21 Grams

This is a review of 21 Grams (2003)

A Sign From God

This is a review of A Sign From God (2000)

Report from Sundance 2003: Religion in Independent Film

This is the report from the Sundance Film Festival 2003

Consent, Ebola, and the fine line between collaboration and exploitation in research conducted during public health emergencies

AUTHOR AFFILIATION: Elysée Nouvet, Western University School of Health Studies, London, Ontario and McMaster, Canada, [email protected]: There is significant and growing scholarship attending to the experiences and motivations of clinical Tx trial participants in Low and Middle Income Countries (LMICs). A smaller and newer body of research is emerging around perceptions and experiences of research conducted during public health emergencies. This presentation is based on one such Research on Research (RoR) study, the R2HC-funded qualitative study "Perceptions and moral experiences of research conducted during the 2014-16 West Africa Ebola outbreak." Objective: This presentation takes West Africans' first-hand accounts of decisions to support or enroll in EVD research as a point of departure for troubling normative parameters and markers of "consent to research". Methodology: Content for this presentation is based on team-based analysis of semi-structured interviews (N=99) with West African EVD study participants, members of research ethics boards, researchers, trial staff, and community leaders. Findings: Our interviews revealed diverse motivations and aspirations or participating or supporting trials, as well as some frustrations around limited options for engagement and impact. A number of researchers with whom we spoke experienced their decisions to "collaborate" on trials as coerced. Others – participants and community leaders – evidently embraced opportunities to enroll in and/or support trials, but simultaneously connected their voluntariness to conviction of their participation's impact on lives, to understandings of collective ownership over bio-samples, and/or to hopes for new political subjectivities. Mismatch between consent to trials (where consent includes both enrollment in or collaboration with) and the loaded significances of that consent for many with whom we spoke indicate a need for more localized and critical attention to the logics and significances of consent to research in particular humanitarian emergencies. Conclusion: Upholding ideals of free and informed consent to research in contexts such as ETCs, where those approached for research are sick, distressed, and quarantined, is never going to be easy. What our research flags is that the complexities of consent during the West Africa EVD epidemic extended beyond the walls of the ETC and beyond infected patients. This in turn supports broadening what normally gets included in discussion of and strategies to uphold consent and voluntariness in humanitarian heath emergency research

The application of drones in healthcare and health-related services in north america: A scoping review

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Using drone aircraft to deliver healthcare and other health-related services is a relatively new application of this technology in North America. For health service providers, drones represent a feasible means to increase their efficiency and ability to provide services to individuals, especially those in difficult to reach locations. This paper presents the results of a scoping review of the research literature to determine how drones are used for healthcare and health-related services in North America, and how such applications account for human operating and machine design factors. Data were collected from PubMed, CINAHL, Scopus, Web of Science, and IEEE Xplore using a block search protocol that combined 13 synonyms for “drone” and eight broad terms capturing healthcare and health-related services. Four-thousand-six-hundred-and-sixty-five documents were retrieved, and following a title, abstract, and full-text screening procedure completed by all authors, 29 documents were retained for analysis through an inductive coding process. Overall, findings indicate that drones may represent a financially feasible means to promote healthcare and health-related service accessibility for those in difficult-to-reach areas; however, further work is required to fully understand the costs to healthcare organizations and the communities they serve

Context-specific challenges, opportunities, and ethics of drones for healthcare delivery in the eyes of program managers and field staff: A multi-site qualitative study

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Unmanned aerial vehicles (UAVs), also known as drones, have significant potential in the healthcare field. Ethical and practical concerns, challenges, and complexities of using drones for specific and diverse healthcare purposes have been minimally explored to date. This paper aims to document and advance awareness of diverse context-specific concerns, challenges, and complexities encountered by individuals working on the front lines of drones for health. It draws on original qualitative research and data from semi-structured interviews (N = 16) with drones for health program managers and field staff in nine countries. Directed thematic analysis was used to analyze interviews and identify key ethical and practical concerns, challenges, and complexities experienced by participants in their work with drones for health projects. While some concerns, challenges, and complexities described by study participants were more technical in nature, for example, those related to drone technology and approval processes, the majority were not. The bulk of context-specific concerns and challenges identified by participants, we propose, could be mitigated through community engagement initiatives

Women\u27s freedom of movement and participation in psychosocial support groups: Qualitative study in northern India

