Search results for: ethics

Authors: Marthadale Acibo Semacio

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Speaking skill is a crucial part of English language teaching and learning. This actually shows the great importance of this skill in English language classes. Through speaking, ideas and thoughts are shared with other people, and a smooth interaction between people takes place. The study examined the levels of speaking proficiency of the control and experimental groups on pronunciation, grammatical accuracy, and fluency. As a quasi-experimental study, it also determined the presence or absence of significant changes in their speaking proficiency levels in terms of pronouncing the words correctly, the accuracy of grammar and fluency of a language given the two methods to the groups of students in the English language, using the traditional and audio-lingual methods. Descriptive and inferential statistics were employed according to the stated specific problems. The study employed a video presentation with prior information about it. In the video, the teacher acts as model one, giving instructions on what is going to be done, and then the students will perform the activity. The students were paired purposively based on their learning capabilities. Observing proper ethics, their performance was audio recorded to help the researcher assess the learner using the modified speaking rubric. The study revealed that those under the traditional method were more fluent than those in the audio-lingual method. With respect to the way in which each method deals with the feelings of the student, the audio-lingual one fails to provide a principle that would relate to this area and follows the assumption that the intrinsic motivation of the students to learn the target language will spring from their interest in the structure of the language. However, the speaking proficiency levels of the students were remarkably reinforced in reading different words through the aid of aural media with their teachers. The study concluded that using an audio-lingual method of teaching is not a stand-alone method but only an aid of the teacher in helping the students improve their speaking proficiency in the English Language. Hence, audio-lingual approach is encouraged to be used in teaching English language, on top of the chalk-talk or traditional method, to improve the speaking proficiency of students.

Keywords: audio-lingual, speaking, grammar, pronunciation, accuracy, fluency, proficiency

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Authors: Ana Mafalda Silva, Rebeca Fontes, Ana Paula Vaz, Carla Carreira, Ana Corte-Real

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Decades of research on the topic of interpersonal violence against minors highlight five main conclusions: 1) it causes harmful effects on children's development and health; 2) it is prevalent; 3) it violates children's rights; 4) it can be prevented and 5) parents are the main aggressors. The child abuse scenario is identified through clinical observation, administrative data and self-reports. The most used instruments are self-reports; however, there are no valid and reliable self-report instruments for minors, which consist of a retrospective interpretation of the situation by the victim already in her adult phase and/or by her parents. Clinical observation and collection of information, namely from the orofacial region, are essential in the early identification of these situations. The management of medical data, such as personal data, must comply with the General Data Protection Regulation (GDPR), in Europe, and with the General Law of Data Protection (LGPD), in Brazil. This review aims to answer the question: In a situation of medical assistance to minors, in the suspicion of interpersonal violence, due to mistreatment, is it necessary for the guardians to provide consent in the registration and sharing of personal data, namely medical ones. A scoping review was carried out based on a search by the Web of Science and Pubmed search engines. Four papers and two documents from the grey literature were selected. As found, the process of identifying and signaling child abuse by the health professional, and the necessary early intervention in defense of the minor as a victim of abuse, comply with the guidelines expressed in the GDPR and LGPD. This way, the notification in maltreatment scenarios by health professionals should be a priority and there shouldn’t be the fear or anxiety of legal repercussions that stands in the way of collecting and treating the data necessary for the signaling procedure that safeguards and promotes the welfare of children living with abuse.

Keywords: child abuse, disease notifications, ethics, healthcare assistance

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Authors: Seema Dutt Bandhu, Yashi Bansal, Tania Moudgil, Barinder Kaur

