Search

Objective: The current study used the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) to (1) examine the incidence and prevalence of mental disorders and (2) estimate the comorbidity of mental disorders over the follow-up period. Method: The CAFVMHS (2018) is a longitudinal study with two time points of assessment. The sample is comprised of 2,941 Canadian Forces members and veterans who participated in the 2002 Canadian Community Health Survey: Canadian Forces Supplement. The World Health Organization Composite International Diagnostic Interview (WHO-CIDI) was utilized to diagnose Diagnostic and Statistical Manual-IV post-traumatic stress disorder (PTSD), major depressive episode (MDE), generalized anxiety disorder, social anxiety disorder (SAD), and alcohol abuse and dependence. Self-report health professional diagnoses were assessed for attention deficit hyperactivity disorder (ADHD), mania, obsessive compulsive disorder (OCD), and personality disorder. We established weighted prevalence of mental disorders and examined the association between mental disorders using logistic regression. Results: In 2018, lifetime prevalence of any WHO-CIDI-based or self-reported mental disorder was 58.1%. Lifetime prevalence of any mood or anxiety disorder or PTSD was 54.0% in 2018. MDE (39.9%), SAD (25.7%), and PTSD (21.4%) were the most common mental disorders. There was a substantial increase in new onset or recurrence/persistence of mental disorders between the two measurement points (16-year assessment gap); 2002–2018 period prevalences were 43.5% for mood and anxiety disorder and 16.8% for alcohol abuse or dependence. The prevalence of self-reported ADHD, OCD, any personality disorder, and mania were 3.3%, 3.0%, 0.8%, and 0.8%, respectively. Comorbidity between mental disorders increased over the follow-up. Conclusions: This study demonstrates a high burden of mental disorders among a large Canadian military and veteran cohort. These findings underscore the importance of prevention and intervention strategies to reduce the burden of mental disorders and alcohol use disorders in these populations.

Objective: Knowledge is limited regarding the longitudinal course and predictors of mental health problems, suicide, and physical health outcomes among military and veterans. Statistics Canada, in collaboration with researchers at the University of Manitoba and an international team, conducted the Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey (CAFVMHS). Herein, we describe the rationale and methods of this important survey. Method: The CAFVMHS is a longitudinal survey design with 2 time points (2002 and 2018). Regular Force military personnel who participated in the first Canadian Community Health Survey Cycle 1.2—Mental Health and Well-Being, Canadian Forces Supplement (CCHS-CFS) in 2002 ( N = 5,155) were reinterviewed in 2018 ( n = 2,941). The World Mental Health Survey–Composite International Diagnostic Interview was used with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition ( DSM-IV) criteria. Results: The CAFVMHS includes 2,941 respondents (66% veterans; 34% active duty) and includes data on mental disorder diagnoses, physical health conditions, substance use, medication use, general health, mental health services, perceived need for care, social support, moral injury, deployment experiences, stress, physical activity, military-related sexual assault, childhood experiences, and military and sociodemographic information. Conclusions: The CAFVMHS provides a unique opportunity to further understand the health and well-being of military personnel in Canada over time to inform intervention and prevention strategies and improve outcomes. The data are available through the Statistics Canada Research Data Centres across Canada and can be used cross-sectionally or be longitudinally linked to the 2002 CCHS-CFS data.

