A case analysis of partnered research on palliative care for refugees in Jordan and Rwanda

© 2021, The Author(s). Background: This case analysis describes dilemmas and challenges of ethical partnering encountered in the process of conducting a research study that explored moral and practical dimensions of palliative care in humanitarian crisis settings. Two contexts are the focus of this case analysis: Jordan, an acute conflict-induced refugee situation, and Rwanda, a protracted conflict-induced refugee setting. The study’s main goal was to better understand ways humanitarian organizations and health care providers might best support ethically and contextually appropriate palliative care in humanitarian contexts. An unintended outcome of the research was learning lessons about ethical dimensions of transnational research partnerships, which is the focus of this case analysis. Discussion: There exist ongoing challenges for international collaborative research in humanitarian conflict-induced settings. Research partnerships were crucial for connecting with key stakeholders associated with the full study (e.g., refugees with life limiting illness, local healthcare providers, aid organization representatives). While important relationships were established, obstacles limited our abilities to fully attain the type of mutual partnership we aimed for. Unique challenges faced during the research included: (a) building, nurturing and sustaining respectful and equitable research partnerships between collaborators in contexts of cultural difference and global inequality; (b) appropriate ethics review and challenges of responding to local decision-maker’s research needs; and (c) equity and fairness towards vulnerable populations. Research strategies were adapted and applied to respond to these challenges with a specific focus on (d) research rewards and restitution. Conclusions: This case analysis sheds light on the importance of understanding cultural norms in all research roles, building relationships with decision makers, and developing teams that include researchers from within humanitarian crisis settings to ensure that mutually beneficial research outcomes are ethical as well as culturally and contextually relevant

Analysis of the effect of renewable generation on the power quality of the grid, modelling and analysis of harmonic and voltage distortion

Thesis (Master of Engineering in Electrical Engineering)--Cape Peninsula University of Technology, 2018.As the electric energy demand grows, there is a significant increase in the penetration of renewable generation (RG) in the existing electrical grid network. Interconnecting of renewable generation technologies to an existing distribution system has proven to provide various benefits such as meeting the growing load demand and its contribution to energy system decarbonisation, long-term energy security and expansion of energy access to new energy consumers in the developing urban and rural areas. However, the aim of this thesis is to conduct a study on the impacts of renewable generation on the power quality of electrical grid. Therefore, this work aims at assessing the potential effects of Distributed Generation (DG) on the operation of electric power system by modelling of harmonics and voltage distortion. With different types of renewable generation available at present, it is believed that some designs contribute significantly to electrical network’s Power Quality (PQ). After the analysis of harmonic currents (chapter 6 and 7 of this thesis) introduced by renewable generation technologies, their negative impact on the power quality of the grid is seen to be apparent at point of connection (POC) but only within controlled limits. Analytical method for modeling of harmonic interactions between the grid and aggregated distributed generation technologies are investigated using DIgSILENT Power Factory software and the results obtained are discussed

A case analysis of partnered research on palliative care for refugees in Jordan and Rwanda

Abstract Background This case analysis describes dilemmas and challenges of ethical partnering encountered in the process of conducting a research study that explored moral and practical dimensions of palliative care in humanitarian crisis settings. Two contexts are the focus of this case analysis: Jordan, an acute conflict-induced refugee situation, and Rwanda, a protracted conflict-induced refugee setting. The study’s main goal was to better understand ways humanitarian organizations and health care providers might best support ethically and contextually appropriate palliative care in humanitarian contexts. An unintended outcome of the research was learning lessons about ethical dimensions of transnational research partnerships, which is the focus of this case analysis. Discussion There exist ongoing challenges for international collaborative research in humanitarian conflict-induced settings. Research partnerships were crucial for connecting with key stakeholders associated with the full study (e.g., refugees with life limiting illness, local healthcare providers, aid organization representatives). While important relationships were established, obstacles limited our abilities to fully attain the type of mutual partnership we aimed for. Unique challenges faced during the research included: (a) building, nurturing and sustaining respectful and equitable research partnerships between collaborators in contexts of cultural difference and global inequality; (b) appropriate ethics review and challenges of responding to local decision-maker’s research needs; and (c) equity and fairness towards vulnerable populations. Research strategies were adapted and applied to respond to these challenges with a specific focus on (d) research rewards and restitution. Conclusions This case analysis sheds light on the importance of understanding cultural norms in all research roles, building relationships with decision makers, and developing teams that include researchers from within humanitarian crisis settings to ensure that mutually beneficial research outcomes are ethical as well as culturally and contextually relevant

Understandings and Responses to Domestic Violence in the African Great Lakes Communities of Western Sydney

