Advance and Retreat of Cordilleran Ice Sheets in Washington, U.S.A.

Cordilleran Ice Sheet glaciations show characteristic patterns of advance and retreat, consisting of (1) advance out outwash, (2) glacial scouring, (3) deposition of till, (4) deposition of recessional outwash south of Seattle in the southern Puget Lowland, glaciomarine drift in the northern lowland, and eskers, kames, and small moraines on the Columbia Plateau. Radiocarbon dates show that the Puget and Juan de Fuca lobes advanced and retreated synchronously. The Puget lobe backwasted to Seattle by 13.4-14 ka yrs BP, where the thinning ice floated in seawater northward to Canada by 13 ka yrs BP depositing glaciomarine drift contemporaneously over 18,000 km2. Compelling evidence against the backwasting, calving, terminus model for the origin of the glaciomarine drift includes: 1) abundant 14C dates demonstrate simultaneous deposition of glaciomarine drift over the entire area; 2) stagnant-ice deposits closely related to glaciomarine drift are not consistent with an actively-calving, backwasting terminus; 3) irrefutable evidence for the nonmarine origin of Deming sand shows that Cordilleran ice was absent immediately prior to deposition of the overlying glaciomarine drift. The pattern of events in the northern Puget Lowland includes: 1) glacial loading under 1800 m of ice during the Vashon maximum; 2) rapid glacial thinning and floating of the ice deposited Kulshan glaciomarine drift 12-13 ka yrs BP; 3) emergence and deposition of fluvial Deming sand 11.5 ka yrs BP; 4) resubmer-gence and deposition of Bellingham glaciomarine drift up to -200 m, well beyond global eustatic sea level rise; 5) emergence 10.5-11.5 ka yrs BP and deposition of Sumas outwash on Bellingham glaciomarine drift; 6) Holocene eustatic sea level rise kept pace with isostatic rebound, thus, post-Sumas marine terraces are absent.Dans la Cordillère, les glaciations se sont produites selon des modes caractéristiques d'avancée et de recul : 1) dépôts fluvioglaciaires d'avancée; 2) poli glaciaire; 3) till; 4) dépôts fluvio-glaciaires de retrait au sud de Seattle, dans le sud des basses-terres de Puget, dépôts glacio-marins dans les basses-terres du nord, et eskers, terrasses fluvioglaciaires et petites moraines sur le plateau de Columbia. La datation au radiocarbone indique que les lobes de Puget et de Juan de Fuca ont avancé et reculé synchroniquement. Parmi les preuves qui nous contraignent à rejeter l'hypothèse selon laquelle un front en fusion, qui vêlait, serait à l'origine des dépôts glacio-marins, citons : 1) les nombreuses datations au radiocarbone qui révèlent la mise en place simultanée de dépôts glacio-marins sur tout le territoire; 2) les dépôts issus de la fusion de la glace stagnante, intimement associés aux dépôts glacio-marins; 3) les preuves irréfutables d'une origine autre que marine des sables de Deming qui révèlent que la Cordillère était libre de glace immédiatement avant la mise en place des dépôts glacio-marins. Dans le nord des basses-terres de Puget le déroulement des événements comprend les étapes suivantes : 1) au cours du maximum de Vashon, charge glaciaire sous 1800 m de glace; 2) 12-13 ka BP, amincissement rapide du glacier et dérive de la glace contribuant à la mise en place des dépôts glacio-marins de Kulshan; 3) vers 11 500 ans BP, emersion et dépôt des sables de Deming d'origine fluviale; 4) nouvelle submersion et mise en place des dépôts glacio-marins de Bellingham jusqu'à une hauteur d'environ 200 m, bien supérieure à l'élévation eustatique du niveau de la mer; 5) vers 10 500-11 500 ans BP, emersion et mise en place des dépôts fluvio-glaciaires de Sumas sur les dépôts glacio-marins de Bellingham; 6) à l'Holocène, élévation eustatique du niveau de la mer au même rythme que le relèvement isostatique.Die Vereisung der Kordilleren-Eisdecke zeigt charakteristische VorstoB- und Rùckzugsmuster, bestehend aus (1) glazialem SchwemmvorstoB, (2) glazialem Scheuern, (3) Ablagerung der Grundmoràne, (4) Ablagerung von Rùckzugsschwemm-Material sùdlich von Seattle im sûdlichen Puget-Lowland, glaziomarines Material im nôrdlichen Tiefland und Esker, Kames und kleine Morànen auf dem Columbia-Plateau. Radiokarbondaten zeigen, daf3 die Puget - und Juan de Fuca-Loben gleichzeitig vorstieBen und sich zurûckzogen. Gegen das rùcklàufige, kalbende Terminus-Modell fur den Ursprung des glaziomarinen Materials sprechen die folgenden Tatsachen in zwingender Weise: 1) zahlreiche '"C-Daten beweisen die gleichzeitige Ablagerung von glaziomarinem Material ùber das gesamte Gebiet; 2) Ablagerungen von stagnierendem Eis, die in enger Verbindung zu glaziomarinem Material stehen, stimmen nicht mit einem aktiv kalbenden rùcklàufigen Terminus ùberein; 3) unwiderlegbares Beweismaterial fur den nichtmarinen Ursprung des Sands von Deming zeigt, daB es kein Kordilleren-Eis gab unmittelbar vor der Ablagerung darùberliegen-den glaziomarinen Materials. Die Abfolge der Ereignisse im nôrdlichen Puget Lowland bein-haltet: 1) glaziale Fracht unter 1800 m Eis wàhrend des Vashon Maximums; 2) schnelles glaziales Ausdùnnen und treibendes Eis lagerte 12-13 ka Jahre v.u.Z. das glazioma-rine Material von Kulshan ab; 3) Auftauchen und Ablagerung von Deming-FluBsand -11.5ka Jahre v.u.Z.; 4) Wiederuntertauchen und Ablagerung von glaziomarinem Belligham-Material bis zu - 200 m, weit ùber die globale eustatische Meeresan-hebung hinaus; 5) Auftauchen - 10.5-11.5 ka Jahre v.u.Z. und Ablagerung von Sumas-Schwemm-Material auf dem glaziomarinen Bellingham-Material; 6) die eustatische Anhebung des Meeresspiegels im Holozàn hielt Schritt mit dem isostatischen Ruckprall

