Active Hope Research Articles

Relentless Hope in Action

In this article we share our understandings of relentless hope; what it looks like when it is practiced and what that makes possible for people and communities, through stories that draw upon our clinical and community engagements. These stories provide an opportunity for those in the space of mental health, community engagements, and advocacy to reflect on hope as little actions that are performed in collaboration with others, imagination as a way to create and hold onto hope, and the construction of relentless hope as a collective movement.

The power of hope in action: Raising Our Heads Above the Clouds Facilitation Guide

This facilitation guide has been created to assist practitioners to use the ‘Raising our heads above the clouds’ methodology from the Mt Elgon Self-Help Community Project. It first outlines the local values that this approach is built on. It then outlines the narrative assumptions and principles that underpin it before taking the reader through each of the steps of the process. The paper also includes stories from practitioners in Rwanda, Tanzania and Uganda and reflections about how this approach fosters community economy through collective narrative practice.

HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV

Liver transplantation (LT) from donors-with-HIV to recipients-with-HIV (HIV D+/R+) is permitted under the HOPE Act. There are only three international single-casereports of HIV D+/R+ LT, each with limited follow-up. We performed a prospective multicenter pilot study comparing HIV D+/R+ to donors-without-HIV to recipients-with-HIV (HIV D-/R+) LT. We quantified patient survival, graft survival, rejection, serious adverse events (SAEs), human immunodeficiency virus (HIV) breakthrough, infections, and malignancies, using Cox and negative binomial regression with inverse probability of treatment weighting. Between March 2016-July 2019, there were 45 LTs (8 simultaneous liver-kidney) at 9 centers: 24 HIV D+/R+, 21 HIV D-/R+ (10 D- were false-positive). The median follow-up time was 23months. Median recipient CD4 was 287cells/µL with 100% on antiretroviral therapy; 56% were hepatitis C virus (HCV)-seropositive, 13% HCV-viremic. Weighted 1-year survival was 83.3% versus 100.0% in D+ versus D- groups (p=.04). There were no differences in one-year graft survival (96.0% vs. 100.0%), rejection (10.8% vs. 18.2%), HIV breakthrough (8% vs. 10%), or SAEs (all p>.05). HIV D+/R+ had more opportunistic infections, infectious hospitalizations, and cancer. In this multicenter pilot study of HIV D+/R+ LT, patient and graft survival were better than historical cohorts, however, a potential increase in infections and cancer merits further investigation.

Hope in Action – Responding to the Pandemic as Researcher-Activists?

Hope in Action – Responding to the Pandemic as Researcher-Activists?

Recruitment considerations for dental short-term missions relating to the holistic development of dentists

BackgroundThe universal need for dentistry persists and short-term missions (STMs) with dentists can make an incalculable difference to the participants and the recipients when charitable dental treatment is offered to underresourced people. The authors studied the holistic benefits of STMs for dentists, identified how STM detractors can be overcome, and provided recruitment recommendations for engaging dentists in STMs. MethodsThe authors of this mixed-methods, phenomenological research explored recruitment recommendations for dentists considering dental STMs via evaluating the holistic benefits and the detractors through the integration of the following developmental areas: emotional, intellectual, physical, moral, social, and spiritual. ResultsDentist participants revealed a relatively equal distribution of holistic beneficial motivators and encouraged participation in dental STMs. The more diversified detractor responses suggested that STM-experienced dentists were not easily deterred from dental STM participation. ConclusionsOutcomes of quantitative research instruments and qualitative interviews strongly suggested that dentists favored the benefits of dental STMs, almost equivalently, in 6 holistic developmental areas and generally disagreed that the detractors of dental STMs adversely affected their involvement. Practical ImplicationsThe dentists surveyed advocated for dental STMs as a “life-transforming,” developmentally holistic experience that brings caring and hope in action to underserved people globally. Detractors of dental STMs can be overcome, and dentists essentially concurred that quality dental STMs could be performed in portable, often austere, situations. Beneficial recruitment recommendations are presented for dentists contemplating STM participation.