The project is a partnership between the Sexualities and Genders Research initiative of Western Sydney University (WSU) and the Great Lakes Agency for Peace and Development (GLAPD). The project is guided by three research questions: what are the views and attitudes of Great Lakes community members in Australia on domestic violence within their communities?; what are the views and experiences of health professionals on domestic violence in the Great Lakes community?; and how can health and welfare responses to domestic violence in the Great Lakes community be improved? We found five overlapping themes to be core to understandings and responses to domestic violence. These were cultural dissonance resulting from migration and displacement; responsibility within and outside of communities; trust; cultural codes of shame and respect; and broader social and structural factors such as racism and socio-economic disadvantage arising from unemployment. Our recommendations were for education within the Great Lakes communities, and of service providers; building trust within Great Lakes communities and between service providers and these communities; and legal sanctions as a last resort

Summary of the sociodemographic characteristics of the sample.

Summary of the sociodemographic characteristics of the sample.</p

Spaces of well-being and regional settlement: International migrants and the rural idyll

Regionalisation is a hallmark of Australia\u27s approach to international migration, reflecting governments\u27 growing concern with where new arrivals live. Residence in regional Australia is encouraged (mandated, for some visas) in response to urban population pressures alongside rural population and economic decline. Parallel to regionally focused visa schemes exists a pattern of voluntary urban-to-rural migration among some international migrants. Such secondary mobility counters the policy logic that international migrants only live outside cities when required to do so. This paper explores 18 African migrants\u27 motivations for ‘urban flight’: Australian cities have failed to sustain their well-being and they consider rural life a remedy. Their preference for rural locations is not purely instrumental, it is shaped by deep-seated affective connections. Given the challenges of regional population retention, settlement policies should be recalibrated to support the aspirations of international migrants who feel an affinity for rural places, rather than compelling the rural settlement of others who do not

Flow diagram for inclusion and exclusion.

Most descriptive data on individuals with bipolar disorder originate from high-resource settings. Very little is known about the accessibility and service provision of intensive mental health care to persons living with bipolar disorder in low-resource settings. This information is needed to inform health systems and guide practitioners to improve standard treatment options and access to treatment. This cross-sectional study explored the level of care for outpatients with bipolar disorder and their help-seeking patterns at the two national referral hospitals in Rwanda. The study found that the majority, 93%, of outpatients with bipolar disorder in Rwanda were on prophylactic psychopharmacological treatment, but mainly first-generation antipsychotics and just 3% received lithium treatment. Furthermore, there was a lack of psychosocial intervention; consequently, 44% were not aware that they had bipolar disorder. Moreover, 1 in 5 participants utilized or had previously used traditional medicine. Awareness of own diagnostic status was not associated with educational level or use of traditional medicine. The study’s sample size of 154 patients is relatively small, and the cross-sectional design does not provide causal inferences. The results demonstrate a considerable unmet need for improved mental health care services for individuals with bipolar disorder in Rwanda, including access to optimal medication and psychosocial interventions. Psychoeducation could be a possible starting point for improving the standard of care, informing the individual on their diagnosis and medication while empowering them to engage in their treatment plan.Trial registration: ClinicalTrials.gov NCT04671225. Registered on November 2020.</div

Clinical rating scales.

Most descriptive data on individuals with bipolar disorder originate from high-resource settings. Very little is known about the accessibility and service provision of intensive mental health care to persons living with bipolar disorder in low-resource settings. This information is needed to inform health systems and guide practitioners to improve standard treatment options and access to treatment. This cross-sectional study explored the level of care for outpatients with bipolar disorder and their help-seeking patterns at the two national referral hospitals in Rwanda. The study found that the majority, 93%, of outpatients with bipolar disorder in Rwanda were on prophylactic psychopharmacological treatment, but mainly first-generation antipsychotics and just 3% received lithium treatment. Furthermore, there was a lack of psychosocial intervention; consequently, 44% were not aware that they had bipolar disorder. Moreover, 1 in 5 participants utilized or had previously used traditional medicine. Awareness of own diagnostic status was not associated with educational level or use of traditional medicine. The study’s sample size of 154 patients is relatively small, and the cross-sectional design does not provide causal inferences. The results demonstrate a considerable unmet need for improved mental health care services for individuals with bipolar disorder in Rwanda, including access to optimal medication and psychosocial interventions. Psychoeducation could be a possible starting point for improving the standard of care, informing the individual on their diagnosis and medication while empowering them to engage in their treatment plan.Trial registration: ClinicalTrials.gov NCT04671225. Registered on November 2020.</div