Unwelcome Guests: The Detention of Refugees in Turkey's "Foreigners' Guesthouses"'

 As European countries bordering the Mediterranean have introduced increasingly harsh measures to stem the flow of irregular migration across their frontiers, Turkey has become one of the main crossroads for flows of migration from Africa, Asia, and the Middle East into Europe. At the same time, as part of Turkey’s accession process, the European Union has stepped up pressure on Turkey to prevent the movement of migrants, asylum seekers, and refugees into Europe. As a result of Turkey’s efforts to limit irregular migration flows, thousands of foreign nation­als without travel documents, refugees among them, are detained while attempting to either enter or exit the coun­try illegally. They are primarily held in detention centres, which are officially referred to as “foreigners’ guesthouses.” Turkey’s Ministry of Interior (MOI) severely limits access to detainees in these facilities by international and domestic NGOs and advocates. Helsinki Citizens’ Assembly Turkey (HCA), a leading human rights NGO based in Istanbul, has provided legal aid to refugees since 2004 through its Refugee Advocacy and Support Program. Based on inter­views conducted by HCA with forty refugees from seventeen countries, this report examines refugees’ access to proced­ural rights in detention, as well as conditions in “foreigners’ guesthouses.” It identifies gaps between reported practice and standards of treatment set forth in Turkish legislation and international guidelines on detention.Alors que les pays européens riverains de la Méditerranée mettent en place des mesures de plus en plus sévères pour endiguer les flux de la migration irrégulière à travers leurs frontières, la Turquie devient l’un des principaux carrefours des flux migratoires vers l’Europe en provenance d’Afrique, d’Asie et du Moyen-Orient. Dans un même temps, dans le cadre du processus d’adhésion de la Turquie à l’Union européenne, cette dernière a intensifié la pression sur les autorités turques pour empêcher la circulation de migrants, demandeurs d’asile et réfugiés vers l’Europe. Suite aux efforts de la Turquie à limiter les flux migratoires irréguliers, des milliers de ressortissants étrangers sans papiers, réfugiés parmi eux, sont détenus soit en tentant de pénétrer ou de quitter le pays illégalement. Ils sont pour la majorité placés dans des centres de détention, officiellement désignés « centre d’ hébergement pour étrangers ». Le ministère de l’Intérieur turc limite sévèrement l’accès des ONG nationales et internationales et des défenseurs des réfugiés aux détenus dans ces établissements. La Helsinki Citizens’ Assembly - Turkey (HCA), chef de file des ONG des droits humains basée à Istanbul, fournit une aide juridique aux réfugiés depuis 2004 grâce à son programme de défense et de soutien des réfugiés. Appuyé par des entretiens qu’a menés la HCA avec une quarantaine de réfugiés provenant de dix-sept pays, cet article étudie le droit procédural des réfugiés en détention, ainsi que les conditions dans les « centres d’ hébergement . » L’auteur identifie des lacunes entre les pratiques déclarées et les normes de traitement énoncées à la fois dans le droit turc et les directives internationales sur la détention

Prediction of HIV status based on socio-behavioural characteristics in East and Southern Africa.

