Holistic Response Research Articles

Moving towards transformative justice for black women survivors of intimate partner violence: an intersectional qualitative study.

Intimate partner violence (IPV) disproportionately affects Black women, yet the current IPV justice response, relying on the criminal legal system, often fails them due to racialized, sexist stereotypes that disrupt Black women's claims to survivorship. Transformative justice, a community-based approach designed to repair harm between the survivor and person who caused harm and transform the social conditions that perpetuate violence, may be a promising alternative approach to facilitate justice and accountability for IPV. However, little is known about the justice preferences of Black women IPV survivors. This qualitative study sought to understand Black women IPV survivors' experiences interacting with police and their justice preferences following IPV. Semi-structured interviews with 15 Black women IPV survivors were conducted between April 2020 and April 2022. Inductive analytic techniques derived from grounded theory were used to contextualize Black women IPV survivors' experiences. One theme was identified that aligned with Black women IPV survivors' experiences interacting with the police: 1) fear and distrust. Four themes were identified that aligned with justice preferences: (1) resolution through dialogue, (2) therapy and counseling services, (3) resource support, and (4) protection and prevention for children. Fear and distrust of the police was mainly driven by anticipated discrimination. Survivors' justice preferences encompassed solution-based dialogue between the survivor and person who caused harm mediated by family and trusted individuals in the community, therapy services, housing support, and attention to preventing the intergenerational cycle of IPV for children as part of a community-based, holistic justice response. Police interactions as part of the current justice response were counterproductive for Black women IPV survivors. Black women IPV survivors deserve alternative forms of justice and accountability for IPV. As an alternative justice response to IPV, transformative justice can encompass their justice preferences and promote equity and center Black women IPV survivors and their communities.

Trauma, truth, and testimony: analysing terrorism survivors’ victim impact statements

ABSTRACT Terrorism inflicts profound and enduring impacts on survivors and communities, yet the complex realities and needs of victims are often obscured in legal and policy discourses. This study examines the lived experiences of Israeli terrorism survivors through a qualitative thematic analysis of 28 victim impact statements submitted to courts from 2010 to 2023. The research uncovers the profound and enduring impact of terrorism on psychological, physical, social, and economic well-being. Pervasive grief, trauma, and irrevocable life changes emerge as central themes alongside the ripple effects on families and communities. Victims also describe daunting practical challenges in rebuilding their lives and express frustration with perceived leniency in sentencing and gaps in institutional support. While conveying urgent needs for comprehensive, trauma-informed assistance, the statements also reveal remarkable resilience and meaning-making in the face of horror. The article discusses the implications of developing more responsive, victim-centred policies and practices guided by the expressed priorities of survivors themselves. Key recommendations are outlined to foster a more humane and holistic response to the suffering of terrorism victims.

Global Impacts of Extended COVID-19 Lockdowns: Intersecting Perspectives on Environmental Quality, Food Security, Human Health, and Societal Dynamics

The COVID-19 pandemic, an unprecedented global health crisis, prompted widespread implementation of prolonged lockdown measures. This study presents a multifaceted analysis of the extensive impacts of these lockdowns on environmental quality, food security, human health, and societal dynamics. Using a mixed-methods approach, the research synthesizes data from various sources, including environmental assessments, public health records, food supply chain analyses, and social surveys, to construct a comprehensive picture of the pandemic's repercussions. In the environmental domain, our analysis reveals a dual nature of impacts. Reduced industrial activity and transportation led to temporary improvements in air quality and lower greenhouse gas emissions in several regions. Wildlife sightings in urban areas increased, indicating temporary relief for particular ecosystems. Conversely, the pandemic exacerbated challenges like increased medical waste generation and heightened pressure on natural resources due to shifts in consumption patterns. Concerning food security, the study identifies a complex interplay of disrupted supply chains, altered agricultural practices, and varying government policies that led to both short-term scarcities and long-term concerns about food sustainability. While essential for controlling the virus spread, the lockdowns inadvertently created food production and distribution bottlenecks, disproportionately affecting vulnerable communities. The impact on human health extends beyond the direct effects of the COVID-19 virus. Our findings highlight increased mental health issues, including anxiety and depression, mainly attributable to prolonged isolation and economic uncertainties. Additionally, the disruption of routine healthcare services emerged as a critical concern, affecting non-COVID health issues. Societal dynamics underwent significant transformations. The study explores shifts in work culture, with remote working becoming a new norm, and examines the pandemic's impact on education, revealing a swift transition to online learning platforms. These changes, while innovative, also widened the digital divide and raised concerns about the long-term implications for social inequality. The study's overarching theme is the interconnectivity of these domains. Environmental changes influence food security, affecting human health and societal structures. The pandemic's multidimensional impacts necessitate a holistic response, integrating environmental, health, social, and economic strategies. In conclusion, this comprehensive analysis underscores the need for adaptive, resilient, and sustainable systems to mitigate future global crises. The COVID-19 pandemic, while presenting significant challenges, also offers a unique opportunity to rethink and redesign our approach to global health, environmental stewardship, food security, and societal well-being.

