Mental Health Disorder Symptoms among Canadian Coast Guard and Conservation and Protection Officers.

Canadian public safety personnel (PSP) screen positive for one or more mental health disorders, based on self-reported symptoms, at a prevalence much greater (i.e., 44.5%) than the diagnostic prevalence for the general public (10.1%). Potentially psychologically traumatic event (PPTE) exposures and occupational stressors increase the risks of developing symptoms of mental health disorders. The current study was designed to estimate the mental health disorder symptoms among Canadian Coast Guard (CCG) and Conservation and Protection (C&P) Officers. The participants (n = 412; 56.1% male, 37.4% female) completed an online survey assessing their current mental health disorder symptoms using screening measures and sociodemographic information. The participants screened positive for one or more current mental health disorders (42.0%; e.g., post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, alcohol use disorder) more frequently than in the general population diagnostic prevalence (10.1%; p < 0.001). The current results provide the first information describing the prevalence of current mental health disorder symptoms and subsequent positive screenings of CCG and C&P Officers. The results evidence a higher prevalence of positive screenings for mental health disorders than in the general population, and differences among the disorder-screening prevalence relative to other Canadian PSP. The current results provide insightful information into the mental health challenges facing CCG and C&P PSP and inform efforts to mitigate and manage PTSI among PSP. Ongoing efforts are needed to protect CCG and C&P Officers' mental health by mitigating the impacts of risk factors and operational and organizational stressors through interventions and training, thus reducing the prevalence of occupational stress injuries.

Mental Health Training, Attitudes toward Support, and Screening Positive for Mental Disorders among Canadian Coast Guard and Conservation and Protection Officers.

Public Safety Personnel (PSP) including members of the Canadian Coast Guard (CCG) and Conservation and Protection (C&P) officers, are regularly exposed to potentially psychologically traumatic events (PPTEs) and other occupational stressors. Several mental health training programs (e.g., critical incident stress management [CISM], critical incident stress debriefing [CISD], peer support, mental health first aid, Road to Mental Readiness [R2MR]) exist as efforts to minimize the impact of exposures. To help inform on the impact of several categories of mental health training programs (i.e., CISM, CISD, mental health first aid, Peer Support, R2MR) for improving attitudes toward support and willingness to access supports among CCG and C&P officers, the current study assessed CCG and C&P Officers perceptions of access to professional (i.e., physicians, psychologists, psychiatrists, employee assistance programs, chaplains) and non-professional (i.e., spouse, friends, colleagues, leadership) support, and associations between training and mental health. Participants (n = 341; 58.4% male) completed an online survey assessing perceptions of support, experience with mental health training and symptoms of mental health disorders. CCG and C&P Officers reported access to professional and non-professional support; however, most indicated they would first access a spouse (73.8%), a friend (64.7%), or a physician (52.9%). Many participants would never, or only as a last resort, access other professional supports (24.0% to 47.9%), a CCG or C&P colleague (67.5%), or their leadership (75.7%). Participants who received any mental health training reported a lower prevalence of positive screens for all mental health disorders compared to those who did not received training; but no statistically significant associations were observed between mental health training categories and decreased odds for screening positive for mental disorders. The current results suggest that the mental health training categories yield comparable results; nevertheless, further research is needed to assess the shared and unique content across each training program. The results highlight the need to increase willingness to access professional and non-professional support among CCG and C&P Officers. Revisions to training programs for leadership and colleagues to reduce stigma around mental health challenges and support for PSP spouses, friends, and physicians may be beneficial.

Suicidal Ideation, Planning, and Attempts among Canadian Coast Guard and Conservation and Protection Officers.

The current study provides estimates of suicidal ideation, planning, and attempts among Canadian Coast Guard personnel and Canadian Conservation and Protection Officers. Participants (n = 385; 59% men) completed a self-report survey that collected past-year and lifetime estimates of suicidal ideation, planning, attempts, sociodemographic information, and symptoms related to mental health disorders. Within the sample, participants reported lifetime suicidal ideation (25.7%), planning (10.9%), and attempts (5.5%). Participants reported past-year suicidal ideation (7.5%), planning (2.1%), and the percentage of attempts was too marginal to report due to ethical considerations. Canadian Coast Guard personnel and Conservation and Protection Officers reported higher percentages of past-year and lifetime suicidal ideation, planning, and attempts than the Canadian general population, but the percentages reported are comparable to other Canadian PSP sectors. No statistically significant results were observed for the sociodemographic covariates within the past-year, whereas, statistically significant results were observed for the lifetime sociodemographic covariates of age, province of residence, and previous work experience. There were statistically significant associations between past-year suicidal ideation and positive screens for major depressive disorder (MDD) and general anxiety disorder (GAD); as well, past-year suicidal planning was associated with social anxiety disorder (SAD). There were also statistically significant associations between lifetime suicidal ideation, planning, and attempts and positive screens for posttraumatic stress disorder (PTSD), MDD, and SAD. Lifetime suicidal ideation and planning were associated with panic disorder (PD). The current estimates provide valuable information for clinicians and stakeholders involved in prevention programs, treatment, or future research.

