Protocol for the Open Sky School: a two-arm clustered randomized controlled trial to test the effectiveness of a nature-based intervention on mental health of elementary school children.

BACKGROUND: This article outlines the protocol for a trial to test the effectiveness of a nature-based intervention called Open Sky School to reduce mental health problems among elementary school children. Experimental studies show that contact with nature (e.g. walks in parks) improve mental health. A growing number of teachers have been applying outdoor education within the regular school curriculum and evidence suggests that such teaching methods could improve students' mental health but a randomized controlled trial has never been conducted. METHODS: A two-arm clustered randomized controlled trial will be conducted in elementary schools across Québec, Canada. Following informed consent by teachers, parents and students, schools will be randomly assigned 1:1 to the intervention or the control group with a total of 2500 5-6th grade students and 100 teachers expected to participate. The intervention will take place outdoors in a green-space (2 h per week for 12 weeks) and include a toolkit of 30 activities to foster well-being (e.g. mindfulness) and academic competencies (e.g. mathematics). Questionnaires will be administered to teachers and students before, immediately after and 3 months after the intervention. The primary outcome will be reductions of mental health problems in children from pre-to-post test (Social Behavior Questionnaire: self and teacher reports). Secondary outcomes include depression, positive and negative affect, nature connectedness, and pro-environmental behaviors among children. We will explore, immediate benefits on teacher's well-being and positive and negative affect and sustained benefits among students at 3 months follow-up. For the primary outcome, we will explore moderators including child's sex, child's disability status, the green-space of neighbourhoods, the school's socio-economic position and teacher's experience. DISCUSSION: In conducting the first randomized controlled trial of the Open Sky School, our results could provide empirical evidence on the effectiveness of nature-based interventions in reducing mental health problems among elementary school children. TRIAL REGISTRATION: This study was registered with clinicaltrials.gov: NCT05662436 on December 22, 2022.

Professional Representations of Collaboration in the Response to Intimate Partner Violence.

Purpose: Due to the complexity of intimate partner violence (IPV) and the many actors involved in its social and legal responses, there is a broad consensus that collaboration is essential if IPV is to be overcome. Few studies, however, have provided details as to how these collaborations occur. Rather, research on collaboration in IPV has typically focused on a series of factors facilitating and hindering it. However, these factors are rarely articulated in a systemic, comprehensive, and integrated way. Method: To gain a better understanding of the socio-judicial response to IPV, we conducted a case study in an administrative region in the Province of Quebec, Canada. We conducted individual interviews with 37 key informants who work with people experiencing IPV. The data were subjected to deductive thematic coding as well as to intra- and inter-role matrices that cross-referenced the themes. Result: According to our findings, interagency referrals and information sharing were the most common collaborative practices reported by participants which leading us to characterize the region studied in this article as poorly integrated. Factors facilitating and hindering collaboration are discussed in relation to previous studies. Conclusion: Recommendations for cross-sectoral training, organizational policy development, and opportunities to leverage the expertise of specialized actors in IPV response systems are made.

A gender study of the social representations of dating violence in Chilean adolescents.

The experiences and viewpoints of adolescents as regards dating violence in southern countries remain poorly documented. It is thus difficult to have an overall understanding of the phenomenon. Based on social representation theory, this paper attempts to fill this gap by answering the question: What is dating violence for Chilean adolescents? Knowing what adolescents consider to be dating violence and the contextual elements that influence their perceptions is essential to developing effective prevention strategies. This is particularly important as prevention policies are currently non-existent in Chile, despite the fact that adolescents living there must deal with many risk factors. In this context, a qualitative multi-methodological study (free association and focus groups) was conducted with 142 Chilean adolescents from public and private schools. This study showed that the explanations of dating violence given by boys and girls were influenced by gender and a context of ambivalent sexism. It also took place in a changing socio-cultural Chilean context. Dating violence used by boys was driven by machismo and its exercise by girls was perceived to come from cultural changes concerning women's rights. In addition, the physical nature of dating violence was deeply entrenched in the study participants' social representations, the figurative image being hits. Based on these results, we recommend that future research and prevention strategies should consider the sociocultural context and gender as aspects likely to influence both the adolescents' social representations of dating violence and their behaviors. Supplementary Information: The online version contains supplementary material available at 10.1007/s43545-022-00407-7.

