et al.

Addictive Behaviors62, 25–34.

Worldwide, 16% of people aged 15 and older engage in harmful use of alcohol. Harmful alcohol use leads to a host of preventable negative social and health consequences. Mobile technology-based interventions provide a particularly promising avenue for the widespread and cost-effective delivery of treatment that is accessible, affordable, individualized, and destigmatized to both alcohol-dependent and nondependent individuals.

Toward a Targeted Treatment for Addiction

Creed, M. C.

Science 357(6350), 464–5.

A major challenge in treating many neuropsychiatric disorders is that diagnoses are regularly based on behavior rather than on biomarkers, as well as the fact that such conditions are often not associated with gross structural brain changes. Addiction is one example of a disorder defined by pathological behavior (drug seeking despite harmful consequences) in which there is no significant loss of neurons and for which there is no cure.

Bucknell study suggests new genetic risks for alcoholism in women


LEWISBURG — Gender and the biology of the brain may make some women more likely to reach for a drink when they feel stressed out, and more likely to become dependent on alcohol.

This finding, the outcome of three-year neuroscience study by Bucknell Professor Judith Grisel, psychology, could improve the screening and diagnosis of alcoholism and other addictions. It also adds to the mounting body of evidence about fundamental differences between the brains of men and women — differences that Grisel notes were ignored for decades, leaving a deep gender gap in medical research that persists today.

Funded by the National Institute of Alcoholism and Alcohol Abuse and published in the journal Addiction Biology, the study examined how men’s and women’s brains respond to alcohol depending upon a specific neurotransmitter called beta-endorphin. While the study used mice bred to produce different amounts of the chemical, beta-endorphin is also found in varying amounts in humans, and is a key tool our bodies use to help manage stress. The study was co-authored by Bucknell master’s graduates Todd Nentwig M’17 and Diane Wilson M’14, as well as biology professor Erin Rhinehart of Susquehanna University.

The Binge-drinking Chemical

Grisel and her collaborators found that while male mice with lower levels of beta-endorphin were less likely to binge drink, females with low beta-endorphin levels binged harder and faster, and more quickly escalated to addictive behavior, choosing to continue drinking even when food and water were also available. “We believe the reason is that the low-endorphin females are naturally more stressed, and binge drinking fixes their hyper-stressed state,” Grisel said.

In humans, this association could prove useful in evaluating genetic risk factors for alcoholism in women, as using alcohol to deal with a problem like stress — to self-medicate — is one popularly accepted marker of addiction. “When you’re medicating something with alcohol, it’s likely to cause problems much more quickly than using it for purely social reasons,” Grisel explained, adding that her study backs up a correlation that physicians have previously noted.

“There are clinical findings in humans showing that children of alcoholics have a deficit of beta-endorphin compared to average — before they ever take their first drink of alcohol,” Grisel said.

A Personal mission

The study is the latest step in answering the fundamental question Grisel has made her life’s work. “I’m interested in what’s different about the brains of people who go on to become drug addicts, before they ever get a drug,” Grisel said.

It’s a deeply personal question for the neuroscientist, whose own career was nearly derailed by addiction before it had even begun.

Grisel struggled with alcohol and drug addiction while in college, and had dropped out and become homeless before entering recovery in her early 20s. Spurred at first by a desire to cure her addiction — a motivation she calls arrogant in hindsight — she would go on to finish college and earn her doctorate, concentrating her studies on the neuroscience of addiction. She interweaves stories from this experience with insights from her career as a scientist in her upcoming book, Never Enough: The Experience and Neuroscience Of Addiction. The mass market, popular science book, slated for publication next year by Doubleday, aims to help readers understand both the science and experience of addiction.

“After 30 years of studying addiction, I don’t have the solution, but I hope to shed light on what the problem is,” Grisel said, “why so many people are addicted, what causes it, and how society might help in ways that it doesn’t right now.”

 Remedying medicine’s gender gap

Grisel’s latest findings also work toward a personal goal to which she has devoted some two decades or work: correcting the longstanding gender gap in biomedical science. “For a long time, we just ignored sex differences. Males were the default in science,” Grisel said. “Until this century, virtually all biomedical research done used only males.”

Not taking sex differences into account can have harmful unintended effects, Grisel noted, citing a study she did for a pharmaceutical company to evaluate a new painkiller it had in development, about 15 years ago. Grisel’s study, which used mice, produced seemingly random results that she couldn’t explain or replicate — until she decided to look at how the drug affected males and females differently. The inconsistent data suddenly took on a clear shape: two lines diverging toward the poles of “less pain” and “more pain.” While the drug proved effective in males, it actually intensified the pain felt by females.

