What We Know about Ethical Research Involving Children in Humanitarian Settings An overview of principles, the literature and case studies

This working paper identifies and explores the issues that should be considered when undertaking ethical research involving children in humanitarian settings. Research grounded in sound ethical principles is critical in ensuring that children’s rights are respected throughout the process and beyond and that the research itself is relevant, useful and valid. This paper examines both the universal (i.e. relevant to all research involving children) and specific ethical issues that may arise when involving children in research in humanitarian settings. This is undertaken through an examination of the literature, a review of relevant case studies and a reflection on the ethical issues highlighted in UNICEF’s Procedure for Ethical Standards in Research, Evaluation, Data Collection and Analysis (the Ethics Procedure). The latter is used as a baseline for generic ethical standards when involving children in research. The key findings of this overview highlight that many of the ethical issues that are present in other settings remain relevant and applicable in the context of humanitarian settings. These ethical issues include: an institution’s capacity to appropriately and respectfully engage children in research, understanding power relations, securing informed consent and assent, ascertaining harms and benefits, maintaining privacy and confidentiality, and ensuring appropriate communication of findings

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

The importance of stories in understanding people's relationship to food: Narrative inquiry methodology has much to offer the public health nutrition researcher and practitioner

AbstractObjectiveDespite the usefulness of quantitative research, qualitative research methodologies are equally needed to allow researchers to better understand the important social and environmental factors affecting food choice and eating habits. The present paper contributes insights from narrative inquiry, a well-established qualitative methodology, to a food-related doctoral research study. The connections between food shoppers and the producer, family, friends and others in the food system, between eaters and the earth, and how these connections affect people’s meaning-making of food and pathways to food citizenship, were explored in the research.DesignThe research used narrative inquiry methodology and focus groups for data collection.SettingFive different food-ways in the Canberra region of Australia were selected for the present research; that is, community gardens, community-supported agriculture, farmers’ markets, fresh food markets and supermarkets.SubjectsFifty-two people voluntarily attended eight focus groups with four to nine participants in each.ResultsFrom a practical perspective, the present paper offers a guide to the way in which narrative inquiry has been applied to one research project. The paper describes the application of narrative inquiry methodology, revealing the important place of narratives in generating new knowledge. The paper further outlines how phased narrative analysis can lead to a defensible and rigorous interpretive framework grounded in the data generated from people’s stories and meaning-making.ConclusionsWe argue that individual, social and system change will not be possible without further rigorous qualitative studies to inform and complement the empirical basis of public health nutrition practice.</jats:sec