Meeting social welfare legal needs in end-of-life care: co-creation of a system-wide research partnership.

Social welfare legal needs (matters of daily life, such as finances, housing and employment with legal rights, entitlements or protections) are prevalent towards end of life, creating significant difficulties for both patients and carers. Most people do not know where to go, although a range of services provide advice and support for addressing social welfare legal problems. Navigating this complex and fragmented system across health, social care and social welfare legal support is very challenging. Healthcare professionals are often the first contact for social welfare legal needs, although these are often overlooked and their impact on health and well-being unrecognised. Interprofessional learning can increase awareness of social welfare legal needs and build connections between service providers, offering a more holistic and cohesive multiagency response to the complex needs around end of life. The aim of the research was to co-create a robust foundation for cross-agency research investigating the impact of interprofessional learning on social welfare legal needs towards end of life in the North East England region. Convene a research partnership group across academics, multiagency service providers and members of the public with lived experience. Consider and agree key issues for successful place-based multiagency research in this area. Co-create a complexity-appropriate research proposal with interprofessional learning as an intervention. A series of research activities was implemented to convene a multiagency partnership group and consider the key issues for successful place-based multiagency research. Data were collected from two online workshops, an optional reflective workbook, and a modified Delphi technique. Initial participants were selectively recruited from our established stakeholder and patient and public involvement groups. Increasing diversity of the partnership continued throughout the project, using contacts provided by group members. Representation of services supporting underserved groups was a priority. All invited participants were recruited to the partnership, although contribution to research activities was variable. The partnership bridged knowledge gaps between services and united diverse perspectives, expertise and experience. A greater understanding of the barriers and opportunities for place-based multiagency working was generated, such as considering the importance of language in facilitating collaboration and responding to concerns around capacity. A non-hierarchical partnership was meaningful, with both personal and professional insights viewed as equally important. Facilitators to engagement with interprofessional learning were identified including the need for leadership endorsement. A non-traditional, mixed-method approach to interprofessional learning evaluation was favoured, with both qualitative and quantitative measures at three levels: patient and carer, professional learners and organisations. Important outcomes included raising awareness, connectedness and space to reflect. The partnership group expanded throughout the course of the project. While this extended diversity, variable participation hindered depth of discussion, with participants engaging at different points and with different understanding levels of the project. Supplementary materials provided some mitigation. Capacity and funding constraints limited engagement for some participants. Convening a multiagency partnership generated insights into the benefits, barriers and facilitators to research co-design and potential measures of success of interprofessional learning. Learning from this project has informed a complexity-appropriate research proposal to evaluate the impact of interprofessional learning as an intervention across different stakeholders. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR135276.