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Introduction: Scleral perforation during the passage of suture needle is a known complication of strabismus surgery. The present study was conducted to evolve a safe and easy technique of passing the suture needle through the sclera. A scleral tunnel was created with a 26-guage needle through which the suture needle was passed. The rest of the steps of strabismus surgery were carried out as usual. Material and Methods: After taking clearance from the Institutional Ethics Committee, an interventional study was carried out on twenty patients. The scleral tunnel technique was performed on the patients of strabismus after taking written informed consent. Before passing the suture needle through the sclera during strabismus surgery, a tunnel through approximately half the thickness of the sclera was created with the help of a bent 26-gauge needle. The suture needle was then passed through this tunnel. Rest of the steps of the surgery were carried out in the conventional manner. In a control group of same number of patients, the surgery was performed in the conventional method. Both the groups were followed up for any complications. Ease of passing suture and surgeons’ satisfaction with the technique was noted on a 10-point Likert scale. Results: None of the patients in either group suffered from any complications. Four surgeons participated in the study. The average Likert scale score of the surgeons for satisfaction with the technique was 4.5 on a scale of 5. The score for ease of passage of suture needle was 5 on a score of 5. Discussion: Scleral perforation during passing the sutures through the sclera is a known complication of strabismus surgery. Incidence reported is 7.8% It occurs due to inappropriate engagement of the scleral tissue or passage of the suture needle along a wrong axis during the process of passing the suture needle. The needle track technique eases the passage of passing the suture needle through the sclera as the engagement of the scleral tissue can be done with greater control with a 26-guage needle. The surgeons have reported that they are highly satisfied with the technique and they have reported that the technique eased the passage of the suture needle through the sclera.

Keywords: suture, scleral tunnel, strabismus, scleral perforation

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Authors: Suresh Lokiah

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The emerging trend of integrating robots into elderly care, particularly for assisting patients with dementia, holds the potential to greatly transform the sector. Assisted living facilities, which house a significant number of elderly individuals and dementia patients, constantly strive to engage their residents in stimulating activities. However, due to staffing shortages, they often rely on volunteers to introduce new activities. Despite the availability of social interaction, these residents, frequently overlooked in society, are in desperate need of additional support. Robots designed for elder care are categorized based on their design and functionality. These categories include companion robots, telepresence robots, health monitoring robots, and rehab robots. However, the integration of such robots raises significant ethical concerns, notably regarding privacy, autonomy, and the risk of dehumanization. Privacy issues arise as these robots may need to continually monitor patient activities. There is also a risk of patients becoming overly dependent on these robots, potentially undermining their autonomy. Furthermore, the replacement of human touch with robotic interaction may lead to the dehumanization of care. This paper delves into the ethical considerations of incorporating robotic assistance in eldercare. It proposes a series of guidelines and strategies to ensure the ethical deployment of these robots. These guidelines suggest involving patients in the design and development process of the robots and emphasize the critical need for human oversight to respect the dignity and rights of the elderly and dementia patients. The paper also recommends implementing robust privacy measures, including secure data transmission and data anonymization. In conclusion, this paper offers a thorough examination of the ethical implications of using robotic assistance in elder care. It provides a strategic roadmap to ensure this technology is utilized ethically, thereby maximizing its potential benefits and minimizing any potential harm.

Keywords: human-robot interaction, robots for eldercare, ethics, health, dementia

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Authors: Hernán A. Perez, Luis J. Armando, Néstor H. García

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Background and aims Cardiovascular disease rates are very high in patients with renal failure (CRF), but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in CRF do not reduce cardiovascular events. These results may be the results of ‘accelerated atherosclerosis’ observed on these patients. The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with CRF. We studied a cohort of patients with CRF not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent from each participant was obtained. We performed a cohort study in 412 patients with Stage 1, 2 and 3 CRF. Clinical and laboratory data were obtained. TPA was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease estimation formula was used to determine renal function. ANOVA was used when appropriate. Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 (p < 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that TPA increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be used to measure effects of antiatherosclerotic therapy.

Keywords: hypertension, chronic renal failure, atherosclerosis, cholesterol

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Authors: Muhammad Jum’at Sasuki

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This study investigates the ethical implications of post-fuel subsidy removal support initiatives in Kwara State, Nigeria, with a focus on the application of Islamic principles. The contentious issue of subsidy removal carries significant social and economic consequences, emphasizing the crucial role of ethical considerations in policy implementation. The research provides a comprehensive background on fuel subsidy removal in Nigeria and its implications. Examining post-fuel subsidy removal palliative measures in Kwara State, the study focuses on design and implementation challenges, ethical considerations, transparency, equity, and public trust. Utilizing a case study approach, it offers insights and best practices. The methodology includes primary sources through in-depth oral interviews and secondary sources like textbooks and journals, aiming for a holistic understanding of the ethical dimensions of support initiatives within the context of Islamic principles in Kwara State. The objective is to contribute to policy decisions and community development. The study recommends an ethically sound implementation of post-fuel subsidy removal support initiatives, emphasizing transparency, accountability, and inclusivity. It advocates for the inclusiveness of governmental palliatives, reaching both civil servants and common individuals in the state. Continuous distribution during fuel subsidy removal challenges is deemed vital. Additionally, extending free or subsidized transportation beyond higher institutions to the general populace is suggested. Consideration should also be given to reducing governmental hospital bills or providing free health services. The study underscores the importance of Islamic ethics in Nigerian governance and employs a case study approach to assess palliative measures in Kwara State, offering practical insights for policymakers and stakeholders.

