Broad Consultation Research Articles

Witness Preparation at the International Criminal Court

Abstract The case law on witness preparation at the International Criminal Court (ICC) does not provide a coherent answer to whether it is admissible. Similarly, scholars have examined this practice from different perspectives, but they have not come to a consensus, and no academic study focuses on the link between witness preparation and witnesses’ well-being. This article analyses ICC case law on this issue and identifies three different approaches to witness preparation. It suggests that witness preparation corresponds to a legal obligation under Article 68 of the Rome Statute to protect witnesses’ well-being. Additionally, Article 68 imposes an obligation to ensure witnesses are adequately prepared upon the entire ICC and not only its judges. This article recommends that the ICC should hold a broad consultation on witness preparation with different actors. Finally, given that the practice has the potential to be abused, this article provides some suggestions on how to balance witness preparation with the right to a fair trial and witnesses’ rights.

Examining academics’ changing approaches to teaching in response to the pandemic disruption: a phenomenographic approach

ABSTRACT University curriculum systems are complex, and their modification requires coordinating multiple processes and broad consultation with teaching academics and leaders. Strong influences including policy changes and external disruptions can bring about rapid system-wide change, but these are not without stress and may not be sustainable. To appreciate how disruptions influence university teaching and learning over the longer term, we need to better understand how teachers respond. We examined the experiences of teaching academics during the disruption of COVID-19, using the relational 3P model as a guiding framework. Using phenomenographic analyses, we defined three key categories within which academics’ experiences varied: Teaching & Learning; Support, and their Role. Teachers’ perceptions of support and role were intertwined, forming a broader context than described by the relational 3P model. We suggest a modified model to better align with academics’ experiences during change, upon which supportive structures and processes can be designed.

Best practice care for acute low back pain: A new clinical standard to assist general practitioners.

Low back pain is one of the most common presentations in general practice. Although there is excellent evidence regarding best management of the condition, in primary care there is often overuse of less effective and expensive options, whereas effective, inexpensive options are underused.After broad consultation and evidence review, the Australian Commission on Safety and Quality in Health Care has developed a clinical care standard in response to this identified gap between best and actual practice. A clinical care standard focuses only on key areas of care where the need for quality improvement is greatest. We explore the new standard using a typical patient scenario in primary care to highlight evidence-based approaches for challenging aspects of management, such as imaging and pain management. General practitioners (GPs) might find the practical GP 'quick guide' resource from the standard useful to support their care of patients with low back pain.

Mapping of community perspectives on land acquisition for biofuel investment in northern Ghana

We apply Q methodology, a model with a qualitative background, albeit with rigorous quantitative analysis, to map community perspectives (concerns, attitudes, beliefs, opinions, and perceptions) towards the acquisition of communal land for a biofuel project in northern Ghana. We extracted four community perspectives, in the order of importance as follows: (1) pro-biofuel project, but pessimistic (2) against the biofuel project (pro-environmental) (3) strong against and (4) optimistic. Taken together, the perspectives suggest the local people believe the biofuel project has no potential to improve their livelihoods, meanwhile, there is a consensus that the project destroyed trees of economic importance and provided poor working conditions for the local employees. We recommend (1) the establishment of enforceable economic and social contracts between the employees, local land users and the biofuel investors (2) direct monetary compensation for the affected communal land users (3) investigation of allegations of late or partial-payment of salaries of the biofuel project’s employees (4) future considerations for acquiring communal land should include broad community consultations and incorporate the local land users’ interests, concerns, and viewpoints and (5) the local bioenergy policy of the government of Ghana must include checks on communal land sale decisions, which directly or indirectly impact the welfare of the people.