© 2019 The Author(s). Background: Depression, the world\u27s leading cause of disability, disproportionately affects women. Women in India, one of the most gender unequal countries worldwide, face systemic gender disadvantage that significantly increases the risk of common mental disorders. This study\u27s objective was to examine the factors influencing women\u27s participation in psychosocial support groups, within an approach where community members work together to collectively strengthen their community\u27s mental health. Methods: This community-based qualitative study was conducted from May to July 2016, across three peri-urban sites in Dehradun district, Uttarakhand, Northern India. Set within an NGO-run mental health project, data were collected through focus group discussions with individuals involved in psychosocial support groups including women with psychosocial disabilities as well as caregivers (N = 10, representing 59 women), and key informant interviews (N = 8) with community members and mental health professionals. Data were analyzed using a thematic analysis approach. Results: The principal barrier to participating in psychosocial support groups was restrictions on women\u27s freedom of movement. Women in the community are not normally permitted to leave home, unless going to market or work, making it difficult for women to leave their home to participate in the groups. The restrictions emanated from the overall community\u27s attitude toward gender relations, the women\u27s own internalized gender expectations, and most significantly, the decision-making power of husbands and mothers-in-law. Other factors including employment and education shaped women\u27s ability to participate in psychosocial support groups; however, the role of these additional factors must be understood in connection to a gender order limiting women\u27s freedom of movement. Conclusions: Mental health access and gender inequality are inseparable in the context of Northern India, and women\u27s mental health cannot be addressed without first addressing underlying gender relations. Community-based mental health programs are an effective tool and can be used to strengthen communities collectively; however, attention towards the gender constraints that restrict women\u27s freedom of movement and their ability to access care is required. To our knowledge, this is the first study to clearly document and analyze the connection between access to community mental health services in South Asia and women\u27s freedom of movement

Positioning ourselves within global health equity goals and landscapes

Twenty years ago, I decided to return to academia after a 2004 visit to Nicaragua, Central America. I was working in documentary film production. I had gotten a small grant to develop a scenario on water privatization. I travelled the country speaking to families and community leaders about unaffordable public water, contaminated well-water from the agricultural industry, and indigenous communal land under threat from a dam project. As I observed casual greetings between neighbours and acquaintances (often in more impoverished neighborhoods or encampments), I was struck by how often the answer to the question “How are things?” would be: “Bad!” (Malo!). Such statements would sometimes lead to vague descriptions of “the situation” (in the country) or specifics: about the buying power of a cordoba (the currency); the theft of a water barrel in the night; too much rain ruining belongings or bringing illnesses; diabetes, back pain, eye problems, toothaches

Barriers to supportive care during the Ebola virus disease outbreak in West Africa: Results of a qualitative study

© 2018 Loignon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background During the 2013–2016 West Africa Ebola outbreak, supportive care was the only non-experimental treatment option for patients with Ebola virus disease (EVD). However, providing care that would otherwise be routine for most clinical settings in the context of a highly contagious and lethal pathogen is much more challenging. The objective of this study was to document and deepen understanding of barriers to provision of supportive care in Ebola treatment units (ETUs) as perceived by those involved in care delivery during the outbreak. Methods This qualitative study consisted of 29 in-depth semi-structured interviews with stakeholders (decision-makers, physicians, nurses) involved in patient care delivery during the outbreak. Analysis consisted of interview debriefing and team-based transcript coding in NVivo10 software using thematic analysis. Findings Participants emphasized three interconnected barriers to providing high-quality supportive care during the outbreak: 1) lack of material and human resources in ETUs; 2) ETU organizational structure limiting the provision of supportive clinical care; and 3) delayed and poorly coordinated policies limiting the effectiveness of global and national responses. Participants also noted the ethical complexities of defining and enacting best clinical practices in low-income countries. They noted tension between, on one hand, scaling up minimal care and investing in clinical care preparedness to a level sustainable in West Africa and, on the other, providing a higher level of supportive care, which in low-resource health systems would require important investments. Conclusion Our findings identified potentially modifiable barriers to the delivery of supportive care to patients with EVD in West Africa. Addressing these in the inter-outbreak period will be useful to improve patient care and outcomes during inevitable future outbreaks. Promoting community trust and engagement through long-term capacity building of the healthcare workforce and infrastructure would increase both health system resilience and ability to handle other outbreaks of emerging diseases