IntroductionSex-based information on differences between Canadian veterans and the general population is important to understand veterans’ unique health needs and identify areas requiring further research. This study compared various health indicators in male and female veterans with their Canadian counterparts.MethodsHealth indicators for recent-era Regular Force veterans (released between 1998 and 2015) were obtained from the 2016 Life After Service Survey and compared with the general population in the 2015–16 Canadian Community Health Survey using a cross-sectional approach. Age-adjusted rates and 95% CIs were calculated for males and females separately.ResultsCompared with Canadians, veterans (both sexes) reported higher prevalence of fair or poor health and mental health, needing help with one or more activity of daily living, lifetime suicidal ideation and being diagnosed with mood and anxiety disorders, post-traumatic stress disorder, migraines, back problems, chronic pain, arthritis, ever having cancer, hearing problems, chronic pain and gastrointestinal problems. A higher prevalence of cardiovascular disease (all types) and high blood pressure was observed in male veterans compared with their Canadian counterparts. Within veterans only, males reported a higher prevalence of diagnosed hearing problems and cardiovascular disease compared with females; conversely females reported a higher prevalence of diagnosed migraines, mood, anxiety and gastrointestinal disorders, and needing help with activities of daily living. These sex differences are similar to the Canadian general population. Some similarities in reporting prevalence between male and female veterans (eg, fair or poor mental health, lifetime suicidal ideation, arthritis, asthma, lifetime cancer incidence, chronic pain and diabetes) were not observed in other Canadians.ConclusionMale and female veterans differed from comparable Canadians, and from each other, in various areas of health. Further research is needed to explore these findings, and veteran-based policies and services should consider sex differences.

Presumptive condition lists formally accept connections between military factors and veteran health conditions. An environmental scan of such lists and their evidentiary basis was conducted across four veterans' administrations to inform other administrations considering the development of such lists. Information on included conditions, qualifying military factors, and scientific processes was obtained through targeted internet searches and correspondence with veterans' administrations. The content of presumptive condition lists across jurisdictions varied by conditions included, as well as military eligibility requirements (e.g., service in particular conflict, context, or time period). Scientific review processes to develop lists also varied across jurisdictions. Findings indicate that evidence and experience may be leveraged across compensation systems (veteran and civilian). Ongoing research to understand links between military exposures and veteran health is recommended.

Herein we provide a living summary of the data generated during the COVID Moonshot project focused on the development of SARS-CoV-2 main protease (Mpro) inhibitors. Our approach uniquely combines crowdsourced medicinal chemistry insights with high throughput crystallography, exascale computational chemistry infrastructure for simulations, and machine learning in triaging designs and predicting synthetic routes. This manuscript describes our methodologies leading to both covalent and non-covalent inhibitors displaying protease IC50 values under 150 nM and viral inhibition under 5 uM in multiple different viral replication assays. Furthermore, we provide over 200 crystal structures of fragment-like and lead-like molecules in complex with the main protease. Over 1000 synthesized and ordered compounds are also reported with the corresponding activity in Mpro enzymatic assays using two different experimental setups. The data referenced in this document will be continually updated to reflect the current experimental progress of the COVID Moonshot project, and serves as a citable reference for ensuing publications. All of the generated data is open to other researchers who may find it of use.

Exposure assessment is an important factor in all epidemiological research seeking to identify, evaluate, and control health risks. In the military and veteran context, population health research to explore exposure-response links is complicated by the wide variety of environments and hazards encountered during active service, long latency periods, and a lack of information on exposures in potentially vulnerable subgroups. This paper summarizes some key considerations for exposure assessment in long-term health studies of military populations, including the identification of hazards related to military service, characterization of potentially exposed groups, exposure data collection, and assignment of exposures to estimate health risks. Opportunities and future directions for exposure assessment in this field are also discussed.