524 Navigator: Providing a foundation for cross team collaboration and custom research service through the CTSA Hub

OBJECTIVES/GOALS: The Oregon Clinical and Translational Research Institute (OCTRI) Clinical Research Navigator program provides a single point of entry for clinical and translational research services, support, advice and guidance. We provide data to illustrate the Navigator model at OHSU and examine continued opportunities to optimize research resources. METHODS/STUDY POPULATION: Requests and activities performed by the OCTRI Navigator program, staffed by 3 FTE (2 Assistant Navigators and 1 Assistant Director) were analyzed. Navigator receives requests through multiple methods: a digital form (REDCap®), email, phone calls. Requests for services and support include focused need for a core or a broad request for multiple services for start-up: informatics, the clinical and translational research center, regulatory knowledge and support, recruitment, qualitative methods, community research, biostatistics or broad consultations. Requests are tracked in SPARCRequest. Navigator also supports wayfinding to institutional resources outside of the CTSA, matchmaking for sponsors seeking investigators, and serves as a connector and facilitator across programs. RESULTS/ANTICIPATED RESULTS: OCTRI Clinical Research Navigator triaged an average of 964 research requests for 613 projects with 388 unique investigators annually between 2018-2022. Navigator also fields more than 80 calls each year that are unrelated to CTSA projects. Project requests are examined to illustrate trends in projects requesting multiple services and display how Navigator simplifies project intake and connects researchers to resources they may have not recognized they needed. Project attributes including funding type and funding status are included in this review. DISCUSSION/SIGNIFICANCE: CTSA resources are essential to the infrastructure available to researchers. While absolute numbers of requests provide little insight into the impact each CTSA hub may have, the timing and clustering trends of projects with multiple program requests shows how a combination of technology and experienced staff can efficiently support researchers.

A framework for defining fire danger to support fire management operations in Australia†

Background Development of the Australian Fire Danger Rating System began in 2017 with a project aimed at demonstrating the feasibility of a new fire danger rating system through a Research Prototype (AFDRSRP) that accounted for variability in Australian vegetation types, was nationally applicable, modular and open to continuous improvement. Aims In this manuscript, we identify and define transition points and categories for the AFDRSRP. We discuss user responses to the categorisation during a live trial evaluation of the AFDRSRP and reflect on limitations and potential improvements. Methods A review of available literature, broad consultation with stakeholders and reanalysis of fire impact data were used to determine suitable thresholds for categorising fire danger within the AFDRSRP. Key results Fire danger categories within the AFDRSRP reflect transitions in fire behaviour that result in application of different fire management strategies or are associated with variation in serious consequences and impacts. Conclusions The AFDRSRP incorporated the best available science, supported by a well-defined framework for categorising and defining fire danger making it suitable for application across Australian fire jurisdictions and range of fuel types. Implications The framework allows fire managers to assess the accuracy and appropriateness of forecasted fire danger.

Women Participation in Informal Sector and Poverty Reduction in Bushenyi District Local Council of Uganda

This study examines informal sector and poverty reduction in Bushenyi local council of Uganda. The study was guided by correlational research design which was used to establish the relationship between women participation in informal sector and poverty reduction in Bushenyi district local council. The study participants were 98, which comprises food vendors, ward executive officers, microfinance bank staff and district council officers. Findings revealed that there is a significant relationship between women participation in informal sector and poverty reduction in Bushenyi district local council. On the basis of the findings, the researcher calls for policy-makers to collaborate with women in the informal part of the economy in order to accelerate national development and improve the position of women in the country. More so, an approach that can remove women’s legal and socioeconomic constraints should be comprehensively taken, and an action plans nationally designed with various women groups in broad consultation. Keywords: Informal sector, Legal constraints, Poverty reduction, Socioeconomic constraints, Women participation

International perspectives on early childhood education curriculum development: reflections on a documentary review

ABSTRACT This paper considers the development of an early childhood education curriculum using an analytic framework informed by international perspectives on early childhood education curriculum development. In particular, the curriculum development framework model developed by Te Whaāriki New Zealand Ministry of Education in 1996 informed the analysis of documents concerned with the provision of early childhood education, specifically looking at how young children develop, grow and learn. The findings indicate that in order for the process of curriculum design and development to proceed effectively and efficiently, the context in which it is carried out must be carefully considered. A good curriculum is one which is drawn from society and embodied in the existing cultural norms, traditions and customs of the particular setting. For a curriculum to hold value, it must result from broad consultation and negotiation with a wide range of shareholders. Throughout, the paper considers how international perspectives of early childhood education curricula development and its enactment might offer possibilities for Tanzania to address concerns and issues relating to curriculum design and development that have been raised in the literature.

Priorities for efficacy trials of gender-affirming hormone therapy with estrogen: collaborative design and results of a community survey.

