Most importantly, I hope God keeps illness away from us : The context and challenges surrounding access to health care for Syrian refugees in Lebanon

The influx of 1.5 million Syrians into Lebanon has created an increased demand for health services, which is largely unmet, due to cost, a highly fragmented and privatised system, and crises around legal documentation and refugee status. The aim of this study was to use a constant comparison analysis of qualitative data to explore how Syrian refugees living in Lebanon describe their experiences accessing healthcare (N = 351 individuals within 46 families). Pervasive fear, lack of confidence in the medical system, and high costs all hinder access to healthcare for Syrians in Lebanon. Findings demonstrate the need for attention to the costs and accessibility of care, and for stronger coordination of care within a centrally led comprehensive emergency plan. While we attend to understanding and alleviating the barriers surrounding refugee healthcare, we must also address the underlying cause of health crisis: the brutal realities caused by armed conflict

Most importantly, I hope God keeps illness away from us : The context and challenges surrounding access to health care for Syrian refugees in Lebanon

The influx of 1.5 million Syrians into Lebanon has created an increased demand for health services, which is largely unmet, due to cost, a highly fragmented and privatised system, and crises around legal documentation and refugee status. The aim of this study was to use a constant comparison analysis of qualitative data to explore how Syrian refugees living in Lebanon describe their experiences accessing healthcare (N = 351 individuals within 46 families). Pervasive fear, lack of confidence in the medical system, and high costs all hinder access to healthcare for Syrians in Lebanon. Findings demonstrate the need for attention to the costs and accessibility of care, and for stronger coordination of care within a centrally led comprehensive emergency plan. While we attend to understanding and alleviating the barriers surrounding refugee healthcare, we must also address the underlying cause of health crisis: the brutal realities caused by armed conflict

Inclusive early childhood education : an analysis of 32 European examples

This report is part of the three-year Inclusive Early Childhood Education (IECE) project run by the European Agency for Special Needs and Inclusive Education (the Agency) from 2015 to 2017. The project aims to identify, analyse and subsequently promote the main characteristics of quality inclusive pre-primary education for all children from three years of age to the start of primary education. This report presents the results of a qualitative analysis of 32 descriptions of examples of IECE provisions across Europe. The descriptions were submitted to the project in August 2015. The findings represent European practitioners’ perceptions of and practices for IECE. An inductive thematic data analysis method was used, in that themes or issues were initially derived from reading the descriptions. This inductive process was, however, also intertwined with relevant theory, particularly the Agency’s ‘ultimate vision for inclusive education systems’ that: ... ensure that all learners of any age are provided with meaningful, high‐quality educational opportunities in their local community, alongside their friends and peers(European Agency, 2015, p. 1). In total, 25 subthemes were identified. These were organised into a new Ecosystem Model of Inclusive Early Childhood Education, which is also presented in a comprehensive diagram (Figure 1). Two major perspectives previously used in describing the quality of ECE settings inspired this new model. These are the Outcome-Process-Structure model and the Ecological Systems model. The subthemes were subsequently grouped into five main themes: • Theme 1: The first main and central theme is ‘Child belongingness, engagement and learning’, often generally understood as active participation. This participation is regarded as both the main outcome and process of IECE. • Theme 2: Five major processesinvolving the child’s direct experience in the IECE setting enable this central outcome and process. These processes are: − Positive interaction with adults and peers − Involvement in play and other daily activities − A child-centred approach − Personalised assessment for learning − Accommodations, adaptations and support. • Theme 3: These processes are in turn supported by structural factors, consisting of the physical, social, cultural and educational environment. These factors may operate at different ecological levels. Some operate within the ECE setting and include: − A warm welcome for every child and family − Family involvement within the ECE setting. − A holistic curriculum designed for all children’s needs − An environment designed for all children − Staff who are appropriately qualified for IECE − A culturally-responsive social and physical environment − Inclusive leadership committed to respect and engagement for all individuals − Collaboration and shared responsibility among all stakeholders. • Theme 4: Inclusive processes experienced by the child are also influenced by more distant structural factors in the community surrounding the ECE setting. These include: − Collaboration between the ECE setting and the children’s families − Relevant in-service training for ECE staff − Wider community commitment and support for serving all children − Inter-disciplinary and inter-agency co-operation of services from outside the ECE setting that serve the children in the pre-school − Organising smooth transitions between home and the ECE setting. • Theme 5: Finally, the analysis found a number of structural factors operating at the macro-system level. These factors were not in direct contact with the ECE setting. However, they still influenced inclusive processes in the setting. They are: − A rights-based approach to ECE − Provision of mainstream ECE access for all − Setting up regional/national standards for a holistic IECE curriculum − Availability of initial education for teachers and other staff for IECE − Good governance and funding systems for IECE − Procedures for regular monitoring and evaluation. This overview of the ecosystem of outcomes, processes and structures for IECE is presented in the Results chapter. Five evidence-based chapters, dedicated to each of the five main themes, follow this. Each chapter presents a brief description of each of the outcome, process or structural factors within each main theme. These are accompanied by one to five quotations from each of the 32 example descriptions. The quotations illustrate and provide concrete evidence of what constitutes quality outcomes, processes and structures that are prevalent across Europe. The quotations were chosen both to reflect the different types of IECE concepts and practices, and to reflect the variety of countries and cultures where they occur. They are intended to stimulate inclusive developments in research, policy and practice in Europe and internationally. Finally, the Conclusion highlights the added value that this analysis contributes to IECE research, policy and practice. Four new insights are addressed: 1. The development of the new Ecosystem Model of IECE, inspired by two previous major models, should clarify the understanding of the issues related to quality ECE. 2. The analysis shows how, within an inclusive perspective, IECE’s primary goal is best conceived as that of ensuring quality outcomes for all children in terms of participation. This is described here as belongingness, engagement and learning. 3. The analysis shines a new light on the major processes in which children are directly involved and which mostinfluence each child’s participation and learning. These need to be a major focus of any intervention to improve ECE quality. 4. The analysis clarifies the structural factors needed to support the development of more inclusive ECE settings. It also shows how these factors are related to local and national policies and practices. Situating the structures at the ECE setting, community and regional/national levels isimportant in levering them to bring about the changes needed to enable each child to participate and learn.peer-reviewe

