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Military Medicine: NATO Lecture Series

On behalf of the CIMVHR:

CIMVHR | Nov 2017

ICRSMV | nov 2017

Canadian Institute for Military and Veteran Health Research
L’Institut canadien de recherche sur la santé des militaires et des vétérans

NATO Lecture Series

 

On the 28 & 29 of November, a lecture series on Moral Injury and Military Mental Health will take place at The Royal’s:  Institute of Mental Health Research in Ottawa. Full details on the lecture series can be found by following this link:

 

If you wish to attend you must first register following the instructions below.

 

How to register:

 

STO Event booking Procedure :

  1. Use the link https://events.sto.nato.int/ 
  2. Click on Create an account (below the button “log in”)
  3. Fill in all the required fields (mandatory),
  4. Also fill in the Captcha (reproducing numbers and letters to prove you are not a robot)
  5. Click on register (bottom of page)
  6. You will receive an email notification to activate your account
  7. Click on the link in above email to activate your account
  8. Once activated you can came back to this site any time and book any event
  9. Go/click on the Event Summary in the top bar of https://events.sto.nato.int/ and scroll to Lecture Series HFM-284 and, click on the event
  10.  Login and book before Nov 22nd

 

It is important that you enrol as there is limited space, there is no cost to enrol.

 

 

Thanks and we hope to see you there.

Série de conférences OTAN

 

Le 28 et 29 novembre, l’OTAN organise une série de conférences sur les blessures morales et la santé mentales des militaires. Les conférences seront tenues à Ottawa, avec l’Institut de recherches en santé mentale l’organe de recherche des Services de santé Royal Ottawa. Pour plus de détails sur la série de conférences, veuillez suivre le lien suivant :

 

Si vous aimeriez participer, vous devez vous inscrire en suivant les directives ci-dessous :

 

Les démarches d’inscription avec STO Events :

  1. Utilisez le lien suivant : https://events.sto.nato.int/ (en anglais seulement)
  2. Créez un nouveau compte (‘Create an account’, le lien est sous la section ‘Login’)
  3. Remplissez les champs obligatoires
  4. Complétez le CAPTCHA requis (test de réponse de vérification pour s’assurer que l’utilisateur est humain)
  5. Appuyez sur ‘Register’ (bas de la page)
  6. Vous recevrez un courriel de confirmation.
  7. Appuyez sur le lien dans le courriel pour activer votre compte.
  8. Une fois votre compte activé, vous pourrez retourner au site pour vous inscrire aux conférences
  9. Appuyez sur le lien ‘Event Summary’ dans le menu de la page  https://events.sto.nato.int/ pour trouver la série ‘Lecture Series HFM-284’, choisissez cette événement
  10. Ouvrez une session et réservez votre place avant le 22 nov.-17

 

Il est important de réserver votre place car l’espace disponible est limité. Il y a aucun cout associé à votre participation.

 

Merci et nous espérons vous voir à la conférence.

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Webinar: New WHO guidelines on ethical issues in public health surveillance

Seminario virtual: Nuevas pautas de OMS sobre ética en la vigilancia de la salud pública –notar enlace para la sesión corregido (AHORA SÍ)
 
La OPS lo invita a un seminario virtual para presentar estas pautas, recientemente publicadas por OMS, que constituyen el primer marco internacional para dar orientación ética en los temas de vigilancia en la salud pública. El seminario contará con presentaciones de la Dr. Amy Fairchild (Profesora de la Escuela Mailman de Salud Pública de la Universidad de Columbia y actualmente también Decana Asociada de Asuntos Académicos de Texas A&M) y el Dr. Michael Selgelid (Director del Centro de Bioética de la Universidad de Monash). Ambos trabajaron en el desarrollo de las pautas y representan a Centros Colaboradores de Bioética de la OPS/OMS.
El seminario virtual se llevará a cabo el 21 de noviembre de 3:00 a 4:30 pm (hora de Washington DC) y será en inglés. Para participar siga este enlace: https://paho.webex.com/paho/onstage/g.php?MTID=e4df9a57d1be734860c8eea47e91646aa
Las pautas están disponibles en inglés en: http://apps.who.int/iris/bitstream/10665/255721/1/9789241512657-eng.pdf?ua=1. La OPS próximamente publicará las pautas en español.
Para recibir más información sobre temas de ética de la salud pública, suscríbase por medio de este hiperlink a la lista de OPS Public Health Ethics .                                     
 
 
Webinar: New WHO guidelines on ethical issues in public health surveillance –note NOW corrected link for session
 