Keywords: considerations, ethical, palliative, subsidy

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Authors: Karen Fang

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Investigative genetic genealogy has attracted much interest in both the field of ethics and the public eye due to its global application in criminal cases. Arguments have been made regarding privacy and informed consent, especially with law enforcement using consumer genetic testing results to convict individuals. In the case of public interest, DNA databases have the strong potential to significantly reduce crime, which in turn leads to safer communities and better futures. With the advancement of genetic technologies, the integration of a universal forensic DNA database in violent crimes, crimes against children, and missing person cases is expected to deter crime while protecting one’s privacy. Rather than collecting whole genomes from the whole population, STR profiles can be used to identify unrelated individuals without compromising personal information such as physical appearance, disease risk, and geographical origin, and additionally, reduce cost and storage space. STR DNA profiling is already used in the forensic science field and going a step further benefits several areas, including the reduction in recidivism, improved criminal court case turnaround time, and just punishment. Furthermore, adding individuals to the database as early as possible prevents young offenders and first-time offenders from participating in criminal activity. It is important to highlight that DNA databases should be inclusive and tightly governed, and the misconception on the use of DNA based on crime television series and other media sources should be addressed. Nonetheless, deterrent effects have been observed in countries like the US and Denmark with DNA databases that consist of serious violent offenders. Fewer crimes were reported, and fewer people were convicted of those crimes- a favorable outcome, not even the death penalty could provide. Currently, there is no better alternative than a universal forensic DNA database made up of STR profiles. It can open doors for investigative genetic genealogy and fostering better communities. Expanding the appropriate use of DNA databases is ethically acceptable and positively impacts the public.

Keywords: bioethics, deterrent effects, DNA database, investigative genetic genealogy, privacy, public interest

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Authors: Stéfani T. A. Dantas, Laura T. S. Takume, Bruna F. Rossi, Érika R. Bonsaglia, Ivana G. Castilho, José C. F. Pantoja, Ary Fernandes Júnior, Juliano L. Gonçalves, Marcos V. Santos, Rinaldo A. Mota, Vera L. M. Rall

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Staphylococcus aureus is one of the main pathogens causing contagious bovine mastitis, being more frequently isolated from subclinical form, although the clinical form also occurs. Clinical mastitis cause visual signs, such as swelling, fever, hardening of the mammary gland, or any change in the characteristics of the milk. Considering the subclinical type, there are no visible signs in the animal nor changes in the milk. S. aureus has many important virulence factors for the establishment of its pathogenicity in animals, such as enterotoxins, which are also responsible for foodborne poisoning. Our objective is to perform a comparative analysis between 103 isolates of S. aureus, obtained from the milk of cows with clinical mastitis and 103 more, from subclinical type, in relation to the presence of these enterotoxins and verify if their presence plays an important role in the signs of illness. We will investigate all enterotoxins described till now, such as sea-see, seg-sez, sel26, sel 27, se01, and se02 (This study was approved by the Sao Paulo State University Animal Use Ethics Committee, No. 0136/2017). For the PCR assay, we used Illustra Bacteria Mini Spin Kit for bacterial DNA. At this moment, we have already tested sea-see, seg-ser, sew, and sex, and the results have already been submitted to Fisher Exact Probability Test or Chi-square Test. Considering the isolates obtained from clinical mastitis, the most frequent enterotoxins were selw (99%), selx (78%) and selh (50.5%), and sec, see, sej, sell, selp,and ser were absent. Among the subclinics, selw (82.5%) selm (15.5%) and selx (14.6%) were the most frequent, and sea-see, seg, sei-sel, sem-ser were absent. We have already observed statistically significant differences for seb, seg, seh, sei, selo, selu, selw and selx. Other interesting results were the low number of genes in each isolate from subclinical mastitis [0 genes: 14 (13.6%); 1 gene: 55 (53.4%); 2 genes: 33 (32%) or 3: 1 (0.97%)] compared to clinical isolates [1 gene: 5 (4.9%); 2 genes: 29 (28.1%); 3 genes: 38 (36.9%); 4 genes: 14 (13.6%); 5 genes: 5 (4.9%); 6 genes: 4 (3.9%); 7 genes: 5 (4.9%); 8 genes: 2 (1.9%) and 9 genes: 1 (1%)]. Based on these results, we can conclude that enterotoxins indeed play an important role in clinical signs in cattle with mastitis.