Cardiovascular and cancer mortality in relation to dietary polychlorinated biphenyls and marine polyunsaturated fatty acids: A nutritional-toxicological aspect of fish consumption

Background. Co-exposure to environmental contaminants present in fish could mitigate the beneficial effects of fish consumption and possibly explain the lack of association observed for mortality in some geographical regions. Objective. To assess the independent associations of dietary exposure to polychlorinated biphenyls (PCBs) and long-chain omega-3 fish fatty acids intake with cardiovascular and cancer mortality. Methods. We used the prospective population-based Swedish Mammography Cohort and the Cohort of Swedish Men comprising 32 952 women and 36 545 men, free from cancer, cardiovascular disease and diabetes at baseline in 1998. Validated estimates of dietary PCBs and long-chain omega-3 fish fatty acids [i.e. eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] intake were obtained via a food frequency questionnaire at baseline. Information on death was ascertained through register linkage. Results. During a mean follow-up of 15.5 years, we ascertained 16 776 deaths. We observed for cardiovascular mortality, comparing extreme quintiles in multivariable models mutually adjusted for PCBs and EPA-DHA, dose-dependent associations for dietary PCB exposure, hazard ratio (HR) 1.31 (CI 95%: 1.08 to 1.57; P-trend 0.005) and for dietary EPA-DHA intake, HR 0.79 (CI 95%: 0.66 to 0.95; P-trend 0.041). For cancer mortality, no clear associations were discerned. Conclusion. The beneficial effect of fish consumption on the cardiovascular system seems compromised by co-exposure to PCBs – one likely explanation for the inconsistent associations observed between fish consumption and mortalityThe Swedish Research Council under the grant no 2017-00822 and 2017-00644 (SIMPLER) supported the stud

Control Performance Optimization for Application Integration on Automotive Architectures

Automotive software implements different functionalities as multiple control applications sharing common platform resources. Although such applications are often developed independently, the control performance of the resulting system depends on how these applications are integrated. A key integration challenge is to efficiently schedule these applications on shared resources with minimal control performance degradation. We formulate this problem as that of scheduling multiple distributed periodic control tasks that communicate via messages with non-zero jitter. The optimization criterion used is a piecewise linear representation of the control performance degradation as a function of the end-to-end latency of the application. The three main contributions of this article are: 1) a constraint programming (CP) formulation to solve this integration problem optimally on time-triggered architectures; 2) an efficient heuristic called Flexi ; and 3) an experimental evaluation of the scalability and efficiency of the proposed approaches. In contrast to the CP formulation, which for many real-life problems might have unacceptably long running times, Flexireturns nearly optimal results (0.5 percent loss in control performance compared to optimal) for most problems with more acceptable running times

