Supporting Successful Foster Care for Unaccompanied Minors and Young People: Key considerations.

The article focuses on foster care provision for unaccompanied minors. It outlines the importance attached to foster care in the international policy and practice arenas, where it tends to be viewed as the preferred method of care for unaccompanied minors. Drawing on the international literature, it discusses the reasons for this, namely the benefits of foster care, but also highlights the significant challenges posed for foster carers for this cohort, particularly given that they are caring for older teenagers whose ethnic and cultural backgrounds may differ significantly from that of their carers. The article explores ways in which successful foster care can be enhanced, highlighting the complexity of “matching” and the significance attached to “cultural matching” and the need for an appropriate training and support in their role so as to maximize the benefits for young people

Research Involving People of a Refugee Background:Considerations for Ethical Engagement

This paper is of relevance to both those considering carrying out research and those participating in it. It is based on discussions between three researchers of a non-refugee background and a small group of nine people of a refugee background living in Ireland and Scotland, all of whom have been involved in research in some way. The paper is divided into three sections outlining what should be considered before, during and after data has been collected from people of a refugee background.Irish Research CouncilUniversity College DublinFunded by the Irish Research Council and the Scottish Irish Migration Initiativ

shaping the deserving refugee insights from a local reception programme in belgium

The sudden increase of asylum applications in the aftermath of the 2015 "refugee crisis", has sparked the debate on the concept of "deservingness" in public discourse. Who deserves to enter into European territory? Who deserves to receive state-funded assistance? This article unpacks the notion of "deservingness" by analysing the rationalities of care underpinning a European-funded local support programme in Antwerp (Belgium). The programme offers special assistance to former unaccompanied minors, recognised as beneficiaries of legal protection, who have recently turned 18. By examining the categories, attitudes and perceptions shaping this local project, we show how the idea of "deservingness", a central notion in wider European discourses on refugee reception, is reproduced and critically implemented by local actors of refugee assistance. Drawing on focus group interviews with five municipal and civil society organizations, we untangle legal, moral and economic dimensions of deservingness and illustrate how these can overlap or contradict each other within stakeholders' perspectives. The analysis of the different stakeholders' perspectives about the assumed characteristics of this "new" category of refugees deserving special care shows the significance of stakeholders' respective organisational backgrounds. On a deeper level, ideas on deservingness reflect stakeholders' different aspirations about the kind of citizens young refugees should become. As such, this chapter contributes to deeper understanding of moralities and rationalities shaping public discourse and local reception of refugees in Europe. It also highlights the role of localities in shaping innovative policies and in the wider debate on refugee assistance

A prospective prostate cancer screening programme for men with pathogenic variants in mismatch repair genes (IMPACT): initial results from an international prospective study.