Keywords: mastitis, S. aureus, PCR, staphylococcal enterotoxin

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Authors: Siswoyo Haryono

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Purpose – The fundamental goal of this research is to see if the integrative organizational behavior model can be used effectively in Islamic boarding schools. This paper also seeks to assess the effect of Islamic organizational culture, leadership, and spiritual intelligence on teachers' organizational commitment to Islamic Boarding schools. The goal of the mediation analysis is to see if the Islamic work ethic has a more significant effect on the instructors' organizational commitment than the direct effects of Islamic organizational culture, leadership, and Islamic spiritual intelligence. Design/methodology/approach – A questionnaire survey was used to obtain data from teachers at Islamic Boarding Schools. This study used the AMOS technique for structural equation modeling to evaluate the expected direct effect. To test the hypothesized indirect effect, employed Sobel test. Findings – Islamic organizational culture, Islamic leadership, and Islamic spiritual intelligence significantly affect Islamic work ethic. When it comes to Islamic corporate culture, Islamic leadership, Islamic spiritual intelligence, and Islamic work ethics have a significant impact. The findings of the mediation study reveal that Islamic organizational culture, leadership, and spiritual intelligence influences organizational commitment through Islamic work ethic. The total effect analysis shows that the most effective path to increasing teachers’ organizational commitment is Islamic leadership - Islamic work ethic – organizational commitment. Originality/value – This study evaluates the Integrative Model of Organizational Behavior by Colquitt (2016) applied in Islamic Boarding School. The model consists of contemporary leadership and individual characteristic as the antecedent. The mediating variables of the model consist of individual mechanisms such as trust, justice, and ethic. Individual performance and organizational commitment are the model's outcomes. These variables, on the other hand, do not represent the Islamic viewpoint as a whole. As a result, this study aims to assess the role of Islamic principles in the model. The study employs reliability and validity tests to get reliable and valid measures. The findings revealed that the evaluation model is proven to improve organizational commitment at Islamic Boarding School.

Keywords: Islamic leadership, Islamic spiritual intelligence, Islamic work ethic, organizational commitment, Islamic boarding school

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Authors: S. Somerset, D. J. Hoare, P. Leighton

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Limited participation in physical activity and sport has been linked to poorer mental and physical health in children. Studies have shown that children who participate in sports benefit from improved social skills, self-confidence, communication skills and a better quality of life. Children who participate in sport are also more likely to continue their participation into their adult life. Deaf or hard of hearing children should have the same opportunities to participate in sport and receive the benefits as their hearing peers. Anecdotal evidence suggests this isn’t always the case. This is concerning given there are 45,000 children in the UK with permanent hearing loss. The aim of this study was to understand what encourages or discourages deaf or hard of hearing children to take part in sports. Ethical approval for the study was obtained from the University of Nottingham School of Medicine ethics committee. We conducted eight focus groups with deaf or hard of hearing children aged 10 to 15 years. A total of 45 children (19 male, 26 female) recruited from local schools and sports clubs took part. Information was gathered on the children’s thoughts and feelings about participation in sport. This included whether they played sports and who with, whether they did or did not like sport, and why they got involved in sport. Focus groups were audio recorded and transcribed. Transcripts were analysed using thematic analysis. Several key themes were identified as being associated with levels of sports participation. These included friendships, family and communication. Deaf or hard of hearing children with active siblings had participated in more sports. Communication was a common theme throughout regardless of the type of hearing-assistive technology a child used. Children found communication easier during sport if they were allowed to use their technology and had particular difficulty during sports such as swimming. Children expressed a desire not to have to identify themselves at a club as having a hearing loss. This affected their confidence when participating in sport. Not surprisingly, children who are deaf or hard of hearing are more likely to participate in sport if they have a good support network of parents, coaches and friends. The key barriers to participation for these children are communication, lack of visual information, lack of opportunity and a lack of awareness. By addressing these issues more deaf and hard of hearing children will take part in sport and will continue their participation.