Pastoral response to unemployment

Pastoral work is about assisting people to live their lives to the full. A great deal of scholarship has accumulated around the employment challenges precipitated by a variety of socio-political and economic factors. The all-encompassing challenge with which we are presented is to create and sustain a community of care, promoting hope, personal agency and self-determination to earn a living, in a life-giving environment This paper rests on the concept of “Hope in Action” as the mission of the church and examines the hermeneutics of hope and work, as mandatory for a meaningful life. The paper suggests a structure for an intervention that could be useful for those who work with young people to awaken hope, as a unique foundation, and make plans to find work so that they can earn a sustainable livelihood and live life to the full.

A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action.

HIV-positive donor to HIV-positive recipient (HIV D+/R+) transplantation is permitted in the United States under the HIV Organ Policy Equity Act. To explore safety and the risk attributable to an HIV+ donor, we performed a prospective multicenter pilot study comparing HIV D+/R+ vs HIV-negative donor to HIV+ recipient (HIV D-/R+) kidney transplantation (KT). From 3/2016 to 7/2019 at 14 centers, there were 75 HIV+ KTs: 25 D+ and 50 D- (22 recipients from D- with false positive HIV tests). Median follow-up was 1.7years. There were no deaths nor differences in 1-year graft survival (91% D+ vs 92% D-, P=.9), 1-year mean estimated glomerular filtration rate (63mL/min D+ vs 57mL/min D-, P=.31), HIV breakthrough (4% D+ vs 6% D-, P>.99), infectious hospitalizations (28% vs 26%, P=.85), or opportunistic infections (16% vs 12%, P=.72). One-year rejection was higher for D+ recipients (50% vs 29%, HR: 1.83, 95% CI 0.84-3.95, P=.13) but did not reach statistical significance; rejection was lower with lymphocyte-depleting induction (21% vs 44%, HR: 0.33, 95% CI 0.21-0.87, P=.03). In this multicenter pilot study directly comparing HIV D+/R+ with HIV D-/R+ KT, overall transplant and HIV outcomes were excellent; a trend toward higher rejection with D+ raises concerns that merit further investigation.

Formation of Primary Care Competencies in the Ukrainian Evangelical Medical Project.

Over the past 50 years, a number of residency programs have been established with medical missionary involvement in low- and middle-income countries across the globe. Current evidence supports the idea that faith-based organizations continue to play a part in health provision, especially in emerging economies and fragile health care systems.In Ukraine, income levels are among the lowest in Europe at approximately US $110 per month. Ukrainian family physicians have insufficient training in practical skills, holistic care, and evidence-based medicine, and less than 1% of family physicians are proficient in English. In 2017, only 3% of young physicians succeeded in passing a standardized Western-style examination.The Ukrainian Christian Mobile Medical Team (UCMMT) is a faith-based medical ministry that has been operating in Ukraine since 2002 under the umbrella of the international humanitarian aid organization “Hope in Action.” During this period, teams have conducted 300 outreach events across Ukraine, caring for approximately 80 000 patients. Currently, around 200 volunteers are involved with UCMMT, including 60 physicians. Assets of the program include 3 mobile units with medical equipment, including diagnostic ultrasound, a mammogram unit, an x-ray unit, and a laboratory providing hematological and biochemical analysis.UCMMT's priorities include assisting remote, poor, and underserved communities and caring for populations in areas affected by war and the Chernobyl nuclear accident. In collaboration with local health authorities and the Ministry of Health of Ukraine, UCMMT empowers local physicians through education and medical seminars. In addition, a curriculum has been developed to provide more formal education for team members who wish to attend educational activities on a regular basis. Assistance in the educational efforts has been provided by Radiologists without Borders, a US organization that provides radiology equipment and training to developing economies, and In His Image International, a family medicine residency in Tulsa, Oklahoma, whose leaders assist medical residencies internationally, and which recently accepted the Ukraine program into its core group of 10 residency programs the organization supports worldwide. The International Classification of Primary Care and the WONCA Global Standards for Postgraduate Family Medicine Education are used as curriculum resources.Since early 2018, 5 Ukrainian physician trainees are mastering 150 competencies in 30 areas of medical science with the goal of improving their performance on standardized tests by at least 20% compared to baseline. During outreach activities, these trainees evaluate 12 patients per day under the preceptorship of a senior physician. Problem-oriented learning and evidence-based medicine are used to facilitate professional growth. Trainees attend an average of 20 full clinic days per year, 5 hours of formal lectures and didactic activities per month, and an additional 15 hours of self-education per month.Due to the lack of financial support, only 30% of trainees can attend all available educational activities. A more formal scholarship award is being considered to sponsor some of the most active participants. The lack of a stationary clinic and an inpatient facility remains a barrier to broader educational opportunities for trainees. The funding of the existing work is sporadic and dependent on donations and grants from individuals and organizations.This formal education program for family medicine trainees, with support from US medical outreach efforts, has been effective in enhancing the professional development of a small group of physicians, with intended benefits for patient care and population health in a nation with a fragile health care system.