Kidney failure is frequently observed during and after COVID-19, but it remains elusive whether this is a direct effect of the virus. Here, we report that SARS-CoV-2 directly infects kidney cells and is associated with increased tubule-interstitial kidney fibrosis in patient autopsy samples. To study direct effects of the virus on the kidney independent of systemic effects of COVID-19, we infected human induced pluripotent stem cell-derived kidney organoids with SARS-CoV-2. Single cell RNA-sequencing indicated injury and dedifferentiation of infected cells with activation of pro-fibrotic signaling pathways. Importantly, SARS-CoV-2 infection also led to increased collagen 1 protein expression in organoids. A SARS-CoV-2 protease inhibitor was able to ameliorate the infection of kidney cells by SARS-CoV-2. Our results suggest that SARS-CoV-2 can directly infect kidney cells and induce cell injury with subsequent fibrosis. These data could explain both acute kidney injury in COVID-19 patients and the development of chronic kidney disease in Long-COVID., Graphical Abstract, Jansen, Reimer, Nagai et al report that SARS-CoV-2 infects kidney cells and is associated with kidney fibrosis in patients. Using single cell transcriptomics of infected kidney organoids, they show that SARS-CoV-2 causes kidney injury and stimulates pro-fibrotic signaling. Viral infection in organoids was inhibited by a recently developed protease blocker.

Introduction: In Canada, there are an estimated 700,000 Veterans of the Canadian military. Veterans are disproportionately prevalent in sub-populations of males, persons with chronic physical conditions, chronic pain, mental health conditions, and those with disabling activity limitations. Veterans are a population of interest to Canadian researchers, but there is no publicly available comprehensive list of Veterans in Canada. This creates a need for a standard set of screening questions suitable for self-report surveys. This article proposes a series of screening questions to identify Canadian Veterans. Methods: The content of the questions were developed considering self-identity, past Canadian surveys, legislation, and relevant characteristics of Canadian military service. Results: The recommended Canadian Veteran identifier questions are: “Have you ever had any Canadian military service? Was this service with the Regular Force? Reserve Force? Navy? Army? Air Force? Are you currently in the Canadian Armed Forces? What year were you released from the Canadian Armed Forces? What year did you join the Canadian Armed Forces?” Discussion: The consistent use of these screening questions allows for comparisons with other studies and will contribute to a better understanding of Veterans in Canada and of the transition from military to civilian life.

Introduction: The Survey on Transition to Civilian Life (STCL) was created to measure the adjustment outcomes of recently released Canadian Armed Forces (CAF) members. The survey was administered to a sample of CAF regular force members released from 1998 to 2007. The aim of the current study was to examine resources that promote the successful adjustment to civilian life. Specifically, the goal was to conduct a secondary analysis of the STCL that examined the roles of mastery and social environment (that is, community belonging and satisfaction with support) in the transition to civilian life, as well as how these variables correlate with health and life stress. Methods: The sample data were used to conduct Kendall's tau correlations. Prevalence estimates, 95 per cent confidence intervals, and ordinal logistic regressions were conducted using weighted data that accounted for the complex survey design to ensure findings were representative of the sampled veteran population. Results: Ordinal logistic regression results revealed that mastery, satisfaction with types of social support (friends and family), and a sense of community belonging acted as potential protective factors that were associated with easier adjustment to civilian life for Veterans with physical health conditions, mental health conditions, and higher levels of life stress. The first model showed that the odds of an easier adjustment were lower for those who were more stressed (adjusted odds ratio [AOR]=0.13), self-reported a physical health condition (AOR=0.53), and self-reported a mental health condition (AOR=0.23). The second model revealed that the odds of an easier adjustment were lower for those Veterans dissatisfied with their family relationships (AOR=0.42) and their relationships with friends (AOR=0.47) and those with a very weak sense of community belonging (AOR=0.39), and they were higher among those with high levels of mastery (AOR=3.93). Discussion: The results of this study point to the importance of personal characteristics and aspects of the social environment in the adjustment to civilian life among military veterans. As well, ensuring a successful adjustment to civilian life may lead to better outcomes, such as enhanced mastery, following transition.