Assessing the Relative Impact of Diverse Stressors among Canadian Coast Guard and Conservation and Protection Officers.

Public Safety Personnel (PSP), including members of the Canadian Coast Guard (CCG) and Conservation and Protection (C&P) officers, are regularly exposed to potentially psychologically traumatic events (PPTEs) and other occupational stressors (organizational and operational stressors). The current study quantified occupational stressors among CCG and C&P and assessed relationships with PPTEs and mental health disorders. Participants (n = 341; 58.4% male) completed an online survey assessing self-reported occupational stressors, PPTEs, and mental health disorder symptoms. CCG and C&P Officers reported significantly lower mean overall and item-level organizational and operational stress scores compared to other Canadian PSP. Mean operational stress scores were statistically significantly associated with increased odds of screening positive for all mental disorders and organizational stress scores were statistically significantly associated with increased odds of screening positive for all mental disorders except social anxiety disorder. Participants reported several item-level occupational stressors associated with screening positive for posttraumatic stress disorder, general anxiety disorder, major depressive disorder, social anxiety disorder, panic disorder, and alcohol use disorder, even after accounting for diverse PPTE exposures. Exposure to PPTEs may be a regular part of employment for CCG and C&P PSP; however, bureaucratic red tape, staff shortages, excessive administrative duties, physical conditioning, healthy eating, and fatigue are occupational stressors that appear significantly related to mental health. Ongoing mental health efforts are needed to mitigate and manage the impact of occupational stressors among CCG and C&P.

Exposures to Potentially Psychologically Traumatic Events among Canadian Coast Guard and Conservation and Protection Officers.

Canadian Public Safety Personnel (PSP) (i.e., municipal/provincial police, firefighters, paramedics, Royal Canadian Mounted Police, correctional workers, dispatchers) report frequent and varied exposures to potentially psychologically traumatic events (PPTEs). Exposure to PPTEs may be one explanation for the symptoms of mental health disorders prevalent among PSP. The objective of the current study was to provide estimates of lifetime PPTE exposures among Canadian Coast Guard (CCG) and Conservation and Protection (C&P) Officers and to assess for associations between PPTEs, mental health disorders, and sociodemographic variables. Participants (n = 412; 55.3% male, 37.4% female) completed an online survey assessing self-reported PPTE exposures and self-reported symptoms of mental health disorders. Participants reported higher frequencies of lifetime exposures to PPTEs than the general population (all ps < 0.001) but lower frequencies than other Canadian PSP (p < 0.5). Several PPTE types were associated with increased odds of positive screens for posttraumatic stress disorder, major depressive disorder, general anxiety disorder, social anxiety disorder, panic disorder, and alcohol use disorder (all ps < 0.05). Experiencing a serious transportation accident (77.4%), a serious accident at work, home, or during recreational activity (69.7%), and physical assault (69.4%) were among the PPTEs most frequently reported by participants. The current results provide the first known information describing PPTE exposures of CCG and C&P members, supporting the growing evidence that PPTEs are more frequent and varied among PSP and can be associated with diverse mental health disorders.

Assessing the Perceptions and Impact of Critical Incident Stress Management Peer Support among Firefighters and Paramedics in Canada.

Relative to the general population, public safety personnel (PSP) appear at an increased risk of developing mental health challenges as a result of repeated exposure to potentially psychologically traumatic events (PPTEs). To help mitigate the impact of PPTEs on PSP mental health, many PSP agencies have implemented diverse peer support despite limited empirical evidence. The current study was designed to expand the empirical evidence surrounding peer support by investigating one of the most widely used and structured peer support resources: Critical Incident Stress Management (CISM). Specifically, the current study with integrated firefighters and paramedics assessed (a) the prevalence of mental disorders; (b) perceptions of high fidelity CISM peer support; and (c) the comparative associations of CISM with high fidelity (n = 91) versus unknown fidelity (n = 60) versus no CISM (n = 64) and mental health. Results indicated that (a) mental disorders are prevalent among PSP irrespective of gender, age, and years of service; (b) participants perceived CISM peer support as offering beneficial and valuable tools (e.g., skills and coping strategies); and (c) high fidelity CISM environments offer some mental health benefits to individuals who screen positive for alcohol use disorder and generalized anxiety disorder. Overall, the current study offers novel information that can inform future directions for evidence-based peer support and policy decisions designed to support the mental health of PSP.