Portrayal of Domestic Violence Trajectories During the Perinatal Period.

Domestic violence during the perinatal period (DVPP) refers to the various ways that women's partners or ex-partners control and coerce them during pregnancy and the 2 years postpartum. From the descriptions of 17 women with firsthand experience of DVPP, this article reports on its manifestations and the associated contexts. The results reveal escalating violence, diverse forms of violence, and exacerbated consequences over the perinatal period. The contexts that pose additional challenges for the women include financial precariousness and the partner's substance abuse, and to a lesser extent the residential situation.

Evaluating the acceptance of ambient assisted living technology (AALT) in rehabilitation: A scoping review.

OBJECTIVES: Ambient assisted living technologies (AALTs) are being used to help community-dwelling older adults (OAs) age in place. Although many AALT are available, their acceptance (perceived usefulness, ease of use, intention to use and actual usage) is needed to improve their design and impact. This study aims to 1) identify AALTs that underwent an acceptance evaluation in rehabilitation contexts, 2) identify methodological tools and approaches to measure acceptance in ambient assisted living (AAL) in rehabilitation research, and 3) summarize AALT acceptance results in existing rehabilitation literature with a focus on peer-reviewed scientific articles. METHODS: A scoping review was conducted in the following databases: Medline, Embase, Cinahl, and PsycInfo, following the Arksey and O'Malley framework (2009). Four acceptance attributes were extracted: 'user acceptance', 'perceived usefulness', 'ease of use', and 'intention to use'. Data regarding AALT, participants, acceptance evaluation methods and results were extracted. RESULTS: A total of 21 articles were included among 634 studies retrieved from the literature. We identified 51 AALTs dedicated to various rehabilitation contexts, most of which focused on monitoring OAs' activities and environmental changes. Acceptance of AALT was evaluated using interviews, questionnaires, focus groups, informal feedback, observation, card sort tasks, and surveys. Although OAs intend to use - or can perceive the usefulness of - AALTs, they are hesitant to accept the technology and have concerns about its adoption. DISCUSSION AND CONCLUSIONS: The assessment of AALT acceptance in contexts of rehabilitation requires more comprehensive and standardized methodologies. The use of mixed-methods research is encouraged to cover the needs of particular studies. The timing of acceptance assessment should be considered throughout technology development phases to maximize AALT implementation.

How Adolescents, Mothers, and Fathers Qualitatively Describe Their Experiences of Co-Occurrent Problems: Intimate Partner Violence, Mental Health, and Substance Use.

This qualitative study examines the perceptions of mothers, fathers, and adolescents on the relations they see between intimate partner violence, mental health and substances use parental problems that co-occur in their family, and the mothers' and fathers' associated parenting challenges. The sample was composed of 43 people (15 mothers, 16 fathers, and 12 adolescents) who were directly affected by the co-occurrence of intimate partner violence and mental health or substances use parental problems. The participants were recruited with the collaboration of public and community organizations in the Province of Québec (Canada). The data were collected through semi-structured interviews and combined with a table detailing the specific problems identified by the participants. A thematic content analysis method was employed to do the coding, and a summary of the results was returned to some participants who agreed to collaborate with the validation of the results. The analysis revealed numerous and diverse relations between the interviewees' co-occurring problems, but two principal patterns emerged. The first one was chiefly observed in the comments made by mothers and adolescents who saw the co-occurring problems as being the consequence of the intimate partner violence on the mother. The second pattern was largely observed in the fathers' comments, who explained that the substance use problems came before the intimate partner violence and acted as an aggravating factor. The co-occurrence of intimate partner violence with other parental problems strongly affected the mothers' and fathers' parenting, making it more difficult to meet the children's needs. Considering the complexity and diversity of the experiences and needs of the mothers, fathers, and children in co-occurring situations, future studies should evaluate the services provided to these families and the coordination between the different concerned organizations.