Relational Empathy as an Instrument of Democratic Hope in Action

ABSTRACT Historically, philosophers have understood hope in relation to an individual's character and have questioned whether or not hope is rational. American pragmatists, however, have tended to characterize hope as fundamentally social and have been concerned with the problems that arise when different hopes for a better future conflict with one another. Pragmatism's philosophy of social hope is often referred to as meliorism, the idea that the world can be made better with human effort. But in a democratic, open society, what makes the world “better” is debatable given the fact that sometimes the attainment of what is hoped for disallows others to flourish. In this article, I reconstruct the radically democratic and inclusive ideal of social hope first by making a distinction between expectant hope and hope in action. I then introduce a historically informed and pluralistic idea of empathy, what I call relational empathy, and suggest that the practice of relational empathy can serve as a vehicle for hope in action and affords us the opportunity to widen the windows of our perception, challenge our biases, and practice democracy as a way of life.

HORIZONS IN TRANSFORMATIONAL DEVELOPMENT AND TRANSNATIONAL MIGRATION: DOES HOPE MATTER?

There is growing interest in the wellbeing of refugees and particularly the strategies they employ in their quest for improved livelihoods. This article reports on a recent study on the dynamics of the refugee phenomenon. It focuses largely on the long-term livelihood strategies that refugee migrants bring into play so as to earn their living and improve their wellbeing amid sheer vulnerability. The study reveals that the majority of African refugees in Cape Town have shifted from short-term survival mechanisms such as the dependence on relief from churches, faith-based organisations, mosques, etc., to long-term strategies. The article concludes by exploring the concept of development as hope in action. Here, it is established that although a considerable number of refugees leave their home countries with a certain level of uncertainty concerning their survival in the hosting country, they use their hope as a resource to improve their livelihoods.

Hope in Action: Subversive Eschatology in the Theology of Edward Schillebeeckx and Johann Baptist Metz by Steven M. Rodenborn, Fortress Press, Minneapolis, 2014, pp. 366, £25.99, pbk

Hope in Action: Subversive Eschatology in the Theology of Edward Schillebeeckx and Johann Baptist Metz by Steven M. Rodenborn, Fortress Press, Minneapolis, 2014, pp. 366, £25.99, pbk

Accounting and the Hope of Action

The paper discusses the role of hope in the construction of an accounting technology to realize a program, by looking at a process of choosing non-financial indicators in an effort to achieve healthier workplaces. By exploring the literature dealing with the concept of hope and by drawing on the debate on the relationship between accounting and action, we highlight the features of three hope-related concepts (hopelessness, naïve hope, and reflective hope). We also highlight how these concepts relate to different areas of uncertainty (validity, accuracy, and relevance) in the development of accounting technologies. Evidence collected through particiapant observation of a team involved in the construction of indicators offers empirical material to investigate the interplay between hopelessness, naïve hope, and reflective hope in relation to uncertainties concerning the link between accounting and action. Beyond analyzing how team members move from a naïve to a reflective hope in making the accounting–action link, the paper shows that among practitioners it is accepted that unintended consequences constitute the rule rather than the exception in the accounting–action link.