Risk Factors for Moral Injury Among Canadian Armed Forces Personnel

Objectives: The traumatic nature of high-risk military deployment events, such as combat, is well-recognized. However, whether other service-related events and demographic factors increase the risk of moral injury (MI), which is defined by consequences of highly stressful and morally-laden experiences, is poorly understood. Therefore, the objective of this study was to examine determinants of MI in Canadian Armed Forces (CAF) personnel. Methods: Data were obtained from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS; unweighted n = 2,941). To identify military characteristics, sociodemographic variables, and deployment-related factors associated with increased levels of MI, a series of multiple linear regressions were conducted across deployed and non-deployed groups. Results: When all variables were considered among the deployed personnel, rank, experiencing military related sexual trauma, child maltreatment (i.e., physical abuse, emotional abuse and neglect), and stressful deployment experiences were significant predictors of increased MI total scores (β = 0.001 to β = 0.51, p &lt; 0.05). Feeling responsible for the death of an ally and inability to respond in a threatening situation were the strongest predictors of MI among stressful deployment experiences. Within the non-deployed sample, experiencing military-related or civilian sexual trauma and rank were significant predictors of increased MI total scores (β = 0.02 to β = 0.81, p &lt; 0.05). Conclusion: Exposure to stressful deployment experiences, particularly those involving moral-ethical challenges, sexual trauma, and childhood maltreatment were found to increase levels of MI in CAF personnel. These findings suggest several avenues of intervention, including education and policies aimed at mitigating sexual misconduct, as well as pre-deployment training to better prepare military personnel to deal effectively with morally injurious experiences.</p