Cardiorespiratory strain during stroke rehabilitation: Are patients trained enough? A systematic review.

BACKGROUND: Rehabilitation is a mandatory component of stroke management, aiming to recover functional capacity and independence. To that end, physical therapy sessions must involve adequate intensity in terms of cardiopulmonary stress to meet the physiological demands of independent living. OBJECTIVE: The aim of this systematic review was to determine the current level of cardiopulmonary strain during rehabilitation sessions in stroke patients. METHODS: Three electronic databases (PubMed, CINAHL and Embase. com) were searched to identify observational studies that documented cardiopulmonary strain during rehabilitation sessions in post-stroke patients (last search performed in February 2019). A manual cross-referencing search was also performed. To be included, articles needed to report data related to both cardiopulmonary strain (heart rate, oxygen consumption or energy expenditure) and active therapy time. The methodological quality of each study was assessed with the Evidence-Based Librarianship Critical Appraisal Tool. Data related to both cardiorespiratory strain and active therapy time were extracted from selected articles. RESULTS: Four of 43 full-text articles assessed for eligibility met the inclusion criteria. Results extracted from these articles suggested that the intensity of rehabilitation sessions was insufficient to induce a cardiopulmonary training effect in a post-stroke context as measured by metabolic stress. Patients were inactive from 21% to 80% of the therapy time. The Evidence-Based Librarianship tool scores ranged from 65% (15/23) to 91% (21/23), which indicates questionable to good quality. CONCLUSION: The current literature on cardiopulmonary solicitation during stroke rehabilitation sessions is poor in terms of both the number of studies available and their methodological quality. Summarized results tend to support previous claims that rehabilitation sessions offered to stroke patients are of suboptimal cardiopulmonary strain, which can interfere with their capacity to regain functional independence.

Child maltreatment in sport: smashing the wall of silence: a narrative review of physical, sexual, psychological abuses and neglect.

Child maltreatment in sport is an undeniable problem. High-profile cases of sexual abuse of child athletes are obvious examples of child maltreatment in this context. Young athletes also face physical and psychological maltreatment, as well as neglect, although these types of child maltreatment are understudied in sport and receive less public attention. Little is known as to how to define physical and psychological maltreatment and neglect in sport and their diverse manifestations. The aim of this paper is to propose concrete manifestations of each type of child maltreatment in sport. We aim to help practitioners better understand and researchers better measure this problem.

Estimation of Needs for Addiction Services: A Youth Model.

OBJECTIVE: In the field of health care services, resource allocation is increasingly determined based on a population needs model. Although service needs models have been developed for adults with substance use problems, it would seem inappropriate to apply them indiscriminately to young people. METHOD: The method used proposes six steps: (1) targeting the population, (2) estimating the proportion of the population affected by substance misuse and (3) the proportion of youths who should receive services, (4) identifying categories of services, (5) estimating the proportions of youths who should have access to each category of services, and (6) applying the model to real use of services by youths to recalibrate it. RESULTS: Youths ages 12-17 from the Province of Québec were classified within a tiered model comprising four levels of substance use severity. Youths in need of services varied from 38% (weak response) to 95% (high response) for the highest severity cases. Service categories retained are detoxification/intoxication, outpatient, and residential, with each one being subdivided into four categories. The proportion of youths from each tier who should access categories and subcategories of services varied widely. After a pre-experimentation, the model was adjusted. CONCLUSIONS: The model can be applied in different jurisdictions, with the caution of adjusting prevalence to local reality. Further improvement will be based on more accurate information concerning the path of clients through services, better strategies to reach youths in need of services, and increased knowledge of optimal service categories. Models adapted to low- or moderate-income countries, where the health care system has minimal services in the areas of mental health and addiction, should be developed.

