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Natural disasters, including floods, earthquakes, and hurricanes, result in devastating consequences at the individual and community levels. To date, much of the research reflecting the consequences of natural disasters focuses heavily on victims, with little attention paid to the personnel responding to such disasters. We conducted a systematic review of the challenges faced by military, medical and public safety personnel supporting natural disaster relief operations. Specifically, we report on the current evidence reflecting challenges faced, as well as positive outcomes experienced by military, medical and public safety personnel following deployment to natural disasters. The review included 382 studies. A large proportion of the studies documented experiences of medical workers, followed by volunteers from humanitarian organizations and military personnel. The most frequently reported challenges across the studies were structural (i.e., interactions with the infrastructure or structural institutions), followed by resource limitations, psychological, physical, and social challenges. Over 60% of the articles reviewed documented positive or transformative outcomes following engagement in relief work (e.g., the provision of additional resources, support, and training), as well as self-growth and fulfillment. The current results emphasize the importance of pre-deployment training to better prepare relief workers to manage expected challenges, as well as post-deployment supportive services to mitigate adverse outcomes and support relief workers' well-being., Author(s): Natalie Ein [sup.1] [sup.2] , Rachel A. Plouffe [sup.1] [sup.2] , Jenny J. W. Liu [sup.1] [sup.2] , Julia Gervasio [sup.1] , Clara Baker [sup.1] , R. Nicholas Carleton [...]

Introduction: Visible minorities, a growing segment of Canada's population, have voiced concerns about experiencing racism while receiving care in the emergency department (ED). Understanding the ED care experiences of visible minorities is crucial to improving care and reducing health disparities. Methods: From June to August 2021, we collected data from participants in Kingston, Ontario using a sensemaking approach. Individuals who had accessed emergency care or accompanied someone else to the ED in the prior 24 months were eligible to participate. After sharing a brief narrative about their care experience, participants interpreted the experience by plotting their perspectives on a variety of pre-determined questions. Here, we conducted a thematic analysis of narratives involving patients who identified as visible minorities and complemented it with quantitative analysis of the participants' interpretative responses. This mixed-methods approach highlighted the distinct experiences of visible minority participants in relation to a comparison group. Results: Of the 1973 unique participants, 117 identified as a visible minority and 949 participants did not identify with an equity-deserving group (comparison group). Visible minority participants were more likely to report that too little attention was paid to their identity and more likely to express a desire for a balance between receiving the best medical care and being treated with kindness and respect. Visible minorities' ED experiences were also more likely to be impacted by how emergency staff behaved. Qualitative analysis revealed negative experiences of feeling uninformed and disempowered, facing judgement and discrimination, and experiencing language barriers. Positive experiences of receiving compassionate care from staff also emerged. Conclusion: Visible minority perceptions of ED care were often negative and mainly focused on staff treatment. Cultural competency and language translation services are key areas for improvement to make ED care more accessible and equitable. [ABSTRACT FROM AUTHOR]

Our study aimed to explore the lived experiences of Venezuelan refugee/migrant women and girls with disabilities to guide humanitarian assistance. The data analysed was part of a larger cross-sectional study whereby refugees and migrants in Ecuador, Peru, and Brazil were asked to share the migration experiences of a Venezuelan woman or girl. The sample for this analysis was drawn from one of the survey questions that asked participants whether the woman/girl in the narrative identified as a person with a disability. Thematic analysis using inductive coding was performed. A total of 126 narratives were included in the final analysis, of which four major themes were identified. Venezuelan refugees and migrants with disabilities described experiences of discrimination, violence, and physical challenges, such as exacerbation of symptoms while in transit. In host countries, refugees and migrants experienced a lack of disability-related accommodations in the workplace and long wait times when trying to obtain healthcare. Since discrimination is a cross-cutting issue, human rights awareness highlighting the dignity of persons with disabilities is imperative. Resources and support for Venezuelan refugee and migrant women and girls with disabilities should aim to create accessible employment opportunities, safe and timely access to medical care, and prioritise violence prevention. [ABSTRACT FROM AUTHOR]

The article focuses on the gendered impacts of the COVID-19 pandemic on marginalized women in Liberia, particularly those who survived the country's brutal civil wars. It explores how the pandemic exacerbated existing vulnerabilities, including poverty, social exclusion, and gender-based violence. It highlights how the intersection of past trauma, economic hardship, and limited access to healthcare has made these women particularly susceptible to the compounded harms of the pandemic.