Funder: Victorian Cancer AgencyFunder: NIHR Manchester Biomedical Research CentreFunder: Cancer Research UKFunder: Cancer Council TasmaniaFunder: Instituto de Salud Carlos IIIFunder: Cancer AustraliaFunder: NIHR Oxford Biomedical Research CentreFunder: Fundación Científica de la Asociación Española Contra el CáncerFunder: Cancer Council South AustraliaFunder: Swedish Cancer SocietyFunder: NIHR Cambridge Biomedical Research CentreFunder: Institut Català de la SalutFunder: Cancer Council VictoriaFunder: Prostate Cancer Foundation of AustraliaFunder: National Institutes of HealthBACKGROUND: Lynch syndrome is a rare familial cancer syndrome caused by pathogenic variants in the mismatch repair genes MLH1, MSH2, MSH6, or PMS2, that cause predisposition to various cancers, predominantly colorectal and endometrial cancer. Data are emerging that pathogenic variants in mismatch repair genes increase the risk of early-onset aggressive prostate cancer. The IMPACT study is prospectively assessing prostate-specific antigen (PSA) screening in men with germline mismatch repair pathogenic variants. Here, we report the usefulness of PSA screening, prostate cancer incidence, and tumour characteristics after the first screening round in men with and without these germline pathogenic variants. METHODS: The IMPACT study is an international, prospective study. Men aged 40-69 years without a previous prostate cancer diagnosis and with a known germline pathogenic variant in the MLH1, MSH2, or MSH6 gene, and age-matched male controls who tested negative for a familial pathogenic variant in these genes were recruited from 34 genetic and urology clinics in eight countries, and underwent a baseline PSA screening. Men who had a PSA level higher than 3·0 ng/mL were offered a transrectal, ultrasound-guided, prostate biopsy and a histopathological analysis was done. All participants are undergoing a minimum of 5 years' annual screening. The primary endpoint was to determine the incidence, stage, and pathology of screening-detected prostate cancer in carriers of pathogenic variants compared with non-carrier controls. We used Fisher's exact test to compare the number of cases, cancer incidence, and positive predictive values of the PSA cutoff and biopsy between carriers and non-carriers and the differences between disease types (ie, cancer vs no cancer, clinically significant cancer vs no cancer). We assessed screening outcomes and tumour characteristics by pathogenic variant status. Here we present results from the first round of PSA screening in the IMPACT study. This study is registered with ClinicalTrials.gov, NCT00261456, and is now closed to accrual. FINDINGS: Between Sept 28, 2012, and March 1, 2020, 828 men were recruited (644 carriers of mismatch repair pathogenic variants [204 carriers of MLH1, 305 carriers of MSH2, and 135 carriers of MSH6] and 184 non-carrier controls [65 non-carriers of MLH1, 76 non-carriers of MSH2, and 43 non-carriers of MSH6]), and in order to boost the sample size for the non-carrier control groups, we randomly selected 134 non-carriers from the BRCA1 and BRCA2 cohort of the IMPACT study, who were included in all three non-carrier cohorts. Men were predominantly of European ancestry (899 [93%] of 953 with available data), with a mean age of 52·8 years (SD 8·3). Within the first screening round, 56 (6%) men had a PSA concentration of more than 3·0 ng/mL and 35 (4%) biopsies were done. The overall incidence of prostate cancer was 1·9% (18 of 962; 95% CI 1·1-2·9). The incidence among MSH2 carriers was 4·3% (13 of 305; 95% CI 2·3-7·2), MSH2 non-carrier controls was 0·5% (one of 210; 0·0-2·6), MSH6 carriers was 3·0% (four of 135; 0·8-7·4), and none were detected among the MLH1 carriers, MLH1 non-carrier controls, and MSH6 non-carrier controls. Prostate cancer incidence, using a PSA threshold of higher than 3·0 ng/mL, was higher in MSH2 carriers than in MSH2 non-carrier controls (4·3% vs 0·5%; p=0·011) and MSH6 carriers than MSH6 non-carrier controls (3·0% vs 0%; p=0·034). The overall positive predictive value of biopsy using a PSA threshold of 3·0 ng/mL was 51·4% (95% CI 34·0-68·6), and the overall positive predictive value of a PSA threshold of 3·0 ng/mL was 32·1% (20·3-46·0). INTERPRETATION: After the first screening round, carriers of MSH2 and MSH6 pathogenic variants had a higher incidence of prostate cancer compared with age-matched non-carrier controls. These findings support the use of targeted PSA screening in these men to identify those with clinically significant prostate cancer. Further annual screening rounds will need to confirm these findings. FUNDING: Cancer Research UK, The Ronald and Rita McAulay Foundation, the National Institute for Health Research support to Biomedical Research Centres (The Institute of Cancer Research and Royal Marsden NHS Foundation Trust; Oxford; Manchester and the Cambridge Clinical Research Centre), Mr and Mrs Jack Baker, the Cancer Council of Tasmania, Cancer Australia, Prostate Cancer Foundation of Australia, Cancer Council of Victoria, Cancer Council of South Australia, the Victorian Cancer Agency, Cancer Australia, Prostate Cancer Foundation of Australia, Asociación Española Contra el Cáncer (AECC), the Instituto de Salud Carlos III, Fondo Europeo de Desarrollo Regional (FEDER), the Institut Català de la Salut, Autonomous Government of Catalonia, Fundação para a Ciência e a Tecnologia, National Institutes of Health National Cancer Institute, Swedish Cancer Society, General Hospital in Malmö Foundation for Combating Cancer

