Canadian Armed Forces Veterans’ Perspectives on the Effects of Exposure to Children in Armed Conflict During Military Service: Protocol for a Qualitative Study

Background: The mental health of military personnel has garnered increased attention over the last few decades; however, the impacts of perpetuating, observing, or failing to prevent acts that transgress deeply held moral standards, referred to as moral injuries, are less understood, particularly in relation to encounters with children during deployment. This paper describes a multiphased research protocol that centers around the lived experiences of Canadian Armed Forces (CAF) Veterans to understand how encounters with children during military deployments impact the well-being and mental health of military personnel. Objective: This study has four objectives: (1) highlight the lived experiences of CAF Veterans who encountered children during military deployments; (2) improve understanding of the nature of experiences that military personnel faced that related to observing or engaging with children during military service; (3) improve understanding of the mental health impacts of encountering children during military service; and (4) use participatory action research (PAR) to develop recommendations for improving preparation, training, and support for military personnel deployed to contexts where encounters with children are likely. Methods: The research project has 2 main phases where phase 1 includes qualitative interviews with CAF Veterans who encountered children during military deployments and phase 2 uses PAR to actively engage Canadian Veterans with lived experiences of encountering children during military deployments, as well as health professionals and researchers to identify recommendations to better address the mental health effects of these encounters. Results: As of January 26, 2024, a total of 55 participants and research partners have participated in the 2 phases of the research project. A total of 16 CAF Veterans participated in phase 1 (qualitative interviews), and 39 CAF Veterans, health professionals, and researchers participated in phase 2 (PAR). The results for phase 1 have been finalized and are accepted for publication. Data collection and analysis are ongoing for phase 2. Conclusions: Prioritizing and valuing the experiences of CAF Veterans has deepened our understanding of the intricate nature and impacts of potentially morally injurious events involving children during military deployments. Together with health professionals and researchers, the PAR approach empowers CAF Veterans to articulate important recommendations for developing and improving training and mental health support. This support is crucial not only during the deployment cycle but also throughout the military career, helping lessen the effects of moral injury among military personnel

DeepTMH: Multimodal Semi-supervised framework leveraging Affective and Cognitive engagement for Telemental Health

To aid existing telemental health services, we propose DeepTMH, a novel framework that models telemental health session videos by extracting latent vectors corresponding to Affective and Cognitive features frequently used in psychology literature. Our approach leverages advances in semi-supervised learning to tackle the data scarcity in the telemental health session video domain and consists of a multimodal semi-supervised GAN to detect important mental health indicators during telemental health sessions. We demonstrate the usefulness of our framework and contrast against existing works in two tasks: Engagement regression and Valence-Arousal regression, both of which are important to psychologists during a telemental health session. Our framework reports 40% improvement in RMSE over SOTA method in Engagement Regression and 50% improvement in RMSE over SOTA method in Valence-Arousal Regression. To tackle the scarcity of publicly available datasets in telemental health space, we release a new dataset, MEDICA, for mental health patient engagement detection. Our dataset, MEDICA consists of 1299 videos, each 3 seconds long. To the best of our knowledge, our approach is the first method to model telemental health session data based on psychology-driven Affective and Cognitive features, which also accounts for data sparsity by leveraging a semi-supervised setup

Do the Tracks Track? Evaluating the Effectiveness of Baited Ink-plates for Rat Monitoring in a Montane Rainforest

Since human arrival to the Hawaiian Islands, non-native predators have decimated native flora and fauna. In particular, native forest bird populations have suffered due to rat (Rattus sp.) depredation. To protect native species, conservation practitioners have been removing rats and other rodents from ecologically sensitive areas. Identifying reliable strategies for assessing the effectiveness of these control efforts is critical, particularly given limited resources for conservation. A common method used for monitoring rodents is baited ink-plates within a tunnel (hereafter ink-plates). While this method is widely used, its effectiveness has yet to be evaluated in many ecosystems, including montane rainforests. To evaluate the effectiveness of monitoring rat presence with ink-plates, we focused on the Alakai Plateau on the island of Kauai, which is home to several of Hawaii’s most critically endangered birds, and where over 300 Goodnature™A24 rat traps are currently in operation. The Alakai experiences approximately 11 m of annual precipitation, giving rise to areas of dense vegetation, which may affect how rats encounter and interact with ink-plates. We paired 116 Reconyx™ HyperFire cameras with individual ink-plates inside tracking tunnels in the summers of 2022 and 2023, at a site with an ungulate exclusion fence and at a site with no fencing, to monitor areas both with and without rat traps. Rats were detected on approximately twice as many cameras (34.5% presence) compared to ink-plates (16.4% presence). These results suggest that cameras could be a powerful tool for accurately assessing the efficacy of conservation interventions to mitigate the impact of invasive predators on Hawaii’s native birds. Increased investments in camera technologies are worth consideration, particularly in the case of critically endangered species. Further research into the cost-effectiveness versus the information gained by the two methods could help further refine conservation strategies