Fostering urban resilience and accessibility in cities: A dynamic knowledge graph approach

This paper explores the utilisation of knowledge graphs and an agent-based implementation to enhance urban resilience and accessibility in city planning. We expand The World Avatar (TWA) dynamic knowledge graph to support decision-making in disaster response and urban planning. By employing a set of connected agents and integrating diverse data sources — including flood data, geospatial building information, land plots, and open-source data — through sets of ontologies, we demonstrate disaster response in a coastal town in the UK and various aspects relevant to city planning for a mid-sized town in Germany using TWA. In King’s Lynn, our agent-based approach facilitates holistic disaster response by calculating optimal routes, avoiding flooded segments dynamically, assessing infrastructure accessibility before and during a flood using isochrones, identifying inaccessible population areas, guiding infrastructure restoration, and conducting critical path analysis. In Pirmasens, for city planning purposes, the knowledge graph-driven isochrone generation provides evidence-based insights into current amenity coverage and enables scenario planning for future amenities while adhering to land regulations. The implementation of agents and knowledge graphs achieves interoperability and enhances urban resilience and accessibility by enabling cross-domain correlation analysis that extends various areas including geospatial buildings, population demographics, accessibility coverage, and land use regulations.

The realities of return migration: Reintegrating women migrant domestic workers in Sri Lanka

This paper critically analyzes the Sri Lankan government’s management of return migration. Adopting an intersectional lens, it examines how exclusionary policies and programs fail to protect the rights and welfare of returnee women migrant domestic workers, resulting in poor reintegration outcomes. The paper focuses on three interconnecting issues that disproportionately impact upon their rights, as revealed by empirical fieldwork carried out in Colombo in 2018. Research findings from interviews and focus group discussions with civil society organizations (9), government agencies (3) and international organizations (3) highlight the need for an inclusive policy approach. Such an approach would involve a holistic response guided by inter-agency coordination and comprehensive data that would better tailor services to the specific skillsets and diverse circumstances of returnee women domestic workers.

Unveiling systemic responses in kidney transplantation: interplay between the allograft transcriptome and serum proteins.

Immunity, as defined by systems biology, encompasses a holistic response throughout the body, characterized by intricate connections with various tissues and compartments. However, this concept has been rarely explored in kidney transplantation. In this proof-of-concept study, we investigated a direct association between the allograft phenotype and serum protein signatures. Time-matched samples of graft biopsies and blood serum were collected in a heterogeneous cohort of kidney-transplanted patients (n = 15) for bulk RNA sequencing and proteomics, respectively. RNA transcripts exhibit distinct and reproducible, coregulated gene networks with specific functional profiles. We measured 159 serum proteins and investigated correlations with gene expression networks. Two opposing axes-one related to metabolism and the other to inflammation-were identified. They may represent a biological continuum between the allograft and the serum and correlate with allograft function, but not with interstitial fibrosis or proteinuria. For signature validation, we used two independent proteomic data sets (n = 21). Our findings establish a biological link between the allograft transcriptome and the blood serum proteome, highlighting systemic immune effects in kidney transplantation and offering a promising framework for developing allograft-linked biomarkers.

MIGRASI ROHINGYA: TANTANGAN INTEGRASI SOSIAL DAN EKONOMI DI NEGARA PENERIMA

Rohingya migration has become a complex challenge that requires in-depth understanding and a holistic response from various relevant parties. In this context, this article discusses various aspects that influence the social, economic and ecological integration of Rohingya migrants in receiving countries, with a special focus on Indonesia. The research method used is a qualitative approach with descriptive methods to explore the phenomenon of Rohingya migration and the challenges of social and economic integration in receiving countries. The descriptive method was chosen because the focus of this research is to describe and explain complex situations from an in-depth and comprehensive perspective. The data collected in this research is descriptive, including words, images and information from various sources, such as books, scientific journals and previous research that are relevant to the topic under study. The results of this research show that there are several main challenges faced by Rohingya migrants, including limited access to education, health services and employment, as well as social discrimination and stigmatization. Apart from that, unclear legal status, cultural and religious differences, as well as political and humanitarian instability also affect their integration process. In addition, this article also describes the environmental impacts of Rohingya migration and the importance of considering ecological factors in natural resource management and infrastructure development. To address these challenges, cross-sectoral and cross-institutional collaboration is key, with a focus on inclusive approaches, human rights protection and environmental sustainability. Diplomatic efforts are also important in resolving the root causes of the Rohingya crisis in their home country. With strong cooperation and commitment to holistic solutions, Indonesia has the potential to be a leader in responding to the challenges of social, economic and ecological integration in the context of Rohingya migration.