PAHO invites you to a webinar to present these guidelines, recently published by WHO, which are the first international framework to provide ethics guidance on issues in public health surveillance. Dr. Amy Fairchild (Professor at Columbia Univeristy Mailman School of Public Health, currently serving as Associate Dean of Academic Affairs at Texas A&M) and Dr. Michael Selgelid (Director of Monash University’s Bioethics Center) will present the guidelines. Both participated in their development and represent Bioethics Collaborating Centers of PAHO/WHO.
The webinar will take place on November 21st from 3:00 to 4:30 pm (Washington DC time) and will be conducted in English. To participate follow this link: https://paho.webex.com/paho/onstage/g.php?MTID=e4df9a57d1be734860c8eea47e91646aa  
The guidelines are available (in English) at: http://apps.who.int/iris/bitstream/10665/255721/1/9789241512657-eng.pdf?ua=1. PAHO will soon publish them in Spanish.
To receive more information on public health ethics topics, subscribe through this hyperlink to PAHO’s listserv Public Health Ethics .                                           
 
 
Suscripción a lista InvestigaciónÉTICA                                       Subscription to list InvestigaciónÉTICA                                             
Programa Regional de Bioética                                                   Regional Program on Bioethics                                                         
www.paho.org/bioetica                                                                www.paho.org/bioethics                                                                                       
Gestión del Conocimiento, Bioética e Investigación                    Knowledge Management, Bioethics and Research                                       
Organización Panamericana de la Salud                                      Pan American Health Organization       
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Is there space for palliative care in humanitarian action?

Read this new blog post to find out about…

MAKING SPACE FOR PALLIATIVE CARE IN HUMANITARIAN ACTION: REFLECTIONS ON OBSTACLES TO THE INTEGRATION OF PALLIATIVE CARE APPROACHES IN HUMANITARIAN HEALTHCARE

by Matthew Hunt, Carrie Bernard and Kevin Bezanson

 

http://www.elrha.org/r2hc-blog/making-space-palliative-care-humanitarian-action-reflections-obstacles-integration-palliative-care-approaches-humanitarian-healthcare/

 


This research project  is funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme.

r2hc_logo_FOR ONLINE USE

R2HC DFID and WT- FOR ONLINE USE

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From Eh to Z(ambia) – Reflections of Canadian’s First Time in the Field

Photo by Gautham Krishnaraj in Kapiri Mposhi, Zambia


Gautham Krishnaraj is a 2017–2018 Aga Khan Foundation Canada International Youth Fellow, 2016–2017 RBC Students Leading Change Scholar, and recent MSc Global Health Graduate (McMaster University). He currently resides in Mombasa, Kenya where he is working with the Madrasa Early Childhood Program, an Aga Khan Development Network Initiative.


There’s something special about the “Z” countries. Often overlooked despite tremendous sights for tourists and rich potential for cultural exchange, they are unique places that not everyone sets out to see. Zambia was an unexpected destination (with a layover in Zimbabwe, but I’m not quite crossing that off my list) during my eight month journey as an Aga Khan Foundation Canada (AKFC) International Youth Fellow, working with the Madrasa Early Childhood Program – Kenya (MECP-K). I am here to provide documentation and reporting support while two MECP-K colleagues are conducting the final support visit in a Care for Childhood Development (CCD) consultancy project with the Luapula and Firelight Foundations. Our work centres around teaching new caregivers (with children 0-3 years old) the importance of play, touch, and stimulation in the critical early years of life. We do so through community based CCD Counsellors, who have been trained in CCD and have engaged their local communities over the past year.

Over the past two weeks, we have observed and mentored our CCD Counsellors interacting with caregivers in Lusaka, Kitwe & Kabwe, as well as more rural communities in Ndola, Rufansa, and Kapiri Mposhi. Covering three provinces and hundreds of kilometers, I can attest to the fact that Zambia is very much, as our local partners have noted, a country under construction. Crimson sunsets are dazzling through the copper dust of the daily grind. It is a beautiful place to have my first true “field experience” of conducting research, although it has not been without its challenges.