Book Review: Hope in Action: Subversive Eschatology in the Theology of Edward Schillebeeckx and Johann Baptist Metz. By Steven M. Rodenborn

Book Review: Hope in Action: Subversive Eschatology in the Theology of Edward Schillebeeckx and Johann Baptist Metz. By Steven M. Rodenborn

Hope in action—facing cardiac death: A qualitative study of patients with life-threatening disease

Coping with existential challenges is important when struck by serious disease, but apart from cancer and palliative care little is known about how patients deal with such issues and maintain hope. To explore how patients with life-threatening heart disease experience hope when coping with mortality and other existential challenges, we conducted a qualitative study with semi-structured interviews. We made a purposive sample of 11 participants (26–88 years) who had experienced life-threatening disease: eight participants with serious heart disease, two with cancer, and one with severe chronic obstructive pulmonary disease. Analysis was by systematic text condensation. The findings showed that hope could enhance coping and diminish existential distress when patients were confronted with mortality and other existential challenges. Hope was observed as three types of dynamic work: to shift perception of mortality from overwhelming horror toward suppression or peaceful acceptance, to foster reconciliation instead of uncertainty when adapting to the new phase of life, and to establish go-ahead spirit instead of resignation as their identity. Meaning of life could, hence, be sustained in spite of serious threats to the persons’ future, everyday life, and self-conception. The work of hoping could be supported or disturbed by relationships with family, friends, and health care professionals. Hope can be regarded as an active, dynamic state of existential coping among patients with life-threatening disease. Physicians may support this coping and thereby provide personal growth and alleviation of existential distress by skillfully identifying, acknowledging, and participating in the work of hoping performed by the patient.

Intergenerational Discussions as a Curriculum Strategy: Modeling Audacious Hope in Action

This article builds upon the idea of audacious hope in action described by Generett and Hicks in “Beyond Reflective Competency: Teaching for Audacious Hope-in-Action.” Outlining the difficulties that teachers experience sustaining hope, the author describes the survival strategies used by African Americans to remain hopeful when there was little evidence to support such a stance. This article proposes that intergenerational conversations with African Americans who are committed to social change can be an effective curriculum strategy for teacher educators seeking to incorporate a hopeful stance into their curriculums.

New hope for a comprehensive test ban

In 1985, the United Nations adopted a record number of resolutions (66) covering almost every conceivable measure of disarmament. Unfortunately, the substantive resolutions will remain, as they have for the last six years, totally unimplemented. One resolution, however, put forward for the first time contains a novel approach that might lead in due course to the achievement of a ban on all nuclear testing. At the very least, it holds out more hope for action than previous approaches. Sponsored by Mexico and five other nonaligned countries, the resolution recommends that the parties to the Partial Test Ban Treaty of 1963 should carry out urgent consultations among themselves as to the advisability and most appropriate method to take advantage of the amendment procedure in Article II of the Treaty for the conversion of the partial Nuclear Test Ban Treaty into a comprehensive nuclear test ban treaty. The General Assembly adopted the resolution by an overwhelming majority of 121 votes to three, with 24 abstentions. The Soviet Union and its allies voted for the resolution and only the United States, the United Kingdom, and France voted against it; a few Western and a few nonaligned and neutral countries abstained. China did notmore » participate in the voting.« less

Hopes and Failures: American Policy Toward East Central Europe, 1941–1947

When the attack on Pearl Harbor plunged the United States into its second world war, the immediate concern of political leaders and public opinion alike was to train its manpower and to mobilize its industrial resources as the fisrst step in the long up-hill climb from initial defeat to decisive victory, first against Germany, then against Japan. Its prime political aim was to forge and maintain an effective working alliance with its major allies, Britain and the Soviet Union. If either faltered or failed in the joint effort, the road to victory and postwar security would stretch out beyond the horizon. After almost two decades of selfimposed isolation, American power was now to be concerned intimately with decisions, taken or not taken, which would in turn affect all parts of the world. Neither possessing the British tradition of continuity in its diplomacy nor possessed by the ruthless Soviet drive for expansion, impsrovised American policy-making toward many areas, including East Central Europe, sometimes mistook sympathy for policy, hope for action.