From Life-Skills Research and Training to Sustainability: A Case Study from a Spanish University

We are currently facing a potential ‘polycrisis’, a critical inflection point that requires a holistic response aimed at building collective foresight and preparedness for short-, medium-, and long-term risks. The role of higher education institutions and social stakeholders is decisive for sustainability goals. This paper presents a case study where academia, governance, and industry have aligned to challenge, inspire, and encourage universities to enhance student growth and bind macro-scale measures leading to a sustainable future. A teaching innovation project has served as a transforming lever, in combination with the private sector, to create a platform that reaches more than 50,000 undergraduate students and teaching staff. This structure, rooted in the 2031 Strategic Plan of the University of Granada, has also served to channel local and regional initiatives, establish effective partnerships with broad social members, raise awareness, and promote actions to advance in the pursuit of Sustainable Development Goals. A comprehensive overview is provided, which details its chronology, materials, results, challenges, impact, and descriptions of the various courses, programs, and actions. The paper concludes with recommendations for future research, policy and cooperation among stakeholders.

Ketimpangan Sosial dan Kemiskinan Pada Masyarakat Perkotaan

The aim of this research is to investigate the factors causing social inequality and poverty in urban communities and identify effective coping strategies. The research method used is a qualitative literature study approach, where data is collected through searching and analyzing various literature sources relevant to the research topic. The results of the analysis show that social inequality and poverty in urban communities are influenced by various factors such as uneven economic growth, limited access to basic services, housing problems, and differences in access to education and health. The impacts of this inequality include health problems, low education, social instability, and deep economic disparities. To overcome social inequality and poverty in urban communities, a holistic response strategy is needed, including investment in inclusive education, strengthening basic infrastructure, community economic empowerment, and affordable housing policies. Collaboration between various stakeholders is also key in creating a more inclusive and sustainable urban society.

ECAP-controlled closed-loop versus open-loop SCS for the treatment of chronic pain: 36-month results of the EVOKE blinded randomized clinical trial

IntroductionThe evidence for spinal cord stimulation (SCS) has been criticized for the absence of blinded, parallel randomized controlled trials (RCTs) and limited evaluations of the long-term effects of SCS in...

Conversion practices in Aotearoa New Zealand: Developing a holistic response to spiritual abuse.

Research arising from conversion practices, also known as conversion therapy and sexual orientation and gender identity change efforts, has generally been underpinned by an emancipatory discourse that has evolved to counter harmful practices by evidencing associated harms and estimating prevalence. Little attention, however, has focused on what is required to support survivors, inclusive of those currently or those having previously experienced conversion efforts. Within a context of Aotearoa New Zealand having recently criminalised conversion practices, this study adopted an in-depth qualitative research design, informed by a dual adherence to life history and an empowerment methodology. Twenty-three religious conversion practice survivors, who had experienced religious conversion practices across a range of Christian identified faith settings, were interviewed. Participants had a median age of 34 and the majority identified as New Zealand European, cisgender, and gay. Participant narratives were discursively analysed. Three primary discourses were identified that inform the needed development of interventions and supports: 1) pervasive framing of conversion practices as harm, rather than spiritual abuse, has minimised the impacts of conversion practices. Rather, conceptualising conversion as spiritual abuse positions conversion practices as requiring urgent intervention and ongoing support, inclusive of the development of policy and operational responses; 2) the coercive nature of spiritual abuse needs to be appreciated in terms of spiritual, social, and structural entrapment; 3) the metaphor of a pipeline was enlisted to encapsulate the need for a multidimensional array of interventions to ensure those entrapped within spiritual abuse have a "pipeline to safety". Holistic survivor-centric conversion-related responses to spiritual abuse are required. These need to be informed by an understanding of entrapment and the associated need for holistic responses, inclusive of extraction pathways and support for those entrenched within abusive religious settings, support immediately after leaving abusive environments, and support throughout the survivors' healing journeys.

