scholarly journals Conducting epigenetics research with refugees and asylum seekers: attending to the ethical challenges

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Faten Taki ◽  
Inmaculada de Melo-Martin
Keyword(s):  
Asylum Seekers ◽  
Evidence Base ◽  
Ethical Challenges ◽  
Physical And Mental Health ◽  
Healthcare Barriers ◽  
Humanitarian Action ◽  
Disease States ◽  
Conducting Research ◽  
Refugees And Asylum Seekers ◽  
Epigenetic Research

AbstractAn increase in global violence has forced the displacement of more than 70 million people, including 26 million refugees and 3.5 asylum seekers. Refugees and asylum seekers face serious socioeconomic and healthcare barriers and are therefore particularly vulnerable to physical and mental health risks, which are sometimes exacerbated by immigration policies and local social discriminations. Calls for a strong evidence base for humanitarian action have encouraged conducting research to address the barriers and needs of refugees and asylum seekers. Given the role of epigenetics factors to mediate the effect of psychological and environmental exposures, epigenetic modifications have been used as biomarkers for life adversity and disease states. Therefore, epigenetic research can be potentially beneficial to address some of the issues associated with refugees and asylum seekers. Here, we review the value of previous and ongoing epigenetic studies with traumatized populations, explore some of the ethical challenges associated with epigenetic research with refugees and asylees and offer suggestions to address or mitigate some of these challenges. Researchers have an ethical responsibility to implement strategies to minimize the harms and maximize the short and long-term benefits to refugee and asylee participants.

The ethical challenges of researching refugee education

2018 ◽  
Vol 18 (4) ◽  
pp. 359-370 ◽  
Author(s):  
Lucy Bailey ◽  
Simon John Williams
Keyword(s):  
Ethical Challenges ◽  
Content Type ◽  
Refugee Education ◽  
Design Procedures ◽  
Procedural Approach ◽  
Institutional Review ◽  
Ethical Approval ◽  
Conducting Research ◽  
Legal Frameworks ◽  
Refugees And Asylum Seekers

Purpose The purpose of this paper is to reflect on the authors’ experiences of conducting research with refugees and asylum seekers in Malaysia over multiple research projects in order to identify limitations to current procedures for receiving ethical approval for a study. It argues that the moral complexity of working with marginalized and excluded groups is not reflected in existing approaches. Design/methodology/approach Ensuring that research is ethical is integral to any empirical study, using any research design. Procedures for ensuring ethics have been developed by professional bodies across many academic fields, predominantly drawing on western legal frameworks and conceptions of agency. However, these procedures may not have applicability to certain cultural, social and political settings. The discussion in this paper focuses on devising ethical approaches for research participants from marginalized and excluded communities in diverse parts of the world, including those with no possibility of legal recourse. Findings Problems with the use of established procedures for four aspects of ethical research are identified, namely, access and gatekeepers; consent; reciprocity; and confidentiality. Originality/value The paper develops a framework for continuous ethical reflexivity. It argues that this framework should replace the established procedural approach to ethics, approved by an Institutional Review Board or ethics committee. Instead, the IRB should assign an ethical mentor who is jointly responsible with the researcher for ensuring research ethics through the use of the framework.

scholarly journals Tortura e disagio psichico tra i rifugiati e i richiedenti asilo

2019 ◽  
Author(s):  
Michela Nosè
Keyword(s):  
Asylum Seekers ◽  
Behavioral Interventions ◽  
Psychosocial Interventions ◽  
Evidence Base ◽  
Ptsd Symptoms ◽  
Prevalence Rates ◽  
Post Traumatic Stress ◽  
Appropriate Treatment ◽  
Refugees And Asylum Seekers ◽  
Asylum Seekers And Refugees

In recent years there has been a progressive rise in the number of asylum seekers and refugees displaced from their country of origin, with significant social, economic, humanitarian and public health implications. In comparison with the general population, refugees and asylum seekers have been shown to experience higher prevalence rates of a range of disorders, including Post-Traumatic Stress Disorder (PTSD). Although there is substantial variability in prevalence rates, PTSD is frequent and is much more likely in refugees and asylum seekers compared to host populations. In terms of psychosocial interventions, cognitive behavioral interventions and narrative exposure therapy are supported by some evidence of efficacy that would suggest the possibility of decreasing PTSD symptoms in this vulnerable group. Overall, psychosocial interventions for asylum seekers and refugees with PTSD were found to provide significant benefits in reducing PTSD symptoms. Therefore these data provide an evidence base to inform decisions in clinical practice and in policy making, considering that an appropriate treatment is a right of refugees and a way to better adaptation and integration in hosted country.

Overcoming the deficiency of refugee mental health research

2019 ◽  
Author(s):  
Kristina Kalfic ◽  
Glenn Mitchell ◽  
Lezanne Ooi ◽  
Sibylle Schwab ◽  
Natalie Matosin
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Research ◽  
Asylum Seekers ◽  
Scientific Discovery ◽  
Mental Health Research ◽  
Psychiatric Research ◽  
Risk And Resilience ◽  
Refugee Mental Health ◽  
Refugees And Asylum Seekers

The growing number of refugees and asylum seekers are one of the most significant global challenges of this generation. We are currently witnessing the highest level of displacement in history, with over 65 million displaced people in the world. Refugees and asylum seekers are at higher risk to develop mental illness due to their trauma and chronic stress exposures, and particularly post-migration stressors. Yet global and Australian psychiatric research in this area is greatly lacking, particularly with respect to our understanding of the molecular underpinnings of risk and resilience to mental illness in traumatised populations. In this Viewpoint, we explore the reasons behind the lack of refugee mental health research and use this context to propose new ways forward. We believe that scientific discovery performed with a multidisciplinary approach will provide the broad evidence-base required to improve refugee mental health. This will also allow us to work towards the removal of damaging policies that prolong and potentiate mental health deterioration among refugees and asylum seekers, which impacts not only on the individuals but also host countries’ social, economic and healthcare systems.