Peer Support for Public Safety Personnel in Canada: Towards a Typology.

Public safety personnel (PSP) are frequently exposed to potentially psychologically traumatic events (PPTEs) which can impact mental health. To help mitigate the negative effects of PPTEs, PSP commonly rely on peer support. Peer support generally refers to a wide variety of mental health resources that offer social or emotional assistance to a peer, and in some cases professional assistance. Despite the use of and demand for peer support, there is relatively little empirical evidence regarding effectiveness. The evidence gaps regarding peer support effectiveness may be due, in part, to inadequate guidelines and standards of practice that are publicly supported by a consensus among peer support providers. The current study was designed to explore the current conceptualization and implementation of peer support among Canadian PSP using a document analysis. The results indicate that peer support can be conceptualized via three models (i.e., peer-enabled, peer-led, peer-partnership) and implemented via two delivery methods (i.e., program, service). The research team proposed a novel diagram towards a typology of peer support to highlight the diversity in peer support conceptualization and implementation and provide a foundation for the development of mutually agreed-upon language and a shared framework. Overall, the current study can help inform peer support resources within and beyond PSP communities.

Examining the Relationship Between Intimate Partner Violence and Concern for Animal Care and Safekeeping.

The current study examined the knowledge and experience of animal welfare and human service providers in urban and rural communities of Saskatchewan, Canada. Nine exploratory qualitative interviews were conducted to gather a more in-depth understanding of whether the concern for animal care and safekeeping impacts the decision to leave situations of intimate partner violence. The interviews were semistructured and guided by four questions, which were designed, reviewed, and revised based on feedback from a community-based research team. Thematic analysis highlighted important findings, allowing for the generation of suggestions for improvement of current supports and services offered. The current study findings suggest that concern for animal care and safekeeping creates significant barriers regarding the decision to leave situations of intimate partner violence and abuse, warranting further research to inform support services and resources within a Canadian context.

Factors Influencing Part-time Faculty Engagement With Online Nursing Programs.

This research investigated factors that influenced the engagement of part-time faculty teaching in online nursing programs with their institutions. Of the 257 part-time faculty surveyed, the most significant factor was being supported in decisions regarding student issues, followed by institutional commitment to quality online education. Compensation was moderately influential; a negative factor was requiring too frequent meetings. Understanding factors that influence the engagement of part-time faculty teaching in online nursing programs can help leaders of online programs attract and retain experienced, highly skilled faculty.

Understanding arithmetic concepts: Does operation matter?

Most research on children's arithmetic concepts is based on (a) additive concepts and (b) a single concept leading to possible limitations in current understanding about how children's knowledge of arithmetic concepts develops. In this study, both additive and multiplicative versions of six arithmetic concepts (identity, negation, commutativity, equivalence, inversion, and associativity) were investigated in Grades 5, 6, and 7. The multiplicative versions of the concepts were more weakly understood. No grade-related differences were found in conceptual knowledge, but older children were more accurate problem solvers. Individual differences were examined through cluster analyses. All children had a solid understanding of identity and negation. Some children had a strong understanding of all the concepts, both additive and multiplicative; some had a good understanding of equivalence or commutativity; and others had a weak understanding of commutativity, equivalence, inversion, and associativity. Associativity was the most difficult concept for all clusters. Grade did not predict cluster membership. Overall, these results demonstrate the breadth of individual variability in conceptual knowledge of arithmetic as well as the complexity in how children's understanding of arithmetic concepts develops.

Improving Online Teaching by Using Established Best Classroom Teaching Practices.