Putting gender upfront in One Health AMR research and implementation strategies

Abstract Despite a gendered approach being increasingly applied across global health challenges, this has been a notable oversight in antimicrobial resistance (AMR) research. Failing to consider the complexity of human behaviours and roles in healthcare, animal production, and environmental settings compromises programmatic effectiveness and sustainability, while risking entrenching or widening existing social disparities. Research demonstrates how gender norms influence health-related behaviours across various sectors, from accessing healthcare to livestock rearing, with strong implications for antimicrobial stewardship and zoonotic disease transmission. The sparse literature connecting and investigating gender, equity and AMR – especially in a One Health context – hampers our ability to comprehensively address this global issue. The responsibility is however shared. This commentary advocates for funders to propel the inclusion of gender and equity-focused perspectives in AMR research and to set expectations in research landscapes, thus fostering a more equitable global health landscape and strengthening strategies against AMR. We outline our rationale and recommendations for other funders to support an ecosystem in AMR that supports gender and equity as a common aspect of AMR research and not an exception. One Health impact statement While AMR is increasingly recognised as a One Health challenge encompassing humans, animals, plants and the environment, sector-specific and cross-sectoral solutions needed to address AMR too often lack the multidisciplinary approach needed for a holistic response to this challenge. To date, AMR research has been largely biomedical, with limited social investigation including on gender and its interplay with factors that drive AMR in different settings such as healthcare, community or farm settings. Intentionally integrating gender analysis that informs AMR research design and implementation across sectors, including with supportive research funding opportunities, will help build the evidence base on how research projects and public programs should integrate and address gender disparities in AMR across the One Health spectrum. This is needed to ensure contextually relevant gender-informed solutions with sustainable impact.

Quantifying holistic capacity response and healthcare resilience in tackling COVID-19: Assessment of country capacity by MCDM.

The resilience of a country during the COVID-19 pandemic was determined based in whether it was holistically prepared and responsive. This resilience can only be identified through systematic data collection and analysis. Historical evidence-based response indicators have been proven to mitigate pandemics like COVID-19. However, most databases are outdated, requiring updating, derivation, and explicit interpretation to gain insight into the impact of COVID-19. Outdated databases do not show a country's true preparedness and response capacity, therefore, it undermines pandemic threat. This study uses up-to-date evidence-based pandemic indictors to run a cross-country comparative analysis of COVID-19 preparedness, response capacity, and healthcare resilience. PROMETHEE-a multicriteria decision making (MCDM) technique-is used to quantify the strengths (positive) and weaknesses (negative) of each country's COVID-19 responses, with full ranking (net) from best to least responsive. From 22 countries, South Korea obtained the highest net outranking value of 0.1945, indicating that it was the most resilient, while Mexico had the lowest (-0.1428). Although countries were underprepared, there was a robust response to the pandemic, especially in developing countries. This study demonstrates the performance and response capacity of 22 key countries to resist COVID-19, from which other countries can compare their statutory capacity ranking in order to learn/adopt the evidence-based responses of better performing countries to improve their resilience.

Insufficient responses to rape in Ouagadougou: Reflections on the experiences of young female survivors

The rape of girls and women raises questions about both prevention and the response in Burkina Faso. This article looks at the inadequacy of the response to rape in Ouagadougou. It is based on an analysis of cases of rape experienced by young women in the city and documented between 2005 and 2009. The study highlights the gap between the attitude of the victims, whether or not they are inclined to report the act and seek support, and the existing response in this area, whether in their entourage, at the community level, or at the institutional level. The study concludes that there is a need for more in-depth research into the representations and experiences of rape survivors in Ouagadougou and, more broadly, in Burkina Faso. Such research will enable us to identify gaps and appropriate strategies so that survivors are offered a holistic response that is more conducive to respect for their sexual and reproductive rights. Appropriate responses should involve improving the response system, so as to minimize obstacles and make institutional support more accessible to survivors.

PENDAMPINGAN MASYARAKAT DALAM UPAYA MENANGKAL RADIKALISME DAN TERORISME DI MASJID AL-JAMA’AH KOMPLEK BIMA ESTATE KOTA CIREBON

The increased threat of radicalism and terrorism in Indonesia demands a holistic and sustainable response from various sectors of society. In this regard, community engagement activities at Masjid Al-Jama’ah Complex, Bima Estate, Cirebon City aim to enhance understanding and active involvement of the community in combating radicalism and terrorism. Participatory Action Research (PAR) is employed as the method in conducting this community engagement. This method is considered transformative as it aims to empower and bring about significant changes within the community. The conclusion drawn from this activity is that community mentoring in combating radicalism and terrorism at Masjid Al-Jama’ah Complex, Bima Estate, Cirebon City is a strategic and relevant step in addressing the challenges of religious extremism. Through inclusive and proactive approaches, this activity is expected to enhance community understanding of the dangers of radicalism and terrorism, and promote moderate and tolerant religious practices.