On Aid

This is an internal ethical dilemma that long predates my arrival in the field. My aspirations are, primarily, humanitarian. I believe that humanitarian health care is the bleeding edge of the aid sector, engaging when local systems are completely overwhelmed by a disaster; man-made or natural. It feels somewhat easier to justify the thousands of dollars spent on humanitarians’ travel, insurance, prophylaxis, R&R, lodging etc., when you know that the local providers are acutely in need of immediate external support.While I recognize and grapple with the challenges of this short-term dialogue of urgency, I struggle far more with the challenges that arise in the context of International Development. Many large organizations, even those starting with the good intentions of building sustainable programs, inevitably fill roles that make it impossible to leave. But eventually they must. Vacuums follow. While I am certain that these questions have have been raised countless times prior, and will be raised countless times to come, it begs the question of a better alternative. I remember reading once that Aid is a sector we all wish didn’t exist, because it recognizes our collective failure to create an equitous global society. Can we do more than wish? How do we contribute without feeling/being complicit?

On Breastfeeding

My role here of documenting feedback on the CCD program involves conducting video recorded interviews, and taking plenty of photos. I’ll discuss consent shortly, but every caregiver and counselor signed consent forms before I pulled out my camera. One challenge I did not expect was that during the vast majority of interviews, with the camera clearly visible and me indicating that I had started recording, many  women start to breastfeed. I fully support and believe in the importance of de-stigmatizing and normalizing breastfeeding, as it is a most natural part of life. However, all but one of the participants were interviewed were young (16-21 year old) mothers, so using video footage that very clearly shows the whole breast introduces some problems. Am I complicit in the stigmatization of breastfeeding by not using that footage, especially as breastfeeding is a critically important aspect of care for Early Childhood Development? The legal age of consent here is 16, but what happens if the reporting video I will make is circulated elsewhere in the larger Aga Khan Development Network (AKDN)?

On Communicating Consent

Finally, and most critically, few of the rural caregivers had a strong grasp of English. Despite the consistent presence of a translator, and despite all of the CCD Counsellors speaking English fluently, one cannot help but wonder how much is lost in translation. This is particularly important when considering consent. Explaining the purpose and/or potential applications of research can be difficult even in a common language; add in translation and the situation is rife with chances of miscommunication. I have never felt entirely sure that the participant understood why three people had come all the way from Kenya “just to see how they play with their baby”. Indeed, the mere fact that we had come from afar may pressure the participant’s perceived ability to decline participation, further exacerbated by a potential sense of obligation based on existing relationships with the CCD Counsellors. It is hard enough to rapidly build rapport and comfort between researcher and participant in English, and immeasurably more so in a few scattered words of Bemba.

While it’s not possible to fully address ethical challenges A-Z, I did my best to keep my camera stowed until the forms were signed, to sit on the ground with the participants, and to capture them in their best light. Under the brilliant Zambian sun, the latter wasn’t hard at all.

The views expressed here are entirely those of the author, and do not represent the views or opinions of the Humanitarian Health Ethics Network, Aga Khan Development Network, Aga Khan Foundation Canada, Madrasa Early Childhood Program Kenya,

 

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Post-Research Ethics Analysis (PREA): Researching Ethics in Humanitarian Research

OMathuna-Donal-2013-1.jpgArticle By Dr. Dónal O’Mathúna, PhD, Associate Professor in the School of Nursing & Human Sciences, Dublin City University, Ireland and in the College of Nursing at The Ohio State University, USA. He is the director of the Center for Disaster & Humanitarian Ethics (http://www.ge2p2.org/cdhe), and the Principal Investigator of the PREA research project investigating ethical issues encountered during humanitarian research (http://PREAportal.org).

The Post-Research Ethics Analysis (PREA) project is a funded research project with two main aims. One is to learn lessons about actual research ethics issues and innovations from health research conducted in humanitarian crises. The second is to develop a tool to facilitate and promote ethical reflection among various stakeholders in such research projects.

The project was the brain-child of Dr. Chesmal Siriwardhana, arising from his experiences in the field and his desire to ensure that research participants were respected in research. Over a number of years while at Anglia Ruskin University, and then as Associate Professor in the Department of Population Health at the London School of Hygiene & Tropical Medicine, Chesmal developed and refined the research proposal. The PREA project was successfully funded in 2016 for two years through the R2HC/ELRHA programme. Tragically, Chesmal died in 2017 in a road traffic accident just as the project was getting started. The new Principal Investigator is Dr. Dónal O’Mathúna, Associate Professor in the School of Nursing & Human Sciences at Dublin City University, Ireland and in the College of Nursing at The Ohio State University, USA.