Pandemic Disease, Public Health, and Ethics

2019 ◽  
pp. 796-811 ◽  
Author(s):  
Maxwell Smith ◽  
Ross Upshur
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Ethical Challenges ◽  
Pandemic Preparedness ◽  
Scarce Resources ◽  
Ethical Frameworks ◽  
Health Measures ◽  
Care Workers ◽  
The Face ◽  
Conducting Research

Infectious disease pandemics raise significant and novel ethical challenges to the organization and practice of public health. This chapter provides an overview of the salient ethical issues involved in preparing for and responding to pandemic disease, including those arising from deploying restrictive public health measures to contain and curb the spread of disease (e.g., isolation and quarantine), setting priorities for the allocation of scarce resources, health care workers’ duty to care in the face of heightened risk of infection, conducting research during pandemics, and the global governance of preventing and responding to pandemic disease. It also outlines ethical guidance from prominent ethical frameworks that have been developed to address these ethical issues and concludes by discussing some pressing challenges that must be addressed if ethical reflection is to make a meaningful difference in pandemic preparedness and response.

scholarly journals A network meta-analysis of psychosocial interventions for refugees and asylum seekers with PTSD

2021 ◽  
Vol 6 (6) ◽  
pp. e005029
Author(s):  
Giulia Turrini ◽  
Federico Tedeschi ◽  
Pim Cuijpers ◽  
Cinzia Del Giovane ◽  
Ahlke Kip ◽  
...  
Keyword(s):  
Low Income ◽  
Asylum Seekers ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Psychosocial Interventions ◽  
Risk Of Bias ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Treatment As Usual ◽  
Refugees And Asylum Seekers

IntroductionRefugees and asylum seekers are vulnerable to common mental disorders, including post-traumatic stress disorder (PTSD). Using a network meta-analysis (NMA) approach, the present systematic review compared and ranked psychosocial interventions for the treatment of PTSD in adult refugees and asylum seekers.MethodsRandomised studies of psychosocial interventions for adult refugees and asylum seekers with PTSD were systematically identified. PTSD symptoms at postintervention was the primary outcome. Standardised mean differences (SMDs) and ORs were pooled using pairwise and NMA. Study quality was assessed with the Cochrane Risk of Bias (RoB) tool, and certainty of evidence was assessed through the Confidence in Network Meta-Analysis application.ResultsA total of 23 studies with 2308 participants were included. Sixteen studies were conducted in high-income countries, and seven in low-income or middle-income countries. Most studies were at low risk of bias according to the Cochrane RoB tool. NMA on PTSD symptoms showed that cognitive behavioural therapy (CBT) (SMD=−1.41; 95% CI −2.43 to −0.38) and eye movement desensitisation and reprocessing (EMDR) (SMD=−1.30; 95% CI −2.40 to −0.20) were significantly more effective than waitlist (WL). CBT was also associated with a higher decrease in PTSD symptoms than treatment as usual (TAU) (SMD −1.51; 95% CI −2.67 to −0.36). For all other interventions, the difference with WL and TAU was not significant. CBT and EMDR ranked best according to the mean surface under the cumulative ranking. Regarding acceptability, no intervention had less dropouts than inactive interventions.ConclusionCBT and EMDR appeared to have the greatest effects in reducing PTSD symptoms in asylum seekers and refugees. This evidence should be considered in guidelines and implementation packages to facilitate dissemination and uptake in refugee settings.

scholarly journals Oral health problems facing refugees in Europe: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eiad Zinah ◽  
Heba M. Al-Ibrahim
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Scoping Review ◽  
Asylum Seekers ◽  
Critical Appraisal ◽  
Oral Health Care ◽  
Health Problems ◽  
Host Countries ◽  
Refugees And Asylum Seekers

Abstract Introduction Europe has been experiencing a flow of refugees and asylum seekers driven by conflicts or poverty. Their oral health is often neglected despite its clear impact on quality of life. Objective To explore the status of oral health among refugees and asylum seekers groups by examining the available literature and to determine which evidence exists regarding the problems they face in terms of oral health. Methods The current paper followed PRISMA guidelines. A scoping review methodology was followed to retrieve 2911 records from five databases and grey literature. Twelve articles met the following inclusion criteria: experimental research concentrated on the oral and dental health of refugees and/or asylum seekers between 1995 and 2020 in English. Analysis was both descriptive and thematic, whilst a critical appraisal was applied using the Critical Appraisal Skills Program (CASP). Results Seven studies (58,3%) were quantitative, while five studies (41,6%) were qualitative. In general, the quality of most of the studies (83.3%) was good. Limited access to oral health care services was shown with a higher prevalence of oral diseases compared to the native populations of the host countries. Approaches to improve oral health have been implemented in some studies and have shown positive outcomes. Conclusions Oral health care strategies should consider the oral health problems facing refugees in Europe, and oral health promotion campaigns are essential to give adequate guidance on how to access oral health care in the host countries.

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