“Breaking Bread, Breaking Barriers”: An Ecological systems theoretical analysis of Food Insecurity in South African Higher Education Institutions

Food insecurity is an increasingly pressing issue in South Africa, affecting higher education institutions. The country’s prevalent poverty and unemployment rates, exacerbated by the economic impact of the COVID-19 pandemic, have led to reduced funding for higher education institutions. As a result, students’ well-being is compromised, with many experiencing hunger and difficulties in their academic progress. While existing literature addresses food insecurity in South African higher education institutions, a comprehensive understanding from a systems theoretical perspective is lacking. This study applies Bronfenbrenner’s ecological systems theory, a multi-level analysis framework, to examine the complexities of food insecurity in South African higher education institutions. The analysis explores the microsystem, mesosystem, exosystem, macrosystem, and chronosystem dimensions of food insecurity as a multidimensional challenge requiring holistic response strategies. Drawing on scholarly literature, news articles, and reports from governmental and non-governmental organisations, this qualitative research sheds light on the multifaceted nature of food insecurity challenges in higher education institutions, with a specific focus on student development. Insights from Bronfenbrenner’s ecological systems theory enhance the understanding of the barriers to student well-being and academic success and underscore the need for targeted interventions. The findings contribute to the literature on food insecurity as a complex problem and guide policy decisions, interventions, and initiatives.

The Doctrine of Retribution and Religious Responses to the HIV and AIDS Pandemic

Despite many decades of interfacing with the HIV and AIDS pandemic, religious responses to the plight of the affected and infected still border on the doctrine of retribution. Some religious leaders, particularly from the Christian perspective, are still preaching about the intersection between infection and promiscuity in relation to the HIV and AIDS pandemic. Such a message from the pulpit overlooks people born with HIV infection and partners, more particularly women in long term permanent relationships including marriage, who are unknowingly infected with HIV. Additionally, religious doctrines and religious moral positions embody perceptions that regard the infected as deserving due punishment for their sins. Using desktop research and drawing from the Job narrative, our article seeks to explore the influence of religion on HIV and AIDS. It acknowledges the ambivalent interface between sexuality, gender and HIV and AIDS, taking into account how such interwoven issues affect health seeking behavior of people living with HIV and AIDS (PLWHA). Espousing the Job narrative as wisdom in revolt, the article acknowledges the complexity of HIV infection and negates the doctrine of retribution. It concludes by proffering an alternative, holistic and sensitive theological response in the face of the HIV and AIDS pandemic.

Late post-COVID syndrome: clinical complications beyong 12 weeks

The persistent and diverse manifestations of post-COVID syndrome present a significant challenge for global healthcare. Beyond the acute phase of infection, individuals continue to grapple with lingering symptoms affecting various organ systems, including the respiratory, cardiovascular, neurological, and endocrine systems. In the respiratory realm, symptoms such as cough, dyspnea, and fatigue endure, particularly in those with a history of severe COVID-19. The cardiovascular impact manifests as chest pain, arrhythmias, and heightened risks of thromboembolic events, emphasizing the intricate connection between COVID-19 and cardiovascular complications. Neurological complications, ranging from headaches to more severe disorders, further contribute to the complex sequelae of post-COVID syndrome. Additionally, disruptions in the endocrine system, including new-onset diabetes and thyroid abnormalities, pose long-term challenges for affected individuals. The review discusses the clinical management challenges posed by the multifaceted nature of post-COVID complications and the necessity for tailored multidisciplinary approaches. A holistic and compassionate response to the long-term effects of COVID-19 requires collaboration across healthcare professionals, researchers and the broader community. By navigating these challenges collectively, we can pave the way for a more comprehensive and effective approach to post-COVID care.

A Holistic Response to the Problem of Evil

A Holistic Response to the Problem of Evil