“Scientists, including those in the pharmaceutical industry, are beginning to appreciate that all brains are not the same,” Grisel said. “We’ve got a lot of studies now, by me and lots of other people, showing that the neurobiology and neurogenetics of males and females are often different in important ways. We hope that paying more attention to factors like sex will help us to better understand complex disorders, and eventually, alleviate human suffering.”

Retrieved from

Ready or Not: Mental Health and Stress


Everyone feels worried, sad or stressed at times. Very high levels of stress can affect your ability to conceive a baby. Developing babies exposed to high levels of stress may develop problems later in life. If you’re concerned about your worrying, sadness or stress speak with your health care provider. There are many things you can do that can help.

Stress is the emotional, mental and physical strain that happens when something changes in the world around you.

It could be a new job, moving, loss of a family member or friend or a change in finances.

Some stress is positive. It challenges you to try something new or learn how to do something you haven’t done before.

However, high levels of stress or stress that lasts a long time can have negative health effects.

Learn more about stress here.

High levels of stress can change your hormones. Hormones are chemicals that travel throughout the body and help control how your cells work.

Stress can affect your body’s ability to release an egg (ovulate). Since stress may delay releasing an egg, the days in your cycle that you’re able to become pregnant (fertility window) will change.

If you’re feeling stressed, you may also be less interested in sex.

Stress can also affect your testosterone levels. This can affect your sperm and sexual function.

Stress can have physical, emotional and mental effects. High levels of stress or constant stress is called toxic stress. If your level of stress is very high and constant, your body is making stress hormones almost all the time. This affects how your brain works and can lead to problems with your mental and physical health.

Developing babies exposed to high levels of stress hormones through their mother’s placenta are at higher risk of developing learning disabilities, attention disorders, and behavioural or emotional problems.

Some signs that your stress level is high include:

  • feeling irritable or easily frustrated
  • arguing more with your partner, friends or family
  • using more tobacco, alcohol or drugs to cope

Long-term stress can increase your risk for:

  • diabetes
  • heart disease
  • depression
  • high blood pressure

Some ways to cope with stress include:

  • eat regular meals
  • eat a healthy diet and drink enough water
  • take time every day to relax, rest and get enough sleep
  • exercise regularly
  • reach out to family or friends
  • talk to people in your social network

For more information please visit:

Fetal Alcohol Spectrum Disorder Webcast

learningseriesbannerRegister now for the February 21, 2018, Fetal Alcohol Spectrum Disorder (FASD) Webcast

Join us for this free webcast entitled: Supporting Employment Success in Adults with FASD.

Securing and maintaining employment for persons with FASD can be challenging.  In this webinar, our presenters will discuss what employment success looks like for persons with FASD, which includes:

  • Sharing findings, including survey responses and video footage, from the CanFASD study “Supporting Employment Success in Adults with FASD”
  • Presenting the preliminary evaluation tool guide for guiding employment professionals in their work with adults with FASD
  • Explaining the prompts for evaluating a client’s well-being and factors for preparing for, obtaining and maintaining employment

This webinar will be of interest to persons directly affected by FASD, employers and anyone else supporting persons with FASD.

Date: Wednesday, February 21, 2018
Time: 9:00 a.m. – 10:00 a.m. MST
Speakers: Dr. Marnie Makela and Aamena Kapasi

Register Here
Format: Presenters with PowerPoint Presentation
Cost: FREE! Please share with your networks
Q&A: You can pose questions to the speakers through the live chat functionality. Remember, the live webcasts are interactive and we encourage you to participate in the question and answer portions by typing questions for speakers in the chat window, which is located below the main video panel on the webcast page.

Dr. Marnie Makela is a registered psychologist in Edmonton and researcher with the Canada FASD Research Network. She focuses her clinical and research work on children, youth and young adults who are presenting with learning, behavioural and mental health concerns related to FASD and other developmental disabilities. She also provides consultation for families of children with complex disabilities, such as FASD, who require a combination of individual therapy for their child and assistance with supports at home, school and other environments.

Aamena Kapasi is a PhD student at the University of Alberta in the School and Clinical Child Psychology program. Aamena has a passion for working with children and youth, and her research interests include supports and interventions for individuals with FASD.

Previous webcasts are available on the CSS Learning Series Website.

The FASD Learning Series helps individuals, caregivers, front-line workers and professionals learn more about FASD, and how to support persons with FASD. The educational sessions cover a broad range of topics and are accessible to all Albertans.

Alberta’s FASD 10-Year Strategic Plan outlines the government’s commitment to provide awareness and prevention of FASD, as well as assessment, diagnosis, and support for individuals with FASD and their caregivers. All services and activities are built on a foundation of stakeholder engagement.

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