Transverse Momentum Spectra of Pions in Particle and Nuclear Collisions and Some Ratio-Behaviours: Towards A Combinational Approach

The nature of transverse momentum dependence of the inclusive cross-sections for secondary pions produced in high energy hadronic($PP$), hadronuclear($PA$) and nuclear($AA$) collisions has here been exhaustively investigated for a varied range of interactions in a unified way with the help of a master formula. This formula evolved from a new combination of the basic Hagedorn's model for particle(pion) production in PP scattering at ISR range of energies, a phenomenological approach proposed by Peitzmann for converting the results of $NN(PP)$ reactions to those for either $PA$ or $AA$ collisions, and a specific form of parametrization for mass number-dependence of the nuclear cross sections. This grand combination of models(GCM) is then applied to analyse the assorted extensive data on various high energy collisions. The nature of qualitative agreement between measurements and calculations on both the inclusive cross-sections for production of pions, and some ratios of them as well, is quite satisfactory. The modest successes that we achieve here in dealing with the massive data-sets are somewhat encouraging in view of the diversity of the reactions and the very wide range of interaction energies.Comment: 19 pages, 19 figure

Measuring Double Parton Distributions in Nucleons at Proton-Nucleus Colliders

We predict a strong enhancement of multijet production in proton-nucleus collisions at collider energies, as compared to a naive expectation of a cross section $\propto A$. The study of the process would allow to measure, for the first time, the double parton distribution functions in a nucleon in a model independent way and hence to study both the longitudinal and the transverse correlations of partons.Comment: 12 pages, 2 figure

QCD corrections to the t-->H+b decay within the minimal supersymmetric standard model

I present the contribution of gluinos and scalar quarks to the decay rate of the top quark into a charged Higgs boson and a bottom quark within the minimal supersymmetric standard model, including the mixing of the scalar partners of the left- and right-handed top quark. I show that for certain values of the supersymmetric parameters the standard QCD loop corrections to this decay mode are diminished or enhanced by several 10 per cent. I show that not only a small value of 3 GeV for the gluino mass (small mass window) but also much larger values of several hundreds of GeV's have a non-neglible effect on this decay rate, against general belief. Last but not least, if the ratio of the vacuum expectation values of the Higgs bosons are taken in the limit of $v_1\ll v_2$ I obtain a drastic enhancement due to a $\tan\beta$\ dependence in the couplings.Comment: UQAM-PHE-94/01, 6 pages, plain tex, 4 figures not included, available under request via mail or fa

Inclusive early childhood education new insights and tools – contributions from a European study