This pilot study explored the effectiveness of an online workshop provided to faculty teaching one course in a large online RN-to-baccalaureate nursing (BSN) program. This exploration helped to fill a gap in knowledge related to implementing best classroom teaching practices into distance education for online nursing students. Focus groups with purposeful sampling (three focus groups: two faculty focus groups with a total of 11 faculty and one student focus group with a total of six students) were used to assess the effectiveness of the workshop and faculty and student perceptions of the seven best classroom teaching practices. Themes derived from the faculty focus groups included reaffirmation, commitments from students, and opportunities for instructor improvement. Themes derived from the student focus group included engagement, availability, encouragement, and diverse learning. Online teaching recommendations, created from the emerged themes of the study, could be considered to improve teaching practices of online nurse educators. J Contin Educ Nurs. 2016;47(5):222-227.

Influence of Nursing Faculty Discussion Presence on Student Learning and Satisfaction in Online Courses.

This study determined the relationships between faculty participation in online discussions with student satisfaction and perceived learning in online RN-BSN and MSN courses. Analysis of faculty participation in online courses (n = 280) demonstrated a relationship between faculty participation and student satisfaction and perceived learning. The results of this study offer guidance on the minimal faculty participation necessary in online discussions in nursing courses.

Comparison of Er:YAG laser and piezoelectric osteotomy: An animal study in sheep.

OBJECTIVES: It was the aim of this study to compare the feasibility of complete osteotomy of long bones in sheep using a newly designed variable square pulsed Er:YAG laser and piezoelectric surgery. In addition to uneventful bone healing after laser osteotomy, the goal was to assess the possibility to cut thick bony structures with both techniques in a surgically acceptable time frame of 2-3 minutes. MATERIAL AND METHODS: A tibia midshaft osteotomy was performed in 24 sheep using either an Er:YAG laser (n = 12) or piezoelectric device (n = 12). Laser and piezoelectric groups were divided in two subgroups (n = 6) with sheep sacrificed after 2 and 3 months, respectively. A complete radiological, histological and histomorphometric analysis was performed to compare the course of bone/fracture healing and remodelling. RESULTS: Laser and piezoelectric osteotomies of the sheep tibia up to a depth of 22 mm were possible without any thermal damage. Radiological and histological results after 2 months showed primary gap healing with distinct periosteal callus formation on the transcortex. After 3 months, radiological and histological analysis revealed less callus formation on the transcortex, with almost no visible osteotomy gap and a distinct formation of lamellar bone crossing the original osteotomy gap. CONCLUSION: Er:YAG laser osteotomy can successfully be used in long bones with a depth of up to 22 mm, thus challenging the dogma of adverse effects of laser osteotomy due to thermal or other damages.

Clinical assessment of repeated propofol-associated anesthesia in cats.

OBJECTIVE: To assess the effects of repeated episodes of propofol-associated anesthesia on quality of recovery from anesthesia, clinical status, and erythrocyte physiology in cats. DESIGN: Original study. ANIMALS: 37 cats undergoing short-duration anesthesia for radiotherapy. PROCEDURES: Twice daily on 5 consecutive days, 13 cats with squamous cell carcinoma of the nasal planum (group 1) underwent anesthesia: first via administration of propofol or a midazolam (0.2 mg/kg [0.09 mg/lb])-propofol combination and then via administration of ketamine and midazolam each day (latter data were not analyzed). During a 19-day period, 24 cats with vaccine associated sarcoma (group 2) were anesthetized 12 times with propofol or a midazolam-propofol combination. Anesthesia was maintained with propofol in both groups. Hematologic analysis was performed before, during, and on completion of radiotherapy; changes in Hct and hemoglobin concentration between groups were compared. RESULTS: Mean duration of anesthesia was 8.1 minutes (range, 5 to 20 minutes); no adverse events were detected during recovery. Total dose of propofol administered did not differ between groups 1 (6.34 mg/kg [2.88 mg/lb]) and 2 (4.71 mg/kg [2.14 mg/lb]). Midazolam administration decreased the propofol dose by 26%. Overall decreases from baseline in Hct and hemoglobin concentration were not significantly different between the 2 groups, nor clinically important; however, compared with baseline, values in group 2 were significantly lower after 6 and 12 anesthetic episodes for both protocols. Heinz bodies were identified in low numbers in both groups during radiotherapy. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that repeated propofol-associated short-duration anesthesia does not lead to clinically relevant hematologic changes in cats undergoing short-duration radiotherapy.

Refining animal models in fracture research: seeking consensus in optimising both animal welfare and scientific validity for appropriate biomedical use.