INTRODUCTION High yield HIV testing strategies are critical to reach epidemic control in high prevalence and low-resource settings such as East and Southern Africa. In this study, we aimed to predict the HIV status of individuals living in Angola, Burundi, Ethiopia, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Zambia and Zimbabwe with the highest precision and sensitivity for different policy targets and constraints based on a minimal set of socio-behavioural characteristics. METHODS We analysed the most recent Demographic and Health Survey from these 10 countries to predict individual's HIV status using four different algorithms (a penalized logistic regression, a generalized additive model, a support vector machine, and a gradient boosting trees). The algorithms were trained and validated on 80% of the data, and tested on the remaining 20%. We compared the predictions based on the F1 score, the harmonic mean of sensitivity and positive predictive value (PPV), and we assessed the generalization of our models by testing them against an independent left-out country. The best performing algorithm was trained on a minimal subset of variables which were identified as the most predictive, and used to 1) identify 95% of people living with HIV (PLHIV) while maximising precision and 2) identify groups of individuals by adjusting the probability threshold of being HIV positive (90% in our scenario) for achieving specific testing strategies. RESULTS Overall 55,151 males and 69,626 females were included in the analysis. The gradient boosting trees algorithm performed best in predicting HIV status with a mean F1 score of 76.8% [95% confidence interval (CI) 76.0%-77.6%] for males (vs [CI 67.8%-70.6%] for SVM) and 78.8% [CI 78.2%-79.4%] for females (vs [CI 73.4%-75.8%] for SVM). Among the ten most predictive variables for each sex, nine were identical: longitude, latitude and, altitude of place of residence, current age, age of most recent partner, total lifetime number of sexual partners, years lived in current place of residence, condom use during last intercourse and, wealth index. Only age at first sex for male (ranked 10th) and Rohrer's index for female (ranked 6th) were not similar for both sexes. Our large-scale scenario, which consisted in identifying 95% of all PLHIV, would have required testing 49.4% of males and 48.1% of females while achieving a precision of 15.4% for males and 22.7% for females. For the second scenario, only 4.6% of males and 6.0% of females would have had to be tested to find 55.7% of all males and 50.5% of all females living with HIV. CONCLUSIONS We trained a gradient boosting trees algorithm to find 95% of PLHIV with a precision twice higher than with general population testing by using only a limited number of socio-behavioural characteristics. We also successfully identified people at high risk of infection who may be offered pre-exposure prophylaxis or voluntary medical male circumcision. These findings can inform the implementation of new high-yield HIV tests and help develop very precise strategies based on low-resource settings constraints

Managing well-being in paediatric critical care: a multiperspective qualitative study of nurses’ and allied health professionals’ experiences

Objectives It is well evidenced that healthcare professionals working in paediatric critical care experience high levels of burn-out, compassion fatigue and moral distress. This worsened during the COVID-19 pandemic. This work examines the nature of challenges to workplace well-being and explores what well-being means to staff. This evidence will inform the development of staff interventions to improve and maintain staff well-being. Design Qualitative study. Setting Paediatric critical care units in the UK. Participants 30 nurses and allied health professionals took part in online interviews and were asked about well-being and challenges to well-being. Lived experiences of well-being were analysed using interpretative phenomenological analysis. Results Themes generated were as follows: perception of self and identity; relationships and team morale; importance of control and balance and consequences of COVID-19. They focused on the impact of poor well-being on participants' sense of self; the significance of how or whether they feel able to relate well with their team and senior colleagues; the challenges associated with switching off, feeling unable to separate work from home life and the idealised goal of being able to do just that; and lessons learnt from working through the pandemic, in particular associated with redeployment to adult intensive care. Conclusions Our findings align closely with the self-determination theory which stipulates autonomy, belonging and competence are required for well-being. Participants' accounts supported existing literature demonstrating the importance of empowering individuals to become self-aware, to be skilled in self-reflection and to be proactive in managing one's own well-being. Change at the individual and staff group level may be possible with relatively low-intensity intervention, but significant change requires systemic shifts towards the genuine prioritisation of staff well-being as a prerequisite for high-quality patient care

The effect of bundling medication-assisted treatment for opioid addiction with mHealth: study protocol for a randomized clinical trial

Completed SPIRIT figure. (PDF 103 kb

Understanding Dwarf Galaxies in order to Understand Dark Matter

Much progress has been made in recent years by the galaxy simulation community in making realistic galaxies, mostly by more accurately capturing the effects of baryons on the structural evolution of dark matter halos at high resolutions. This progress has altered theoretical expectations for galaxy evolution within a Cold Dark Matter (CDM) model, reconciling many earlier discrepancies between theory and observations. Despite this reconciliation, CDM may not be an accurate model for our Universe. Much more work must be done to understand the predictions for galaxy formation within alternative dark matter models.Comment: Refereed contribution to the Proceedings of the Simons Symposium on Illuminating Dark Matter, to be published by Springe