Before the end of World War Two, many nations had implemented entitlements for veterans, such as disability pensions, health care, and vocational rehabilitation. However, the concept of disability has evolved since then, and some nations have modernized disability compensation. We examined how disability is assessed, how compensation is structured, and modern principles in designing and reforming veteran disability compensation for 11 nations through a survey, interviews with subject matter experts, and a literature review. While there are some similarities in these schemes, substantial differences were found in the components of the schemes and the context in which they operate. This makes best practices difficult to identify and limits the application of certain aspects of program design to other nations. As a result, this chapter presents five key interrelated guiding principles in designing effective compensation systems: adequacy of compensation for losses; program affordability; integration of rehabilitation; simplicity; and comprehensiveness as well as a description of modern concepts of disability. This provided a framework for developing five recommendations that can help guide nations without compensation schemes in their development and to guide reforms among nations with existing schemes.

Military-to-civilian transition (MCT) is a complex process that service members, veterans, and their families experience in different ways, and each country's unique history, culture, and institutions will shape how it addresses the needs of families undergoing MCT. Nonetheless, research on transitioning members and their families across NATO nations suggests that there are several essential components for a successful transition to civilian life. This chapter introduces an overarching MCT framework composed of the nine essential components for nations developing or enhancing the services and support they provide to service members returning to civilian life.

Most service members who leave the armed forces do well after the military-to-civilian transition. However, some veterans are less fortunate. They experience difficulties during their transition out of the military that result in impaired quality of life due to physical or psychological health problems, financial problems, relationship problems, homelessness, legal issues, difficulties in finding or keeping a new job, or adjusting to civilian culture. Despite support often being available, some veterans may be vulnerable for such unfavorable outcomes of the military-to-civilian transition because of their background, personal characteristics, experiences, specific circumstances, or the interplay of these factors. This chapter provides a literature review of factors that may contribute to a veteran's vulnerability and outlines a promising avenue to support vulnerable veterans.

Military-to-civilian transition (MCT) is a challenging process to some degree for all military members, veterans (former members), and their families. Some might need prompting to seek specialized MCT supports, while others might need reassurance that they will do well with usual services. This chapter describes a tool for self-assessing need to seek MCT support services. The tool comprises 12 well-being statements, two for each of six well-being domains: employment or other purposeful activity, finances, health, life skills and preparedness, social integration, and housing. Users score themselves into one of three categories for each statement: should be good to go (green), think about it (yellow), and consider seeking assistance (red). The tool can be adapted for various transition support systems and cultural contexts. The tool can be distributed in print or electronic media to serving members, veterans, family members, and others to promote timely decisions about seeking transition supports specific to their needs.

The Records of Early English Drama, founded in 1976, remains a productive humanities research project, with thirty-three volumes in print and two open access research and educational websites to date. This retrospective essay reflects on the individuals who contributed to its founding and evolution; the establishment of systematic research and editorial principles for an international team of contributors; the challenges of funding a collaborative enterprise with long term goals; some of its key contributions to the field of theatre history; and the transition from a print-based series to REED Online, a multi-faceted digital enterprise. In summary, while the re-envisioning of REED as an interoperable research and educational online resource represents a major shift in editorial and publication processes, the core values of the project remain intact: to work together in interdisciplinary collaboration with like-minded partners to deliver the results of systematic research in early theatre to as wide an audience as possible in the twenty-first century., Le Records of Early English Drama, fondé en 1976, consiste toujours en un projet fructueux de recherche en sciences humaines, totalisant à ce jour 33 volumes imprimés et deux sites web ouverts de recherche et d’éducation. Cet article rétrospectif se penche sur les personnes ayant contribué à sa fondation et son évolution, l’établissement d’une systématique de recherche et de principes éditoriaux à l’intention d’une équipe internationale de contributeurs, les défis de financer un projet collectif avec des objectifs à long terme, quelques unes de ses principales contributions dans le domaine de l’histoire du théâtre, et la transition d’une publication imprimée vers le format REED Online, un projet numérique polyvalent. En effet, bien que la transformation du projet en une ressource collaborative REED de recherche et d’enseignement en ligne représente un changement majeur dans les processus éditoriaux et de publication, les valeurs centrales du projet demeurent inchangées : le projet vise toujours la collaboration interdisciplinaire avec des partenaires ayant la même approche afin d’obtenir des résultats de recherche systématique en histoire du théâtre, et à les rendre disponibles à un public aussi large que possible en ce vingt-et-unième siècle.