Treatment guidelines for gender-affirming hormone therapy with estrogen (GAHT-E) recommend specific dosing regimens based on limited data. Well-controlled efficacy trials are essential to tailoring treatment to patient goals as the guidelines recommend. The goal of this study was to take a foundational step toward designing community-centered effectiveness trials for gender-diverse individuals seeking GAHT-E. Our team developed a cross-sectional survey based on broad clinical experience and consultation with our community advisory board. The survey included 60 items covering demographics, transition history, goals and priorities for treatment, indicators of treatment success, sexual function goals, and future research priorities. The survey was distributed during the summer of 2021, primarily through social networks designed for gender-expansive individuals seeking treatment with estrogen. A total of 1270 individuals completed the survey. Overall treatment goals most frequently rated "extremely important" or "very important" were the following: (1) improved satisfaction with life (81%), (2) appearing more feminine (80%), (3) appearing less masculine (77%), (4) improved mental health (76%), and (5) being seen as your true gender by others (75%). The three body characteristics most frequently rated "highest priority" or "high priority" among changes were the following: (1) facial hair (85%), (2) breast shape or size (84%), and (3) body shape (80%). The highest-rated research priority was comparing feminization with different routes of estrogen administration. The goals and experiences of individuals seeking GAHT-E are diverse. Future clinical trials of GAHT-E should be grounded in the needs and priorities of community stakeholders.

Complications of Epicardial Pacing Wire Removal Following Adult Cardiac Surgery: A Systematic Review.

Pacing wires are commonly used during cardiac surgery to monitor heart rhythm and, if necessary, provide temporary pacing. These wires are usually removed a few days after surgery, but the procedure has been associated with complications.The purpose of this study was to summarize the literature on complications related to pacing wire removal after cardiac surgery. A systematic review was conducted using the PubMed, Embase, and Cochrane Library databases. Articles from January 1, 1998, to December 31, 2022, were considered.The literature was then registered with PROSPERO (registration number: CRD42023418165). PROSPERO is the first database to record systematic reviews in health, and it promotes best practices around the world through broad consultation to eliminate redundancy and waste of time and money. Following that, Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) was used to screen the data.PRISMA consists of a four-stage flow diagram and a "checklist" of 27 elements necessary for the rigorous and transparent dissemination of the systematic review's techniques and conclusions. These methods were used to ensure the integrity of the systematic review. The systematic review included six studies with a total of 18,453 patients.The most common pacing wire removal complications were retention of the wire (0.56%), arrhythmia (0.67%), delayed discharge due to delayed wire removal (0.41%), and cardiac tamponade (0.1%). The overall complication rate was 1.74%. A subgroup analysis revealed that earlier removal (within 48-72 hours of surgery) was associated with a higher incidence of bleeding, whereas later removal (after 72 hours) was associated with a higher incidence of delayed discharge. Pacing wire removal following cardiac surgery is associated with many complications, including retention of wire, arrhythmia, delayed discharge, tamponade, and death. These complications are more likely to occur with earlier or later removal of the pacing wires. Although the complication rate was lower, clinicians should be aware of these risks and take appropriate precautions when scheduling pacing wire removal. More research is needed to determine the necessity of pacing wires in cardiac surgery.

Evidence-Informed Recommendations for Community-Based Organizations Developing Physical Activity Information Targeting Families of Children and Youth With Disabilities.

Parents of children and youth with disabilities (CYD) have expressed unique physical activity (PA) information needs. Community-based organizations (CBOs) require assistance to meet these needs. Guided by the Appraisal of Guidelines, Research and Evaluation II, this project established evidence-informed recommendations for developing PA information targeting families of CYD. This process involved a systematic scoping review to inform draft recommendations (k = 23), which were revised via a consensus meeting with researchers, knowledge users from CBOs, and families of CYD. Broader consultation with CBO knowledge users informed the final recommendations (k = 5) that fit within the following categories: (a)language and definitions, (b)program information, (c)benefits of PA, (d)barriers to PA, and (e)PA ideas and self-regulation tools. CBOs are encouraged to consider these recommendations when developing PA information for families of CYD. Future research will focus on the development of knowledge products to disseminate the recommendations to CBOs and support implementation.