Quality in early childhood education is a prominent concern for policy-makers, and has recently become a priority concern for many international and European organisations. These include the OECD, UNESCO, UNICEF, the European Commission, Eurydice and the European Agency for Special Needs and Inclusive Education, among others. Over the past three years (2015–2017), the European Agency for Special Needs and Inclusive Education (the Agency) has examined the latest policy documents and relevant research in this field. This has been a springboard for exploring the main characteristics of quality inclusive early childhood education (IECE) for all children from three years of age to the start of primary education. The project data from across Europe has provided an opportunity to closely examine how, within the inclusion perspective, early childhood education provisions are addressing the quality principles set out by the European Commission and the OECD. Sixty-four inclusive early childhood education experts from across Europe contributed to the project. They participated in data collection and analysis through descriptions of example provisions, as well as observations and discussions during field work and case study visits. This report first sets out the main policy and practice developments towards inclusive early childhood education, with particular reference to European policy issues (Chapters 2–3). It then presents the project’s three new contributions towards improving quality inclusive early childhood education (Chapters 4–6). These are: 1. A clear rationale for and an analysis of the implications of adopting an inclusive vision and goals as the main standards of inclusive early childhood policy and provision. The project found that high-quality services that benefited all children were guided by an inclusive vision and worked towards inclusive goals. As their primary outcome, they sought to ensure each child’s belongingness, engagement and learning. This reflects the changes in early childhood intervention in recent decades. The focus has shifted from ‘working with the child’ towards a holistic approach that creates an inclusive environment for all children’s engagement and learning. The report thus refers to quality early childhood education (ECE) as ‘inclusive early childhood education’ (IECE). It only uses the terms ‘early childhood education’ (ECE) or ‘early childhood education and care’ (ECEC) when referring to the literature. 2. A new Self-Reflection Tool for improving inclusive early childhood education settings. This enables practitioners to review their service’s quality in terms of the inclusiveness of the physical, social and other learning environments it offers to children and families. The tool has been validated by project experts and additional ecological studies. It is ready for use by practitioners in inclusive early childhood education settings in different education systems and countries across Europe and beyond. 3. A new Ecosystem Model of Inclusive Early Childhood Education for policy-makers and other stakeholders wishing to collaborate towards effective action in this field. This model can support policy-makers and practitioners to collaborate in planning, reviewing and improving quality IECE services. The model is founded on the project data. It is inspired by three major frameworks for quality IECE, namely: (1) The structure-process-outcome framework used by European and international policy-makers (European Commission, 2014; OECD, 2015; European Agency, 2009) (2) The ecological systems framework (Bronfenbrenner and Morris, 2006) (3) The inclusive education perspective (European Agency, 2015). It incorporates all the principles of the EU and OECD frameworks for quality early childhood education. However, it enhances their applicability by locating them at different ecological levels (inclusive early childhood education setting, home/community and regional/national levels). Finally, the report gives an account of the lessons learned during the three-year project and the resulting recommendations (Chapter 7). These are presented within the framework of the new Ecosystem Model of IECE. They are mainly directed at policy- makers, but they also point to the implications for practitioners. Indeed, they are formulated in terms of how policy-makers can support practitioners to ensure quality provisions.peer-reviewe

"So the World Will Know Our Story": Ethical Reflections on Research with Families Displaced by War

In this article we examine the ethical implications of a qualitative research study exploring the everyday mobilities of Syrian families displaced in Lebanon. The multiple methods of data collection - collaborative family interviews, children's drawing and mapmaking, GIS-tracked neighborhood walks, and activity logging - encouraged children and family voices. At the same time, these methods provide an opportunity to explore family networks, relationships, and environments that are impacting their lives in the context of war and displacement. These methods, like all research with vulnerable populations, also raise several ethical questions. Using a process of ethical reflexivity, we discuss six ethical points related to both procedural and micro-ethics. In addition to shedding light on the importance of uncovering the everyday experiences of refugees using creative methods, we suggest broader ethical implications regarding how we respectfully work with vulnerable populations while still upholding research integrity.In diesem Beitrag befassen wir uns mit den ethischen Implikationen einer qualitativen Studie zu Mobilität im Alltag von syrischen Familien, die angesichts des Krieges in Syrien in den Libanon geflohen sind. Die Daten wurden mit verschiedenen Methoden erhoben - mit kollaborativen Familieninterviews, Zeichnungen und Karten von Kindern, GIS-unterstützten Spaziergängen sowie einem Logbuch für Aktivitäten - wodurch insbesondere die Teilnahme von Kindern und Familien ermöglicht wurde. Diese Methoden erlaubten es, familiäre Netzwerke und Beziehungen zu untersuchen und auch die Umwelten zu erfassen, die auf das Leben der Familien nach Krieg und Flucht einwirken. Unser Vorgehen, wie im Grunde jede Erforschung von vulnerablen Gruppen, war von ethischen Fragen begleitet. Auf Basis eines ethischen Reflexionsprozesses diskutieren wir in diesem Beitrag sechs Punkte, die sowohl mit Fragen der prozeduralen Ethik als auch mit Fragen der Mikro-Ethik verbunden sind. Dabei unterstreichen wir die Bedeutung von kreativen Forschungsmethoden, die es erlauben, alltägliche Erfahrungen von geflüchteten Familien zu erfassen. Darüber hinaus besprechen wir weiter gefasste ethische Implikationen, insbesondere wie sich eine respektvolle Arbeit mit vulnerablen Bevölkerungsgruppen mit einer Gewährleistung der Integrität als Forschende verbinden lässt