The PREA project arose in recognition of the growth in humanitarian health research which is crucial to provide evidence to guide decision-makers in humanitarian contexts. Health research in such contexts, including during disaster relief, often involves traumatized, vulnerable populations and faces numerous ethical challenges. The PREA project was developed in response to anecdotal discussions and team members’ personal experiences that research in humanitarian crises faces difficulties with the current research ethics governance model. Attention has focused on issues of ethical approval procedures and informed consent, but anecdotal evidence suggests that other ethical challenges predominate. The PREA team is concerned that procedures focused mostly on ethics approval prior to research starting may unintentionally overlook the actual ethical challenges experienced during and after the implementation of research projects. As a result, we believe that research is needed into the actual experiences of researchers (and other stakeholders and participants) involved with humanitarian research. A manuscript arguing this case and providing justifications has been submitted for publication by members of the PREA team and will be linked here when available. In addition, tools that help facilitate ethical reflection and decision-making throughout the research process would be helpful, especially in projects involving vulnerable participants.

The PREA project will gather evidence on the actual experiences of research ethics issues by researchers, ethics committees and other stakeholders when conducting health research in humanitarian and disaster settings. This will be done by carrying out qualitative interviews in a number of humanitarian settings in countries in Asia and Africa. Local researchers will be trained to carry out the interviews and thus help facilitate the development of local research infrastructure. Currently, research ethics approval and other permissions are being obtained for the various sites. By interviewing those involved in the conduct and review of humanitarian research, insight will be gained into the actual ethical issues encountered during the research process. We are also very interested in learning about innovative ways that researchers have responded to ethical challenges so that we can learn from other teams and share best practice.

The interviews from the different sites will be analyzed qualitatively and themes identified that will be used in developing a tool to help future researchers reflect on the ethical issues in their research projects. An early version of this tool will be piloted in each of the sites where interviews will be conducted as part of a research ethics training programme to be delivered in each country. This will give local researchers an opportunity to comment on the qualitative analysis and the developing PREA tool. In this way, the PREA project aims to contribute to the promotion of ethical values and practices in the conduct of humanitarian health research. In keeping with Chesmal’s vision and passion, we hope this will help promote humanitarian health research of the highest ethical standard, and help ensure future participants and their communities are respected throughout their involvement in research.

Details about the PREA team and partner research organizations are available on our project website at http://www.preaportal.org. This portal will eventually allow researchers to post examples of ethical challenges they have faced, and ways they have developed to address them in a humanitarian context. To get in contact with us, you can email info@preaportal.org, or follow us on Twitter @Ethics_Analysis or Facebook https://www.facebook.com/EthicsAnalysis/.   

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Obstacles and moral experiences with palliative care provision in humanitarian crises…

From September 17-19, Kevin Bezanson represented the Humanitarian Health Ethics research group at the 5th International Public Health and Palliative Care Conference held in Ottawa, ON.

Here is the PDF version of the poster entitled –

Health professionals’ lived experiences of palliative care provision in humanitarian crisis: Moral experiences confronting the suffering of patients who are dying or likely to die in settings of war, disaster, or epidemic.

img_0845-e1506450953721.jpg
Kevin Bezanson presenting the HHE poster at the 5th International Public Health and Palliative Care Conference, Ottawa, ON, Sept. 17-19, 2017.

 

The poster is based on ongoing research for a R2HC funded project entitled:

Aid when there is ‘nothing left to offer’: A study of ethics and palliative care during international humanitarian action


The research project is funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme. The Research for Health in Humanitarian Crises (R2HC) programme aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. Visit www.elrha.org/work/r2hc for more information. The R2HC programme is funded equally by the Wellcome Trust and DFID, with Elrha overseeing the programme’s execution and management.
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Resisting Borders, 9-11 October 2017

CLICK HERE FOR THE CONFERENCE PROGRAM

Refugees and many migrants suffer from limits on their abilities to move around the world, even in pressing or urgent circumstances. They are often forced to leave their homes for reasons beyond their control, including war and civil unrest, political and religious persecution, economics, or famine and other natural or man-made disasters. Once displaced, whether internally or externally, they face pressing needs for food, water, shelter, and health care. Local governments, international agencies and non-governmental organizations often struggle with providing for their needs, particularly in resource-poor regions of the world. Recent socio-political changes in the United States, Western Europe and elsewhere have placed additional restrictions on the rights of migrants and refugees.

In solidarity with these refugees and migrants, we are hosting a no-travel virtual conference to explore the ethical, legal, philosophical, and social issues associated with refugee and migrant health in a world of economic, geopolitical, and psychological borders.