The nature and impacts of deployment-related encounters with children among Canadian military Veterans: a qualitative analysis

Background: As armed conflict grows increasingly complex, the involvement of children in armed violence across diverse roles is rising. Consequently, military personnel are more likely to encounter children during deployment. However, little is known about deploymentrelated encounters with children and their impact on the mental health of military personnel and Veterans. Objective: This study qualitatively examines the nature and impacts of deployment-related encounters with children. Methods: We conducted semi-structured interviews with 16 Canadian Armed Forces Veterans, eliciting rich information on the nature of child encounters on deployment, the psycho-socialspiritual impacts of these encounters, and perceptions of support. Interview transcripts were analysed using thematic analysis. Results: Six primary themes were identified: types of encounters (i.e. factual aspects of deployment-related encounters with children), contextual factors (i.e. aspects of the mission, environment, and personal context relevant to one’s experience of the encounter), appraisals of encounters (i.e. sensory or sense-making experiences relevant to the encounter), impacts of encounters (i.e. psycho-social, existential, and occupational impacts), coping strategies engaged in both during and after deployment, and support experiences, describing both formal and informal sources of support. Conclusions: Encounters with children are diverse and highly stressful, resulting in impacts pertinent to mental health, including psychological and moral distress, and difficulties with identity, spirituality, and relationships. These impacts are prompted by complex interactions among appraisals, expectations of morality, cultural norms, and professional duties and are amplified by various personal factors (e.g. childhood maltreatment history, parenthood), feelings of unpreparedness, and lack of post-deployment support. Implications for prevention, intervention, and policy are discussed with the aim of informing future efforts to safeguard and support military personnel facing a high likelihood of encounters with children

Toward interprofessional learning and education:Mapping common outcomes for prequalifying healthcare professional programs in the United Kingdom

Introduction: Interprofessional education (IPE) continues to be a key component in prequalifying health professional education, with calls for regulators to publish a joint statement regarding IPE outcomes. To date, the regulatory documents for healthcare education in the United Kingdom have not been examined for common learning outcomes; information that could be used to inform such a statement and to identify opportunities for interprofessional learning. Methods: A mapping of the outcomes/standards required by five, UK, health profession regulatory bodies was undertaken. This involved the identification of common outcomes, a keyword search and classification of common outcomes/standards; presented as themes and subthemes. Results: Seven themes were identified: knowledge for practice, skills for practice, ethical approach, professionalism, continuing professional development (CPD), patient-centered approach and teamworking skills, representing 22 subthemes. Each subtheme links back to the outcomes/standards in the regulatory documents. Conclusions: This study identifies the key areas of overlap in outcomes/standards expected of selected healthcare graduates in the United Kingdom. The mapping provides a framework for informing prequalifying IPE curricula, for example, identifying possible foci for interprofessional education outcomes and associated learning opportunities. It allows reference back to the standards set by regulatory bodies, a requirement for all institutions involved in health profession education

The potentially morally injurious nature of encountering children during military deployments: A call for research

Armed forces personnel are a population at risk for exposure to potentially traumatic and morally injurious events because of the high-risk nature of military operations. One potentially morally injurious event (PMIE) could be when military personnel encounter children during deployment. These encounters may lead to acute and chronic psychological, behavioural, and social consequences, culminating in moral injury and other adverse mental health problems. According to anecdotal evidence, military personnel reported feeling torn, morally and ethically, in their decisionmaking when they encounter children in the line of duty. The decision to engage or kill a child may be difficult to reconcile with one’s moral and ethical code, and decisions may have deadly consequences for oneself and others. To date, however, no reliable data exist as to the impact that encountering children during deployment may have on psychosocial and spiritual well-being. In this article, additional research into this domain is encouraged by providing a rationale for studying encounters with children during deployment through the lens of a PMIE, as well as r

Adult cancer risk in women who were breastfed as infants: large UK prospective study.