In the past 15 years in Canada, as in other nations, the mental health of veterans has emerged as a key concern for both government and the public. As mental health service enhancement unfolded, the need for wider population studies became apparent. This paper describes the renewal of services and key findings from national surveys of serving personnel and veterans.

This article briefly outlines the history of the Records of Early English Drama (REED) Patrons and Performances website project. Its aim is to enable users to gain access to the complete picture of professional performance activities (drama, music, dance, acrobatics, animal acts, and what have you?) outside London before 1642. The article is designed as a guide to individual on-screen exploration of some of the capacities of the website; readers can follow step-by-step the guide to the site by reading the paper while logged onto the site and following one or another of the four major search paths offered on the home page, to search for information about Patrons, Events, Venues or Troupes. Readers can access the GIS map on-line to investigate playing routes, venues and other geographical details. As well one can search the Bibliography, carefully compiled to reveal the information sources used to assemble the data presented on the site.

OBJECTIVES: Suicide in recent veterans is an international concern. An association between mental disorders and suicide has been established, but less information is available about an association between physical health problems and suicide among veterans. This study extends this area of inquiry by examining the relationship of both physical and mental health problems with suicidal ideation in a representative national sample of Canadian veterans. METHODS: Subjects were a stratified random sample of 2,658 veterans who had been released from the Canadian Armed Forces Regular Force during 1998-2007 and had participated in the 2010 Survey on Transition to Civilian Life. Associations between physical and mental health and past-year suicidal ideation were explored in multivariable regression models using three measures of physical and mental health. RESULTS: The prevalence of suicidal ideation was 5.8% (95% confidence interval [CI]: 5.0%-6.8%). After adjustment for covariates, ideation was associated with gastrointestinal disorders (adjusted odds ratio [AOR] 1.66, CI: 1.03-2.65), depression or anxiety (AOR 5.06, CI: 2.97-8.62) and mood disorders (AOR 2.91, CI: 1.67-5.07); number of physical (AOR 1.22, CI: 1.05-1.42) and mental conditions (AOR 2.32, CI: 2.01-2.68); and SF-12 Health Survey physical health (AOR 0.98, CI: 0.96-0.99 for each 1 point increase) and mental health (AOR 0.88, CI: 0.87-0.89). CONCLUSIONS: Physical health was independently associated with suicidal ideation after adjustment for mental health status and socio-demographic characteristics. The findings underscore the importance of considering physical health in population-based suicide prevention efforts and in mitigating suicide risk in individual veterans.

Background Adjustment to civilian life in Canadian veterans after release from military service has not been well studied. Objectives The objectives of this study were: (1) to explore dimensions of postmilitary adjustment to civilian life and (2) to identify demographic and military service characteristics associated with difficult adjustment. Design Data were analyzed from a national sample of 3,154 veterans released from the regular Canadian Forces during 1998 to 2007 in a cross-sectional survey conducted in 2010 called the Survey on Transition to Civilian Life. Methods The prevalence of difficult adjustment to civilian life for selected characteristics was analyzed descriptively, and confidence intervals were calculated at the 95% level. Multivariable logistic regression analysis was used to identify characteristics available at the time of release that were associated with difficult adjustment. Results The prevalence of difficult adjustment to civilian life was 25%. Statistically significant differences were found across indicators of health, disability, and determinants of health. In multivariable regression, lower rank and medical, involuntary, mid-career, and Army release were associated with difficult adjustment, whereas sex, marital status, and number of deployments were not. Limitations Findings cannot be generalized to all veterans because many characteristics were self-reported, important characteristics may have been omitted, and causality and association among health, disability, and determinants of health characteristics could not be determined. Conclusions Postmilitary adjustment to civilian life appears to be multidimensional, suggesting the need for multidisciplinary collaboration between physical therapists and other service providers to mitigate difficult transition. Potential risk and protective factors were identified that can inform interventions, outreach strategies, and screening activities, as well as further research.