Defining operational research priorities to improve malaria control and elimination in sub-Saharan Africa: results from a country-driven research prioritization setting process

BackgroundIn order to reignite gains and accelerate progress toward improved malaria control and elimination, policy, strategy, and operational decisions should be derived from high-quality evidence. The U.S. President’s Malaria Initiative (PMI) Insights project together with the Université Cheikh Anta Diop of Dakar, Senegal, conducted a broad stakeholder consultation process to identify pressing evidence gaps in malaria control and elimination across sub-Saharan Africa (SSA), and developed a priority list of country-driven malaria operational research (OR) and programme evaluation (PE) topics to address these gaps.MethodsFive key stakeholder groups were engaged in the process: national malaria programmes (NMPs), research institutions in SSA, World Health Organization (WHO) representatives in SSA, international funding agencies, and global technical partners who support malaria programme implementation and research. Stakeholders were engaged through individual or small group interviews and an online survey, and asked about key operational challenges faced by NMPs, pressing evidence gaps in current strategy and implementation guidance, and priority OR and PE questions to address the challenges and gaps.ResultsAltogether, 47 interviews were conducted with 82 individuals, and through the online survey, input was provided by 46 global technical partners. A total of 33 emergent OR and PE topics were identified through the consultation process and were subsequently evaluated and prioritized by an external evaluation committee of experts from NMPs, research institutions, and the WHO. The resulting prioritized OR and PE topics predominantly focused on generating evidence needed to close gaps in intervention coverage, address persistent challenges faced by NMPs in the implementation of core strategic interventions, and inform the effective deployment of new tools.ConclusionThe prioritized research list is intended to serve as a key resource for informing OR and PE investments, thereby ensuring future investments focus on generating the evidence needed to strengthen national strategies and programme implementation and facilitating a more coordinated and impactful approach to malaria operational research.

Fully integrating probabilistic flood forecasts into the decision-making process across southern Quebec, Canada: some factors to consider

Flood forecasts can enable decision-makers to plan for mitigation measures, ensure the safety of people and reduce damages to private and public property. However, while flood forecasting systems are becoming increasingly sophisticated, those technical improvements do not always translate into a reduction of damages. In particular, ensemble and probabilistic streamflow forecasts provide more information regarding the uncertainty, but such forecasts are also more difficult to interpret. The connection between streamflow, water depth and flood extent is also not straightforward, as this connection requires extensive previous experience with a given river reach. Streamflow forecasts can be transformed in predictive flood maps through a hydraulic model, and those maps might have a more intuitive interpretation. However, if the system is designed to also represent the uncertainty of both water depth and extent, the interpretation becomes considerably more complex. Within this context of continuous improvement of flood forecasting systems, a broad consultation (90 participants) of forecast users was conducted across southern Quebec, Canada, with the aim of understanding their perception of flood forecasts and how they use those forecasts for decision-making. Participants responses emphasize the importance of contextualizing the forecasts according to potential consequences, providing an accurate representation of the time evolution of flood events, and facilitating the communication between forecasters and decision-makers. Following this, our main recommendation is to organize workshops to provide training for decision-makers on how to interpret hydrological forecasts correctly. Another recommendation is to implement additional communication channels between forecasters and end-users.

Refugee Education in Bangladesh: A Nation-State Paradox

This article critically analyzes the politically driven exclusion of Rohingya refugees in the national education system of Bangladesh. By employing realist humanitarianism theory, this study examines the inducement of discrimination against refugees in education and the political factors that have influenced such policy choices and formulation in Bangladesh. Qualitative research involving 35 semi-structured interviews produced in-depth information on key informants' experiences, perceptions, and suggestions on refugee education in Bangladesh. This study revealed that excluding refugees from education was a politically plotted decision, and the reason for such exclusion persisted until now because prolonged discrimination against the refugees created local myths about refugees’ eligibility for their human rights to education. The findings of this study provide insights into both academic research and policy analysis in the field of refugee education by highlighting a protracted refugee situation in Bangladesh that political exclusion can create the ambiance to nullify refugees’ human rights to education. The study recommends weighing refugee voices in refugee program design, broader consultation among humanitarian agencies, and policy review to allow refugees to receive formal, official education.

Inclusive medical education for students with disabilities: a new guidance document from Medical Deans Australia and New Zealand.