Keywords: barrier, children, deaf, participation, hard of hearing, sport

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Authors: Eric Dede, Marcus Tindall, John W. Cherrie, Steve Hankin, Christopher Collins

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Current exposure models used in contaminated land risk assessment are highly conservative. Use of these models may lead to over-estimation of actual exposures, possibly resulting in negative financial implications due to un-necessary remediation. Thus, we are carrying out a study seeking to improve our understanding of human exposure to selected toxic elements in soil: arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni), and lead (Pb) resulting from allotment land-use. The study employs biomonitoring and physiologically-based pharmacokinetic (PBPK) modelling to quantify human exposure to these elements. We recruited 37 allotment users (adults > 18 years old) in Scotland, UK, to participate in the study. Concentrations of the elements (and their bioaccessibility) were measured in allotment samples (soil and allotment produce). Amount of produce consumed by the participants and participants’ biological samples (urine and blood) were collected for up to 12 consecutive months. Ethical approval was granted by the University of Reading Research Ethics Committee. PBPK models (coded in MATLAB) were used to estimate the distribution and accumulation of the elements in key body compartments, thus indicating the internal body burden. Simulating low element intake (based on estimated ‘doses’ from produce consumption records), predictive models suggested that detection of these elements in urine and blood was possible within a given period of time following exposure. This information was used in planning biomonitoring, and is currently being used in the interpretation of test results from biological samples. Evaluation of the models is being carried out using biomonitoring data, by comparing model predicted concentrations and measured biomarker concentrations. The PBPK models will be used to generate bioavailability values, which could be incorporated in contaminated land exposure models. Thus, the findings from this study will promote a more sustainable approach to contaminated land management.

Keywords: biomonitoring, exposure, PBPK modelling, toxic elements

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Authors: Joseph L. Mathew, Shourjendra N. Banerjee, R. K. Ratho, Sourabh Dutta, Vanita Suri

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Background: In India and many other developing countries, a single dose of measles vaccine is administered to infants at 9 months of age. This is based on the assumption that maternal transplacentally transferred antibodies will protect infants until that age. However, our previous data showed that most infants lose maternal anti-measles antibodies before 6 months of age, making them susceptible to measles before vaccination at 9 months. Objective: This prospective study was designed to compare susceptibility in pre-term vs term infants, at different time points. Material and Methods: Following Institutional Ethics Committee approval and a formal informed consent process, venous blood was drawn from a cohort of 45 consecutive term infants and 45 consecutive pre-term infants (both groups delivered by the vaginal route); at birth, 3 months, 6 months and 9 months (prior to measles vaccination). Serum was separated and anti-measles IgG antibody levels were measured by quantitative ELISA kits (with sensitivity and specificity > 95%). Susceptibility to measles was defined as antibody titre < 200mIU/ml. The mean antibody levels were compared between the two groups at the four time points. Results: The mean gestation of term babies was 38.5±1.2 weeks; and pre-term babies 34.7±2.8 weeks. The respective mean birth weights were 2655±215g and 1985±175g. Reliable maternal vaccination record was available in only 7 of the 90 mothers. Mean anti-measles IgG antibody (±SD) in terms babies was 3165±533 IU/ml at birth, 1074±272 IU/ml at 3 months, 314±153 IU/ml at 6 months, and 68±21 IU/ml at 9 months. The corresponding levels in pre-term babies were 2875±612 IU/ml, 948±377 IU/ml, 265±98 IU/ml, and 72±33 IU/ml at 9 months (p > 0.05 for all inter-group comparisons). The proportion of susceptible term infants at birth, 3months, 6months and 9months was 0%, 16%, 67% and 96%. The corresponding proportions in the pre-term infants were 0%, 29%, 82%, and 100% (p > 0.05 for all inter-group comparisons). Conclusion: Majority of infants are susceptible to measles before 9 months of age suggesting the need to anticipate measles vaccination, but there was no statistically significant difference between the proportion of susceptible term and pre-term infants, at any of the four-time points. A larger study is required to confirm these findings and compare sero-protection if vaccination is anticipated to be administered between 6 and 9 months.