OBJECTIVES: Describe health-related quality of life (HRQoL) of former Canadian Forces (CF) men and women in uniform (Veterans) after transition to civilian life, and compare to age- and sex-adjusted Canadian norms. METHODS: The 2010 Survey on Transition to Civilian Life was a national computer-assisted telephone survey of CF Regular Force personnel who released during 1998-2007. HRQoL was assessed using the SF-12 Physical (PCS) and Mental (MCS) Component Summary scores. Descriptive analysis of HRQoL was conducted for socio-demographic, health, disability and determinants of health characteristics. RESULTS: Mean age was 46 years (range 20-67). Compared to age- and sex-adjusted Canadian averages, PCS (47.3) was low and MCS was similar (52.0). PCS and MCS were variably below average for middle age groups and lowest for non-commissioned ranks, widowed/divorced/separated, 10-19 years of service, physical and mental health conditions, disability, dissatisfaction with finances, seeking work/not working, low social support and difficulty adjusting to civilian life. Among Veterans Affairs Canada clients, 83% had below-average physical PCS, 49% had below-average MCS, and mean PCS (38.2) was significantly lower than mean MCS (48.3). CONCLUSIONS: HRQoL varied across a range of biopsychosocial factors, suggesting possible protective factors and vulnerable subgroups that may benefit from targeted interventions. These findings will be of interest to agencies supporting Veterans in transition to civilian life and to researchers developing hypotheses to better understand well-being in Canadian Veterans.

HE ACTING TROUPE OF ROBERT DUDLEY, EARL OF LEICESTER, was one of the most prominent of its time, receiving a royal patent in 1574 to act in London and anywhere else in England without restriction.' Two years after the patent was granted, one of its members, James Burbage, established a base for the company on the outskirts of London at the first public playhouse, called-appropriately enough-"the Theatre."2 As one of the premier Elizabethan companies, Leicester's Men have received their fair share of attention in published theater histories. Both E. K. Chambers and J. T. Murray have documented the troupe's provincial travels and court appearances, while T. W. Baldwin uses them as a basis for his discussion in The Organization and Personnel of the Shakespearean Company.3 However, no one has yet made a full search of all surviving Dudley family papers for information about the patron's relationship with his players and with other performers.4 My own interest in Leicester's Men derives from my chance discovery in 1986 of a long-forgotten Dudley household-account book preserved by the Evelyns, a family of local importance in the county of Surrey. The book covers the period 2 October 1584 to 30 June 1586 and forms part of a collection of Elizabethan state papers that once belonged to the seventeenth-century diarist John Evelyn. In Evelyn's own words, writing to William Wotton in 1703

In 2002, the Records of Early English Drama (REED) project marked its twenty-fifth anniversary with a special series of sessions at the International Medieval Congress at Leeds University. The REED sessions were designed to allow critical reflection on the past, present, and future of the project as it entered the twenty-first century. Thirteen essays amplifying the content of selected conference papers, and a fourteenth submitted at the editors' invitation, make up REED in Review . Contributors to the collection describe the conception and early years of REED, assess the project's impact on recent and current scholarship, and anticipate or propose stimulating new directions for future research. Individual essays address a wide variety of subjects, from the impact of REED research on Shakespeare textual editing, Robin Hood, patronage, and Elizabethan theatre studies, to a thought provoking redefinition of 'drama,' details of recent ground-breaking research in Scottish records, and the broadening possibilities for editorial and research relationships with information technology. The editors' introduction and a select bibliography, with commentary and a list of REED-related publications by editors and scholars from a variety of disciplines, make up the remainder of this landmark volume.