Risk Factors for Moral Injury Among Canadian Armed Forces Personnel

Objectives: The traumatic nature of high-risk military deployment events, such as combat, is well-recognized. However, whether other service-related events and demographic factors increase the risk of moral injury (MI), which is defined by consequences of highly stressful and morally-laden experiences, is poorly understood. Therefore, the objective of this study was to examine determinants of MI in Canadian Armed Forces (CAF) personnel. Methods: Data were obtained from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS; unweighted n = 2,941). To identify military characteristics, sociodemographic variables, and deployment-related factors associated with increased levels of MI, a series of multiple linear regressions were conducted across deployed and non-deployed groups. Results: When all variables were considered among the deployed personnel, rank, experiencing military related sexual trauma, child maltreatment (i.e., physical abuse, emotional abuse and neglect), and stressful deployment experiences were significant predictors of increased MI total scores (β = 0.001 to β = 0.51, p &lt; 0.05). Feeling responsible for the death of an ally and inability to respond in a threatening situation were the strongest predictors of MI among stressful deployment experiences. Within the non-deployed sample, experiencing military-related or civilian sexual trauma and rank were significant predictors of increased MI total scores (β = 0.02 to β = 0.81, p &lt; 0.05). Conclusion: Exposure to stressful deployment experiences, particularly those involving moral-ethical challenges, sexual trauma, and childhood maltreatment were found to increase levels of MI in CAF personnel. These findings suggest several avenues of intervention, including education and policies aimed at mitigating sexual misconduct, as well as pre-deployment training to better prepare military personnel to deal effectively with morally injurious experiences.</p

Moral injury associated with increased odds of past-year mental health disorders: a Canadian Armed Forces examination

Background: Potentially morally injurious experiences (PMIEs) are common during military service. However, it is unclear to what extent PMIEs are related to well-established adverse mental health outcomes. Objective: The objective of this study was to use a population-based survey to determine the associations between moral injury endorsement and the presence of past-year mental health disorders in Canadian Armed Forces (CAF) personnel and Veterans. Methods: Data were obtained from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS). With a sample of 2,941 respondents, the weighted survey sample represented 18,120 active duty and 34,380 released CAF personnel. Multiple logistic regressions were used to assess the associations between sociodemographic characteristics (e.g. sex), military factors (e.g. rank), moral injury (using the Moral Injury Events Scale [MIES]) and the presence of specific mental health disorders (major depressive episode, generalized anxiety disorder, panic disorder, social anxiety disorder, PTSD, and suicidality). Results: While adjusting for selected sociodemographic and military factors, the odds of experiencing any past-year mental health disorder were 1.97 times greater (95% CI = 1.94–2.01) for each one-unit increase in total MIES score. Specifically, PTSD had 1.91 times greater odds (95% CI = 1.87–1.96) of being endorsed for every unit increase in MIES total score, while odds of past-year panic disorder or social anxiety were each 1.86 times greater (95% CI = 1.82–1.90) for every unit increase in total MIES score. All findings reported were statistically significant (p \u3c .001). Conclusion: These findings emphasize that PMIEs are robustly associated with the presence of adverse mental health outcomes among Canadian military personnel. The results of this project further underscore the necessity of addressing moral injury alongside other mental health concerns within the CAF

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

Four decades of military posttraumatic stress:Protocol for a meta-analysis and systematic review of treatment approaches and efficacy

Background: Over 85% of active members of the Canadian Armed Forces have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as 1 in 8 veterans may be diagnosed with PTSD. Given the high prevalence of PTSD in military and veteran populations, the provision of effective treatment considering their unique challenges and experiences is critical for mental health support and the well-being of these populations. Objective: This paper presents the protocol for a meta-analysis and systematic review that will examine the effectiveness of treatment approaches for military-related PTSD. Methods: This PROSPERO-preregistered meta-analysis is being conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. A comprehensive search of the literature wasconducted using the databases PsycInfo, Medline, Embase, CINAHL, and ProQuest Dissertation &amp; Theses. Effect sizes will be computed based on changes in PTSD symptom scores over time across studies using validated PTSD scales. A multilevel meta-analysis will examine the overall effects, between-study effects, and within-study effects of available evidence for PTSD treatments in military populations. Effect sizes will be compared between pharmacotherapeutic, psychotherapeutic, and alternative/emerging treatment interventions. Finally, meta-regression and subgroup analyses will explore the moderating roles of clinical characteristics (eg, PTSD symptom clusters), treatment approaches (eg, therapeutic orientations in psychotherapy and alternative therapies and classifications of drugs in pharmacotherapy), as well as treatment characteristics (eg, length of intervention) on treatment outcomes. Results: The literature search was completed on April 14, 2021. After the removal of duplicates, a total of 12, 002 studies were screened for inclusion. As of July 2021, title and abstract screening has been completed, with 1469 out of 12, 002 (12.23%) studies included for full-text review. Full review is expected to be completed in the summer of 2021, with initial results expected for publication by early winter of 2021. Conclusions: This meta-analysis will provide information on the current state of evidence on the efficacy and effectiveness of various treatment approaches for military-related PTSD and identify factors that may influence treatment outcomes. The results will inform clinical decision-making for service providers and service users. Finally, the findings will provide insights into future treatment development and practice recommendations to better support the well-being of military and veteran populations.</p

