Experiences and perceptions of military and emergency services personnel identifying as LGBTQIA+ and their families: a qualitative systematic review protocol.

OBJECTIVE: The objective of this review is to explore the perceptions and experiences of military and emergency personnel who identify as lesbian, gay, bisexual, transgender, questioning, intersex, asexual, or other (LGBTQIA+), and the perceptions and experiences of their families. INTRODUCTION: LGBTQIA+ military and emergency first response personnel report disproportionately poorer career and personal outcomes than their cisgender and heterosexual counterparts. Research examining the underlying lived experiences and perceptions of people serving who are LGBTQIA+, particularly those of their family members, is sparse. Hence, the aim of this review is to identify, aggregate, and synthesize relevant qualitative research findings. INCLUSION CRITERIA: This review will consider studies of LGBTQIA+ military or emergency first response personnel and their families that include qualitative data capturing their experiences and perceptions of navigating industrial institutions and service communities. Military personnel include those employed in any role within any military organization; emergency first response personnel will include ambulance workers, paramedics, police, firefighters, and other public safety roles. Families will be limited to any configuration of immediate family members of active or retired LGBTQIA+ service personnel. No limits will be applied to the age of service personnel or their family members, nor to duration or chronology of service. METHODS: Databases searched will include PsycINFO, PubMed Central, ProQuest Central, Scopus, MEDLINE, Embase, and PTSDpubs. Domain-specific journals will be manually searched, and gray literature and unpublished studies will be searched via ProQuest Central. Study screening and selection against inclusion criteria will be performed in Covidence. Data extraction and critical appraisal will be performed using the standardized JBI templates and checklists for qualitative research. All stages will be performed by 2 independent reviewers, with conflicts resolved by a third reviewer. REVIEW REGISTRATION: PROSPERO CRD42022323913.

Effectiveness of Operation K9 Assistance Dogs on Suicidality in Australian Veterans with PTSD: A 12-Month Mixed-Methods Follow-Up Study.

Post-traumatic stress disorder (PTSD) is a pervasive disorder among both current and ex-serving Australian Defence Force (ADF) members. Studies have shown current psychological and pharmacological treatments for PTSD are suboptimal in veterans, with high dropout rates and poor adherence to treatment protocols. Therefore, evaluating complementary interventions, such as assistance dogs, is needed for veterans who may not receive the ultimate benefit from traditional therapies. The present longitudinal mixed-method study examined the effectiveness of Operation K9 assistance dogs among sixteen veterans with PTSD, specifically, their effects on suicidality, PTSD, depression, and anxiety from baseline to 12 months post-matching. Self-reported measures were completed prior to receiving their dog (baseline) and at three time points (3, 6, and 12 months) following matching. The Clinician-Administered PTSD Scale for DSM-5 was used to assess the severity of every PTSD case. Veterans participated in a semi-structured interview 3 months post-matching. Whilst there was a reduction in the proportion of veterans reporting any suicidality, there was no significant change in the probability of veterans reporting suicidality between time points. There was a significant effect of time on PTSD, depression, and anxiety symptoms. Three major themes emerged from qualitative data analysis: life changer, constant companion, and social engagement. Qualitative data suggest assistance dogs can have a positive impact on important areas of daily life and support veterans in achieving some of the prerequisites for health, including access to services, transport, education, employment, and development of new and diverse social and community connections. Connections were key in improving health and wellbeing. This study exemplifies the power of human-animal relationships and adds emphasis to the need to take these seriously and create supportive healthy environments for veterans with PTSD. Our findings could be used to inform public health policy and service delivery, in line with the Ottawa Charter action areas and indicate that for veterans with PTSD, assistance dogs may be a feasible adjunct intervention.

Child Development Outcomes of DIR/Floortime TM-based Programs: A Systematic Review.

BACKGROUND: Occupational therapy is often part of the multi-disciplinary approach within the Developmental, Individual-differences, Relationship-based (DIR) FloortimeTM Model. The model addresses the emotional development of children, which is considered to be critical for the other child developmental areas. PURPOSE: This review serves to inform practitioner decision-making about the use of this model, as no systematic reviews exist on child development outcomes. METHODS: The systematic search included Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Cochrane. For critical appraisal, the McMaster Critical Review was utilized. FINDINGS: Nine studies were identified with varying quality levels. Outcomes were mostly reported for increased socio-emotional development. IMPLICATIONS: The evidence base for this model is emerging from a published research perspective. It is recommended that the use of this model be supported by sound clinical reasoning processes, intervention fidelity, use of valid outcome measures, and regular monitoring. Higher quality research is urgently needed to progress the research base for this intervention.