The BARCODE1 Pilot: a feasibility study of using germline single nucleotide polymorphisms to target prostate cancer screening

Funder: FP7 Ideas: European Research Council; Id: http://dx.doi.org/10.13039/100011199; Grant(s): ERC‐2013‐AdG‐339208Objectives: To assess the feasibility and uptake of a community‐based prostate cancer (PCa) screening programme selecting men according to their genetic risk of PCa. To assess the uptake of PCa screening investigations by men invited for screening. The uptake of the pilot study would guide the opening of the larger BARCODE1 study recruiting 5000 men. Subjects and Methods: Healthy males aged 55–69 years were invited to participate via their general practitioners (GPs). Saliva samples were collected via mailed collection kits. After DNA extraction, genotyping was conducted using a study specific assay. Genetic risk was based on genotyping 130 germline PCa risk single nucleotide polymorphisms (SNPs). A polygenic risk score (PRS) was calculated for each participant using the sum of weighted alleles for 130 SNPs. Study participants with a PRS lying above the 90th centile value were invited for PCa screening by prostate magnetic resonance imaging (MRI) and biopsy. Results: Invitation letters were sent to 1434 men. The overall study uptake was 26% (375/1436) and 87% of responders were eligible for study entry. DNA genotyping data were available for 297 men and 25 were invited for screening. After exclusions due to medical comorbidity/invitations declined, 18 of 25 men (72%) underwent MRI and biopsy of the prostate. There were seven diagnoses of PCa (38.9%). All cancers were low‐risk and were managed with active surveillance. Conclusion: The BARCODE1 Pilot has shown this community study in the UK to be feasible, with an overall uptake of 26%. The main BARCODE1 study is now open and will recruit 5000 men. The results of BARCODE1 will be important in defining the role of genetic profiling in targeted PCa population screening. Patient Summary: What is the paper about?: Very few prostate cancer screening programmes currently exist anywhere in the world. Our pilot study investigated if men in the UK would find it acceptable to have a genetic test based on a saliva sample to examine their risk of prostate cancer development. This test would guide whether men are offered prostate cancer screening tests. What does it mean for patients?: We found that the study design was acceptable: 26% of men invited to take part agreed to have the test. The majority of men who were found to have an increased genetic risk of prostate cancer underwent further tests offered (prostate MRI scan and biopsy). We have now expanded the study to enrol 5000 men. The BARCODE1 study will be important in examining whether this approach could be used for large‐scale population prostate cancer screening

Safe Haven: The Needs of Refugee Children Arriving in Ireland Through the Irish Refugee Protection Programme: An Exploratory Study

Ireland has rightly promised to provide support for people fleeing war and persecution through the Irish Refugee Protection Programme. By June 2019, 2,519 people had been relocated or resettled in Ireland under this programme. At the time of our study, around half of the people who arrived in Ireland were children under 18. The report is a scoping study on the needs of children and young people coming to Ireland under the International Refugee Programme.Children's Rights Allianc

Invisible People: The Integration Support Needs of Refugee Families Reunified in Ireland

The separation of families when people flee persecution and conflict can have devastating consequences on family members’ wellbeing and their ability to rebuild their lives. One of the key themes that emerges from the testimonies set out in this report is how family unity is for many a primary dimension of the refugee experience and one which can continue to have a profound effect on the lives of refugees far beyond the recognition of status. UNHCR believes that refugees must be at the centre of decision-making concerning their protection and well-being. In order to gain a deeper understanding of the protection problems they face, it is essential to consult them directly and to listen to them. As such, participatory assessment forms the basis for the implementation of a rights and community-based approach. When Nasc invited me to join the Steering Committee for this report, I was therefore delighted to accept and to support this important research which, by design, places the voices of refugees at the heart of its works.The Migrant and Refugee Rights CentreIrish Human Rights and Equality Grants Schem