This paper outlines: 1) the work undertaken by Medical Deans Australia and New Zealand (MDANZ) to review and update its 2017 guidelines related to selecting and supporting students with disabilities, and 2) the resulting new recommendations. The review group considered common approaches to supporting medical students with a disability through an inclusive, strengths-based lens. The outcome was a guidance document that centres the importance of a strengths-based and inclusive culture within medical schools, and emphasises an individualised, context-specific and inclusive approach based on early, open dialogue. Strong project governance and broad consultation were critical to achieving this outcome. As social norms and technologies evolve, regular re-examination of guidance on how to support potential or current medical students with a disability will be necessary.

Priorities for ecological research on cetaceans in the Galápagos Islands

Located in the eastern tropical Pacific, the Galápagos Islands are an oceanic insular ecosystem subject to strong environmental variability driven by local and regional processes. Past research has shown that such conditions can attract and sustain at least 23 cetacean species, out of which 14 are common, including nine Delphinids, one Ziphiid, one Physeterid, and three Balaenopterids. These species occupy both coastal and oceanic habitats, most are present year-round, and a few are migratory. However, research on cetaceans in Galápagos has been sporadic and chronically underfunded and is not currently considered a priority in the research agenda for Galápagos. Based on a review of existing information and an assessment of knowledge gaps, here we identify priorities for ecological research on cetaceans in Galápagos along five topical areas: 1) spatiotemporal occurrence, 2) population assessment, 3) health assessment, 4) social ecology, and 5) trophic ecology. Addressing these knowledge gaps will also help inform actions to preserve cetacean biodiversity and to manage human activities involving or affecting cetaceans in Galápagos. Given the logistical and funding challenges of conducting cetacean research in Galápagos, we recommend optimizing data sampling and accessibilityviaintegrated research protocols and open data repositories. We also recommend capitalizing on local citizen science activities, such as those conducted from cruise ships and whale-watching tours, which can serve as platforms of opportunity for obtaining basic data, thereby contributing to long-term data acquisition. Our proposed priorities should be assessed by Ecuadorian and Galápagos governmental institutions in broad and inclusive consultation with stakeholders and the scientific community prior to development and implementation of a research agenda. Collectively, these efforts will advance our understanding of the ecological role that marine megafauna, such as cetaceans, play in Galápagos and other oceanic islands, including maintaining large-scale connectivity and mitigating climate change.

Palliative and Supportive Care Consultation for Patients With Malignant Gastrointestinal Obstruction is Associated With Broad Interdisciplinary Management.

The aim of this study was to assess rates of palliative care (PC) involvement in the care of patients with malignant gastrointestinal obstruction (GIO) and its influence on interdisciplinary team involvement. Malignant GIO is an advanced oncologic diagnosis with associated poor prognosis. Data regarding PC and interdisciplinary team involvement in these patients is lacking. We identified consecutive surgical consultations for GIO in cancer patients at a single institution from August 2017 to July 2019. Clinical characteristics were collected. Rates of PC consultation, ACP discussion, code status change to do not resuscitate, and interdisciplinary service consultation were evaluated. We identified 200 patients with consultations for GIO, of whom 114 (57%) had malignant GIO and were included in our study. Of these patients, 95 (83%) had stage IV disease; 68 (60%) had peritoneal metastasis, and 70 (61%) had other intra-abdominal recurrence or metastasis. PC consultation was obtained in 69 patients (61%). PC consultation was associated with higher rates of ACP discussion (64% vs 29%; P < 0.001), code status change to do not resuscitate (30% vs 2%; P < 0.001), nonsurgical procedure (46% vs 11%; P < 0.001), discharge to hospice (30% vs 7%; P < 0.001), and involvement of spiritual care (48% vs 22%; P = 0.01), social work (77% vs 42%, P < 0.001), psychology/psychiatry (42% vs 4%, P < 0.001), nutrition (86% vs 62%, P = 0.006), physical therapy (54% vs 31%, P = 0.02), and occupational therapy (42% vs 16%, P = 0.004). PC consultation benefits patients with malignant GIO by facilitating comprehensive interdisciplinary care, ACP discussions, and transition to hospice care, where appropriate. Diagnosis of malignant GIO should be a trigger for PC consultation or, in facilities with limited PC resources, consideration of deliberately broad interdisciplinary consultation.