Four decades of military posttraumatic stress:Protocol for a meta-analysis and systematic review of treatment approaches and efficacy

Background: Over 85% of active members of the Canadian Armed Forces have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as 1 in 8 veterans may be diagnosed with PTSD. Given the high prevalence of PTSD in military and veteran populations, the provision of effective treatment considering their unique challenges and experiences is critical for mental health support and the well-being of these populations. Objective: This paper presents the protocol for a meta-analysis and systematic review that will examine the effectiveness of treatment approaches for military-related PTSD. Methods: This PROSPERO-preregistered meta-analysis is being conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. A comprehensive search of the literature wasconducted using the databases PsycInfo, Medline, Embase, CINAHL, and ProQuest Dissertation &amp; Theses. Effect sizes will be computed based on changes in PTSD symptom scores over time across studies using validated PTSD scales. A multilevel meta-analysis will examine the overall effects, between-study effects, and within-study effects of available evidence for PTSD treatments in military populations. Effect sizes will be compared between pharmacotherapeutic, psychotherapeutic, and alternative/emerging treatment interventions. Finally, meta-regression and subgroup analyses will explore the moderating roles of clinical characteristics (eg, PTSD symptom clusters), treatment approaches (eg, therapeutic orientations in psychotherapy and alternative therapies and classifications of drugs in pharmacotherapy), as well as treatment characteristics (eg, length of intervention) on treatment outcomes. Results: The literature search was completed on April 14, 2021. After the removal of duplicates, a total of 12, 002 studies were screened for inclusion. As of July 2021, title and abstract screening has been completed, with 1469 out of 12, 002 (12.23%) studies included for full-text review. Full review is expected to be completed in the summer of 2021, with initial results expected for publication by early winter of 2021. Conclusions: This meta-analysis will provide information on the current state of evidence on the efficacy and effectiveness of various treatment approaches for military-related PTSD and identify factors that may influence treatment outcomes. The results will inform clinical decision-making for service providers and service users. Finally, the findings will provide insights into future treatment development and practice recommendations to better support the well-being of military and veteran populations.</p

Measuring moral distress and moral injury:A systematic review and content analysis of existing scales

BACKGROUND: Moral distress (MD) and moral injury (MI) are related constructs describing the negative consequences of morally challenging stressors. Despite growing support for the clinical relevance of these constructs, ongoing challenges regarding measurement quality risk limiting research and clinical advances. This study summarizes the nature, quality, and utility of existing MD and MI scales, and provides recommendations for future use.METHOD: We identified psychometric studies describing the development or validation of MD or MI scales and extracted information on methodological and psychometric qualities. Content analyses identified specific outcomes measured by each scale.RESULTS: We reviewed 77 studies representing 42 unique scales. The quality of psychometric approaches varied greatly across studies, and most failed to examine convergent and divergent validity. Content analyses indicated most scales measure exposures to potential moral stressors and outcomes together, with relatively few measuring only exposures (n = 3) or outcomes (n = 7). Scales using the term MD typically assess general distress. Scales using the term MI typically assess several specific outcomes.CONCLUSIONS: Results show how the terms MD and MI are applied in research. Several scales were identified as appropriate for research and clinical use. Recommendations for the application, development, and validation of MD and MI scales are provided.</p