BACKGROUND: In an attempt to establish some consensus on the proper use and design of experimental animal models in musculoskeletal research, AOVET (the veterinary specialty group of the AO Foundation) in concert with the AO Research Institute (ARI), and the European Academy for the Study of Scientific and Technological Advance, convened a group of musculoskeletal researchers, veterinarians, legal experts, and ethicists to discuss, in a frank and open forum, the use of animals in musculoskeletal research. METHODS: The group narrowed the field to fracture research. The consensus opinion resulting from this workshop can be summarized as follows: RESULTS & CONCLUSION: Anaesthesia and pain management protocols for research animals should follow standard protocols applied in clinical work for the species involved. This will improve morbidity and mortality outcomes. A database should be established to facilitate selection of anaesthesia and pain management protocols for specific experimental surgical procedures and adopted as an International Standard (IS) according to animal species selected. A list of 10 golden rules and requirements for conduction of animal experiments in musculoskeletal research was drawn up comprising 1) Intelligent study designs to receive appropriate answers; 2) Minimal complication rates (5 to max. 10%); 3) Defined end-points for both welfare and scientific outputs analogous to quality assessment (QA) audit of protocols in GLP studies; 4) Sufficient details for materials and methods applied; 5) Potentially confounding variables (genetic background, seasonal, hormonal, size, histological, and biomechanical differences); 6) Post-operative management with emphasis on analgesia and follow-up examinations; 7) Study protocols to satisfy criteria established for a "justified animal study"; 8) Surgical expertise to conduct surgery on animals; 9) Pilot studies as a critical part of model validation and powering of the definitive study design; 10) Criteria for funding agencies to include requirements related to animal experiments as part of the overall scientific proposal review protocols. Such agencies are also encouraged to seriously consider and adopt the recommendations described here when awarding funds for specific projects. Specific new requirements and mandates related both to improving the welfare and scientific rigour of animal-based research models are urgently needed as part of international harmonization of standards.

Preliminary evaluation of a behaviour-based system for assessment of post-operative pain in horses following arthroscopic surgery.

OBJECTIVE: To develop a method for objective assessment of equine post-operative pain. STUDY DESIGN: Prospective nonblinded clinical study. ANIMALS: Twelve adult horses: Group 1 (G1, n = 6), admitted for arthroscopy (under general anaesthesia, with multimodal analgesia); Group 2 (G2, n = 6), 'pain free' controls. MATERIALS AND METHODS: Horses were filmed continuously (CVI, time-lapse video recorder) over 72 hours, from 24 hours pre-surgery (PS) to 48 hours post-recovery (PR) (G1), and over 24 hours (G2). Activity budgets were determined from 24 to 0 hours PS, 0-24 and 24-48 hours PR (G1) and for 24 hours (G2). Using direct observation (DO), active behaviours and postures were recorded at set time points PS and PR (G1) and at two time points (morning/evening) (G2). Heart rate (HR) and respiration rate (RR) were recorded simultaneously. Statistical analysis investigated within-group and between-group time-related changes in behaviour, HR and RR. RESULTS: There was no difference in HR or RR between G1 and G2 at any time point. Anaesthetic 'hangover' and hunger-related activity modulated behaviour from 0 to 6 hours PR, when abnormal postures and locomotion occurred in all G1 horses, but no G2 horses. Compared with G1 (0-24 hours PR), G2 spent more time eating (t = -3.34, p < 0.01), more time at the front of the stable (t = -2.42, p < 0.05), and less time exhibiting 'abnormal' behaviour (U = 56, p < 0.01). Comparing PS and PR behaviour, G1 spent less time exploring from 24 to 48 hours PR (t = 3.49, p < 0.05), less time in sternal recumbency (t = -3.8, p < 0.05) and less time moving (t = 3.19, p < 0.05). Horses tended (p < 0.07) to spend less time positioned in the front of the stable PR (less from 24 to 48 hours PR than from 0 to 24 hours PR). Comparing PR (evening) behaviour, G2 spent more time with head above withers (U = 21.5, p < 0.01), and ears forwards (U = 22, p < 0.01). G1 showed time-related changes (all p < 0.05) in time with lower lip tense (S = 15.8), eating (S = 17.08) and with head positioned above withers (S = 18.04). No differences in event behaviours were observed between G1 and G2. Within G1, only olfactory behaviour varied significantly with time (S = 14.52, p < 0.05). CONCLUSIONS: Changes in equine behaviour suggestive of post-operative discomfort were identified using both DO and CVI. Analysis of activity budgets may be a more sensitive method of identifying behavioural changes indicative of equine discomfort than repeated DO of specific events and postures.