The Impact of Lifetime Victimization and Polyvictimization on Adolescents in Québec: Mental Health Symptoms and Gender Differences.

This study documents lifetime experiences of victimizations, polyvictimization, and trauma symptoms among 1,400 adolescents from the province of Québec. The vast majority (81%) of adolescents were victimized during their lifetime, with most victims (82%) being the target of more than one form of victimization. Polyvictimization accounted for most variability in scores of depression, posttraumatic stress disorder (PTSD), and anger/ aggression compared to individual victimization categories. Sexual victimization and maltreatment still made an independent contribution in predicting all trauma scores once polyvictimization was considered. Gender differences were found in the victimization experiences contributing to the prediction of mental health symptoms. Sexual victimization was a significant predictor of PTSD and anger/aggression symptoms for girls, whereas witnessing violence predicted anger and PTSD symptoms for boys, and assault predicted their anger. This study outlines the importance of assessing various types of victimization among adolescents. Systematic data and observation of trends on child victimization are needed in Canada and elsewhere.

Co-occurrence of intimate partner violence and child sexual abuse: Prevalence, risk factors and related issues.

This article proposes a review of the scientific literature on the cooccurrence of intimate partner violence and intrafamilial child sexual abuse. The review of these two types of violence has evolved in distinct research fields and their cooccurrence has rarely been examined. The objective of this article is to examine the existing knowledge about this cooccurrence. A systematic examination of the scientific literature in several relevant databases was conducted using combinations of 20 keywords so as to identify scientific articles, published between 2003 and 2013, that investigated this cooccurrence. The final sample comprised 10 studies. These studies revealed the presence of much heterogeneity regarding the prevalence of the cooccurrence for intimate partner violence with sexual abuse and other maltreatment (from 12% to 70%). The review also highlighted a greater risk for children to be victims of sexual abuse or other maltreatment when exposed to intimate partner violence. The implications of these results and the ensuing recommendations for practice and future research are considered in the discussion section.

[Children and adolescents from elsewhere: the violence experienced in their host society and the effects on their health, a literature]. / Enfants et adolescents venus d'ailleurs : la violence vécue dans leur société d'accueil et les effets sur leur santé, une recension des écrits.

OBJECTIVE: This integrative literature review aims to present a comprehensive portrayal of social violence experienced by first-generation immigrant children and adolescents, and its effects on their health and well-being. METHOD: A French and English languages literature search was conducted in eight databases, without restrictions on dates of publication. Thirty studies were selected. Results were summarized according to three aspects: 1) types of violence experienced by young immigrants; 2) conditions under which this violence occurs; 3) effects of such violence on the health and well-being of young immigrants. SYNTHESIS: Immigrant children and adolescents can experience various forms of physical, verbal, and relational violence. This violence seems to be mostly instigated by their peers and it has mainly been studied in terms of discrimination. Victimization may vary depending on factors such as ethnic composition of schools or time of residence in the host society. Violence may have many effects on mental health of immigrant youth: it is associated with both increased psychopathological symptoms and poorer mental health. Finally, the experience of violence is related to a more negative attitude of young immigrants toward their host society and a more positive attitude toward their own cultural community. CONCLUSION: In addition to its having numerous adverse effects on their mental and social health and well-being, violence may prove to be a key factor in the experience of marginalization of immigrant youth. We propose certain research avenues to explore.

Novel apatite-based sorbent for defluoridation: synthesis and sorption characteristics of nano-micro-crystalline hydroxyapatite-coated-limestone.