There are known short-term benefits in breastfed infants versus bottle-fed infants in terms of lower risks of infection and obesity in infancy and childhood, but the long-term effect on the risk of adult cancers is unclear. In a cohort of 1 in 4 UK women born in 1935-1950 we report the incidence of adult cancers in relation to having been breastfed in infancy. In median year 2001 (interquartile range 2000-2003) 548,741 women without prior cancer reported whether they had been breastfed. There was 81% agreement between women's report of having been breastfed and information on breastfeeding recorded when they were 2 years old. Participants were followed by record-linkage to national cancer registration, hospital admission and death databases. Cox regression yielded adjusted relative risks (RRs) and 95% confidence intervals (CI) by having been breastfed or not for eight cancer sites with > 2000 incident cases and for related conditions, where appropriate. Of the eight cancers examined here one association was highly statistically significant: an increase in colorectal cancer incidence among women who had been breastfed versus not (RR 1.18, 95% CI 1.12-1.24, n = 8651). To investigate further the findings for colorectal cancer, we studied eight other gastro-intestinal conditions, and found increased risks in women who had been breastfed versus not for benign colorectal polyps (RR 1.09, 95% CI 1.05-1.13, n = 17,677) and for appendicitis (RR 1.19, 95% CI 1.07-1.31, n = 2108). The greater risks of adult colorectal cancer, colorectal polyps and appendicitis associated with having been breastfed in infancy suggest possible long-term effects of infant feeding practices on the gastrointestinal tract. Further studies are required to clarify this novel association

Exploring the Feasibility of Service Integration in a Low-Income Setting: A Mixed Methods Investigation into Different Models of Reproductive Health and HIV Care in Swaziland.

Integrating reproductive health (RH) with HIV care is a policy priority in high HIV prevalence settings, despite doubts surrounding its feasibility and varying evidence of effects on health outcomes. The process and outcomes of integrated RH-HIV care were investigated in Swaziland, through a comparative case study of four service models, ranging from fully integrated to fully stand-alone HIV services, selected purposively within one town. A client exit survey (n=602) measured integrated care received and unmet family planning (FP) needs. Descriptive statistics were used to assess the degree of integration per clinic and client demand for services. Logistic regression modelling was used to test the hypothesis that clients at more integrated sites had lower unmet FP needs than clients in a stand-alone site. Qualitative methods included in-depth interviews with clients and providers to explore contextual factors influencing the feasibility of integrated RH-HIV care delivery; data were analysed thematically, combining deductive and inductive approaches. Results demonstrated that clinic models were not as integrated in practice as had been claimed. Fragmentation of HIV care was common. Services accessed per provider were no higher at the more integrated clinics compared to stand-alone models (p>0.05), despite reported demand. While women at more integrated sites received more FP and pregnancy counselling than stand-alone models, they received condoms (a method of choice) less often, and there was no statistical evidence of difference in unmet FP needs by model of care. Multiple contextual factors influenced integration practices, including provider de-skilling within sub-specialist roles; norms of task-oriented routinised HIV care; perceptions of heavy client loads; imbalanced client-provider interactions hindering articulation of RH needs; and provider motivation challenges. Thus, despite institutional support, factors related to the social context of care inhibited provision of fully integrated RH-HIV services in these clinics. Programmes should move beyond simplistic training and equipment provision if integrated care interventions are to be sustained

Girls Are Good At STEM: Opening Minds And Providing Evidence Reduce Boys\u27 Stereotyping Of Girls\u27 STEM Ability

Girls and women face persistent negative stereotyping within STEM (science, technology, engineering, mathematics). This field intervention was designed to improve boys\u27 perceptions of girls\u27 STEM ability. Boys (N = 667; mostly White and East Asian) aged 9-15 years in Canadian STEM summer camps (2017-2019) had an intervention or control conversation with trained camp staff. The intervention was a multi-stage persuasive appeal: a values affirmation, an illustration of girls\u27 ability in STEM, a personalized anecdote, and reflection. Control participants discussed general camp experiences. Boys who received the intervention (vs. control) had more positive perceptions of girls\u27 STEM ability, d = 0.23, an effect stronger among younger boys. These findings highlight the importance of engaging elementary-school-aged boys to make STEM climates more inclusive

Junior-elite football: time to re-position talent identification?

There remains limited understanding of the processes and factors which contribute to young footballers being identified as talented. Talent identification is imperative for the development of future elite performers, though most studies conflate talent identification and talent development. Moreover, within the literature there is a lack of operational or procedural distinction for talent identification, causing issues for those researching and working within applied contexts. This paper sought to clarify issues related to talent identification in junior-elite football, offering a review of the extant literature and proposing future directions for applied research. There are unanswered questions associated with how scouts, recruitment staff, and coaches decide what constitutes talent and the importance placed on particular attributes during that process. We suggest that further research into the ascribed processes, observations and perceptions of those involved in talent identification is needed to provide more sound understanding of the talent identification process in football