Rural health workforce response to Australia's recent natural disasters and emergencies, with a focus COVID-19.

Australia has recently been heavily impacted by natural disasters and emergencies including drought, bushfire, floods and COVID-19. The New South Wales Rural Doctors Network (RDN) and partners developed and implemented strategies to support the primary health care response during this challenging time. Strategies included the establishment of an inter-sectoral working group of 35 government and non-government agencies, a stakeholder survey, a rapid literature review, and broad consultation aimed at understanding the impacts of natural disasters and emergencies on primary health care services and workforce in rural NSW. Several key initiatives were established, including the RDN COVID-19 Workforce Response Register and #RuralHealthTogether, a website to support the wellbeing of rural health practitioners. Other strategies included financial support for practices, technology enabled service support and a Natural Disaster and Emergency Learnings Report. The cooperation and coordination of 35 government and non-government agencies led to development of infrastructure to support the crisis response to COVID-19 and other natural disasters and emergencies in an integrated way. Benefits included consistency of messaging, coordination of support locally and regionally, sharing of resources and collation of localised data to inform coordination and planning. Stronger primary healthcare engagement in emergency response pre-planning is required to ensure maximum benefit and use of established resources and infrastructure. This case study shows the value and applicability of an integrated approach to support primary healthcare services and workforce when responding to natural disasters and emergencies.

Does the Window of Hope training module for Ghanaian teacher trainees meet the requirements of UNESCO’s Technical Guidance on Sexuality Education?

The Window of Hope (WoH) training Module was introduced in Ghanaian Colleges of Education (CoE) by the Ministry of Education (MoE) to prepare trainees to teach sexuality education upon completion of their training. Using a document analysis methodology, we compared the processes of developing the WoH module and its content to the international technical guidance framework for teacher training on sexuality education. We found that the WoH module is unlikely to achieve its stated objectives as key components of the technical guidance are not catered to in the module. We recommend a comprehensive review of the content of WoH using the National Teacher Preparation Standards Framework and Ghana’s newly developed teacher training standards. We also recommend, broad consultations involving all interest groups in Ghana in the review process.

Fostering Security in Albania and the Eu’s Role in the Security Sector Reform

In today’s world of complex and interdependent security challenges within and across borders, national security sectors need to adapt to fast-changing and unpredictable environments. Experience shows that an accountable, effective and inclusive security sector with full respect for human rights, including gender equality and the rule of law can effectively provide security to a State and its people, while at the same time promoting stability, trust and confidence in the OSCE area and beyond . It is important to first define what we mean by the security sector and security sector reform. The security sector is taken to mean all those organisations which have authority to use, or order the use of force, or threat of force, to protect the state and its citizens, as well as those civil structures that are responsible for their management and oversight. The security sector can therefore be viewed as forming three pillars: a) Groups with a mandate to wield the instruments of violence – military, paramilitaries and police forces; b) Institutions with a role in managing and monitoring the security sector – civilian ministries, parliaments and NGOs; and c) Bodies responsible for guaranteeing the rule of law – the judiciary, the penal system, human rights ombudsmen and, where these bodies are particularly weak, the international community . The overall aim of ‘Security Sector Reform’ is the transformation of security institutions so that they play an effective, legitimate and democratically accountable role in providing external and internal security for their citizens. Transformation of the security sector requires broad consultation and includes goals such as strengthening civilian control and oversight of the security sector; professionalisation of the security forces; demilitarisation and peace-building; and strengthening the rule of law . Security sector reform addresses security problems and tries to improve the situation through institutional reforms. Security and peace are seen as a public good. Society as a whole, as well as its individual members, benefits from an increase in security. Security sector reform must be understood as a broad concept, which also entails a more efficient use of scarce resources to improve security. It seeks to align the contributions of military, diplomatic, development and security actors. Democratic, civilian control over security forces is crucial for the provision of security in the interests of the population. Democratic decision-making requires transparency and accountability. Security sector reform is widely recognised as key to conflict prevention, peace-building, sustainable development and democratisation. Almost all states need to reform their security sectors to a greater or lesser extent, according to the specific security, political and socio-economic contexts, as well as in response to the new security challenges resulting from globalization.&#x0D; &#x0D; &#x0D; Received: 15 September 2022 / Accepted: 24 October 2022 / Published: 30 November 2022