The Democratic Republic of Congo hosts the longest-running and largest United Nations peacekeeping mission in history. The United Nations also has reckoned with sexual exploitation and abuse in its own ranks and, in 2003, recognized its importance with a Bulletin which became known as the 'zero tolerance policy'. Policymakers and researchers have paid little sustained attention, however, to children fathered by peacekeepers. In this article, we share the results of our mixed-methods SenseMaker® research with community members who interact with peacekeeping personnel and interviews with 58 women who are raising children fathered by peacekeepers. Despite the United Nations policies in place, most women did not report children fathered by peacekeepers and did not receive systematic support. The analysis reveals a large gap between the aspirations of the 'zero tolerance policy' and its operationalization in the Democratic Republic of Congo. We uncovered deep poverty and insecurity as both driving and resulting from women's sexual encounters with peacekeepers, with support needs largely unmet. We argue that there is a lack of enforcement of the United Nations policies, jurisdictional complexity and inaccessible justice, as well as significant gaps between the United Nations' approach to investigating and supporting children fathered by peacekeepers and the expectations of mothers, resulting in worsened life conditions for mothers and their children. [ABSTRACT FROM AUTHOR]

Abstract Background Sexual exploitation and abuse (SEA) by UN peacekeepers perpetrated against local women and girls is a concern in the Democratic Republic of Congo (DRC). While stigma associated with sexual and gender-based violence is well documented more broadly, little is known about stigma associated with peacekeeper-perpetrated SEA. Methods The aim of this study was to examine how the degree of exposure to SEA affects community perceptions of a woman or girl’s (1) social status (public stigma) and (2) institutional support in her community (structural stigma). Two poisson regression models with robust variance estimation were constructed utilizing community survey data of SEA experiences from eastern DRC (n = 2867) to quantify these associations. Relevant demographic variables were assessed for confounding and effect modification. Results The prevalence of public and structural stigma were 62.9 and 19.3% respectively across the sample. A positive relationship was demonstrated between level of exposure of SEA and diminished social status in which women and girls experiencing moderate levels of SEA were at the greatest risk of public stigmatization after adjusting for confounding (RR: 1.94; CI: 1.66–2.26). Similarly, a positive relationship between exposure to SEA and inadequate institutional support was shown for female narrators wherein women and girls experiencing a high degree of SEA were 6.53 times as likely to receive inadequate support (RR: 6.53; CI: 3.63, 11.73). This contrasted with male narrated stories for whom there was no significant association between the SEA exposure level and institutional support. Conclusions Women/girls with high exposure levels to UN peacekeeper-perpetrated SEA are at the highest risk of public and structural stigmatization, which should be more routinely considered when conceptualizing the consequences of SEA in peacekeeping contexts. The frequent occurrence of both public and structural stigma, coupled with the varying perceptions by sex, demonstrates the need for a multi-faceted approach for stigma reduction.

Background: Persons with disabilities (PWD) are more likely to visit the emergency department (ED) and often have complex health needs when accessing care in the ED. Yet there is limited understanding of ED care experiences among PWD, especially in a Canadian context. The aim of this study was to examine the ED care experiences of PWD in contrast to a comparison group in Kingston, Ontario to better understand their health care needs. Methods: A mixed-methods study with a community-based participatory approach examining participants' past ED care experiences (within 24 months) was conducted in Kingston, ON. Quantitative data from those with disabilities and those from the comparison group were compared using chi squared tests to identify differences between groups. An inductive and deductive thematic analysis approach was used to identify themes in the shared qualitative data. Convergence of findings across quantitative and qualitative data was undertaken. Results: A total of 175 participants identified as having a disability. In contrast with the comparison group (N = 949), PWD were more likely to report being given too little attention to their needs (p < 0.001), that it was more important to be treated with kindness/respect than to receive the best possible medical care (p < 0.001), to report feelings of disrespect and/or judgement (p < 0.001), and that better understanding of personal identity/situation/culture and better communication would improve ED care. Qualitative analysis highlighted the following themes: poor communication between PWD and health care providers (HCP), compassionate medical care received, perceived HCP negative attitudes/beliefs related to having a disability and substance misuse, and perceived HCP lack of knowledge/skill to treat the unique health needs of PWD. Conclusion: Findings highlight the need to improve ED care for PWD. Future quality improvement initiatives should focus on incorporating a deeper understanding of disability into medical education and emergency medicine (EM) residency education, designing curricula that emphasize cultural humility, and implementing community-based placements providing opportunities for health professionals to work with and learn from PWD. [ABSTRACT FROM AUTHOR]

Federal and professional mandates call for increased family involvement in education, yet most teacher preparation programs do not teach skills necessary to engage families in a thorough or systematic manner. The current project addressed this training deficit by offering a program that included a sequence of three graduate courses to a cohort of school professionals in a high-need school district. Courses were taught at a school within that district and included projects designed to address the needs of the community in which the participants were employed. Qualitative analysis suggests that following completion of the courses, school professionals enhanced their ability to engage families and experienced positive changes in attitude toward family-professional collaboration. Importantly, participants were able to articulate specific ways in which they planned to utilize new skills in the school setting. A unique aspect of this study was investigation of continued use of new knowledge and skills and implementation of action plans six months post-training. (Contains 4 tables and 1 figure.)