ResistingBorders_Picture

Location: Online (no travel)

Cost: Free

For registration and other information: http://www.resistingborders.com

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Call for Abstracts

1st World Congress on Migration, Ethnicity, Race and Health (MERH)
The MERH 2018 Congress is hosted by an independent, non-profit making company working under the auspices of The University of Edinburgh, the European Public Health Association and NHS Health Scotland.  We intend to deliver to you a memorable, affordable, academic and social programme in one of the most spectacular cities in the world.
Congress aims :
  • To improve research, population health and health care for migrants and other discriminated-against populations
  • To bring together policy, social science, clinical, social service and public health perspectives and share and transfer learning within and across countries.
  • To examine contemporary problems across the globe and debate suggested solutions
  • To Consider health effects of social, environmental and demographic change associated with population migration, and the effects on diseases and their causes
  • To find ways to overcome differences in concepts and terminology so the field can be understood internationally in acceptable language.
  • To provide opportunities for people to showcase their work and to meet to share experience and motivations
  • To build networks that will last beyond the Congress itself
Abstract Submission and Registration is now open. 
Deadline for submissions is October 6, 2017.

http://www.merhcongress.com

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Perceptions of EVD Research — August 2017 Progress Report

One year into this project, we are finalizing data collection, moving forward with analysis, and have begun dissemination activities. Progress includes:

Fieldwork:

  • We have conducted interviews with 108 stakeholders, over 90% of these being with stakeholders in the three countries most severely affected by the epidemic: Guinea, Liberia, and Sierra Leone.
  • Stakeholders include:
    • Research participants, people who opted not to participate in research projects for which they were solicited, and proxy-decision makers who made treatment decisions for relations too ill to provide consent
    • Research Ethics Board members who evaluated proposed research projects, either for national-level boards serving affected countries or for organization-specific boards operating within international organizations that assisted with the response
    • Investigators who led or supported research projects conducted during the outbreak, as well as healthcare providers who worked on the frontlines of the epidemic, administering experimental interventions and monitoring patients’ condition
    • Public sector representatives who were called on to oversee or regulate research conducted during the epidemic: decision-makers in health and other ministries involved in planning the response to the epidemic; representatives of Ebola survivors’ associations and other civil society groups; others
  • We have spoken to people involved with a range of research projects: vaccine trials, pharmaceutical and other intervention trials, and observational studies.

Analysis:

  • We have conducted a review of publications exploring or addressing ethical and practical challenges associated with research conducted in West Africa during the Ebola outbreak. Over 2,000 peer-reviewed articles were selected for screening by members of the research team; of these, over 100 were selected for inclusion in the review. Findings are currently being written up for publication.
  • Analysis of interviews is underway. Draft report of findings will be ready by November 2017.
  • We are preparing meetings to present and discuss draft report of findings with stakeholders and research participants in West Africa in November-December 2017. Participants’ feedback will be incorporated into analysis and output materials.
  • We are preparing a meeting of co-investigators in Hamilton in December 2017. This will serve to finalize findings, prepare a recommendations draft paper, and finalize components of a webinar (to be held in January).
EVD Report Pic
Photo: Ebola education mural outside Université Sonfonia, Conakry, Guinea.

Outputs to date

Invited Presentations

Nouvet, Elysée (2016) Recherche anthropologique au service de la santé publique : méthodes, considérations, et EER (évaluation ethnographique rapide). Training session presented to the Comité National d’Évaluation de la Recherche en Santé (CNERS), Conakry, Guinée, le 19 décembre

Schwartz, Lisa (2016) L’éthique de recherche socio-anthropologique. Training session presented to the Comité National d’Évaluation de la Recherche en Santé (CNERS), Conakry, Guinée, le 19 décembre

Peer-Reviewed Presentations

Nouvet, Elysée & Schwartz, Lisa (2017) From the front lines: Trialing research ethics in the time of Ebola. Paper presented at the World Association for Disaster and Emergency Medicine Congress on Disaster and Emergency Medicine. Toronto, Canada. April 28th

Nouvet, Elysée (2017) The need to care, learn, and improvise: Enacting research ethics during the West Africa Ebola outbreak. Paper accepted for presentation at Ethox: Oxford Global Health and Bioethics International Conference. University of Oxford, Oxford, England. July 17-18th

Pringle, John (2017) Lessons in research ethics: Experiences of clinical research participation during the West Africa Ebola crisis. Paper accepted for presentation at Ethox: Oxford Global Health and Bioethics International Conference. University of Oxford, Oxford, England. July 17-18th

Workshop Participation

Pringle, John. Ethical Design of Vaccine Trials in Emerging Infections Workshop. Hosted in conjunction with the Oxford Global Health and Bioethics International Conference and Sponsored by a Wellcome Strategic Award and the Ethox Centre. University of Oxford. July 18-19, 2017