Elevated levels of fluoride (F(-)) in groundwaters of granitic and basaltic terrains pose a major environmental problem and are affecting millions of people all over the world. Hydroxyapatite (HA) has been shown to be a strong sorbent for F(-); however, low permeability of synthetic HA results in poor sorption efficiency. Here we provide a novel method of synthesizing nano- to micrometer sized HA on the surfaces of granular limestone to improve the sorption efficiency of the HA-based filter. Our experiments with granular limestone (38-63, 125-500 µm) and dissolved PO4(3-) (0.5-5.3 mM) as a function of pH (6-8) and temperature (25-80 °C) indicated rapid formation of nano- to micrometer sized HA crystals on granular limestone with the maximum surface coverage at lower pH and in the presence of multiple additions of aqueous PO4(3-). The HA crystal morphology varied with the above variables. The sorption kinetics and magnitude of F(-) sorption by HA-coated-fine limestone are comparable to those of pure HA, and the F(-) levels dropped to below the World Health Organization's drinking water limit of 79 µM for F(-) concentrations commonly encountered in contaminated potable waters, suggesting that these materials could be used as effective filters. Fluorine XANES spectra of synthetic HA reacted with F(-) suggest that the mode of sorption is through the formation of fluoridated-HA or fluorapatite at low F(-) levels and fluorite at high F(-) loadings.

The bank of standardized stimuli (BOSS): comparison between French and English norms.

Throughout the last decades, numerous picture data sets have been developed, such as the Snodgrass and Vanderwart (1980) set, and have been normalized for variables such as name and familiarity; however, due to cultural and linguistic differences, norms can vary from one country to another. The effect due specifically to culture has already been demonstrated by comparing samples from different countries where the same language is spoken. On the other hand, it is still not clear how differences between languages may affect norms. The present study explores this issue by collecting and comparing norms on names and many other features from French Canadian speakers and English Canadian speakers living in Montreal, who thus live in similar cultural environments. Norms were collected for the photos of objects from the Bank of Standardized Stimuli (BOSS) by asking participants to name the objects, to categorize them, and to rate their familiarity, visual complexity, object agreement, viewpoint agreement, and manipulability. Names and ratings from the French speakers are available in Appendix A, available in the supplemental materials. The results show that most of the norms are comparable across linguistic groups and also that the ratings given are correlated across linguistic groups. The only significant group differences were found in viewpoint agreement and visual complexity. Overall, there was good concordance between the norms collected from French and English native speakers living in the same cultural setting.

Symmetry brings an impression of familiarity but does not improve recognition memory.

Studies have shown that symmetric stimuli are recognized better than asymmetric stimuli but evidence suggests that this advantage may result from a familiarity bias induced by symmetry. We used a classic episodic memory paradigm to test this bias and see if it truly accounts for the symmetry advantage. Subjects first encoded symmetric and asymmetric figures. During a subsequent recognition phase, they discriminated the encoded (old) figures from new intermixed figures. The recognition rate of old figures was higher with symmetric figures than asymmetric figures. However, the tendency to falsely recognize new figures was also higher when they were symmetric, meaning that the higher recognition rate for symmetric figures was artificially inflated by a response bias. Three other experiments further tested this finding and examined the influence of some variables (rotation in virtual 3D space, stimulus meaningfulness, and redundancy of information) on the bias. A fifth experiment with photo stimuli confirmed that the response bias also applies to objects that we regularly encounter in everyday life. In conclusion, our results show that symmetry does not enhance mnemonic processes but instead induces a response bias leading individuals to judge such stimuli as having been seen.

Coping strategies among couples adjusting to primary breast cancer.

In psychosocial oncology social support is a recognized factor in facilitating adaptation to cancer. Spouses are often the first source of support for each other. However, the adaptation process of couples dealing with cancer has been little explored. This article presents the results of a qualitative study carried out with 16 couples, in each of which the woman had breast cancer. The goal of this study was to better understand the manner in which the couple as a dyad deals with the disruptions and demands related to the disease and its treatments. This report highlights the principal issues that confront couples in the first year after diagnosis and the adjustment strategies they use to deal with these issues. A theoretical understanding of the adjustment process of couples dealing with breast cancer emerges as a result of this study.