Keywords: measles, preterm, susceptibility, term infant

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Authors: Eryati Darwin, Arina Widya Murni, Adnil Edwin Nurdin

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Background: Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Most patients with FD complain of symptoms related to the intake of meals. Psychological stress may promote peptic ulcer and had an effect on ulcers associated Hp, and may also trigger worsen symptoms in inflammatory disorders of the gastrointestinal. Cells in mucosal gastric stimulate the production of several cytokines, which might associated with Helicobacter pylori infection. The cascade of biological events leading to stress-induced FD remains poorly understood. Aim of Study: To determine the prion-flammatory cytokine IL-6, and Helicobacter pylori activity on mucosal gastric of FD and their association with psychological stress. Methods: The subjects of this study were dyspeptic patients who visited M. Djamil General Hospital and in two Community Health Centers in Padang. On the basis of the stress index scale to identify psychological stress by using Depression Anxiety and Stress Scale (DASS 42), subjects were divided into two groups of 20 each, stress groups and non-stress groups. All diagnoses were confirmed by review of cortisol and esophagogastroduodenoscopy reports. Gastric biopsy samples and peripheral blood were taken during diagnostic procedures. Immunohistochemistry methods were used to determine the expression of IL-6 and Hp in gastric mucosal. The data were statistically analyzed by univariate and bivariate analysis. All procedures of this study were approved by Research Ethics Committee of Medical Faculty Andalas University. Results: In this study, we enrolled 40 FD patients (26 woman and 14 men) in range between 35-56 years old. Cortisol level of blood FD patients as parameter of stress hormone which taken in the morning was significantly higher in stress group than non-stress group. The expression of IL-6 in gastric mucosa was significantly higher in stress group in compared to non-stress group (p<0,05). Helicobacter pylori activity in gastric mucosal in stress group were significantly higher than non-stress group. Conclusion: The present study showed that psychological stress can induce gastric mucosal inflammation and increase of Helicobacter pylori activity.

Keywords: functional dyspepsia, Helicobacter pylori, interleukin-6, psychological stress

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Authors: Yasmin Nanabhay

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The paper scrutinizes the literature on accountability and non-accountability, and then presents an analysis of a South African case which demonstrated consequences of a lack of accountability. Ethical conduct displayed by members of the public sector is integral to creating a sustainable democratic government, which upholds the constitutional tenets of accountability, transparency and professional ethicality. Furthermore, a true constitutional democracy emphasises and advocates the notion of service leadership that nurtures public participation and engages with citizens in a positive manner. Ethical conduct and accountability in the public sector earns public trust; hence these are key principles in good governance. Yet, in the years since the advent of democracy in South Africa, the government has been plagued by rampant corruption and mal-administration by public officials and politicians in leadership positions. The control measures passed by government in an attempt to ensure ethicality and accountability within the public sector include codes of ethics, rules of conduct and the enactment of legislation. These are intended to shape the mindset of members of the public sector, with the ultimate aim of an efficient, effective, ethical, responsive and accountable public service. The purpose of the paper is to analyse control systems and accountability within the public sector and to present reasons for non-accountability by means of a selected case study. The selected case study is the corruption trial of Jackie Selebi, who served as National Commissioner of the South African Police Service but was dismissed from the post. The reasons for non-accountability in the public sector as well as recommendations based on the findings to enhance accountability will be undertaken. The case study demonstrates the experience and impact of corruption and/or mal-administration, as a result of a lack of accountability, which has contributed to the increasing loss of confidence in political leadership in the country as elsewhere in the world. The literature is applied to the erstwhile National Commissioner of the South African Police Service and President of Interpol, as a case study of non-accountability.

Keywords: corruption, internal control, maladministration, non-compliance, oversight mechanisms, public accountability, public sector

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Authors: Ayse Inel Manav, Nuray Simsek

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The number of people with dementia and the problems that are experienced by these people are increasing along with aging world population. This study was carried out to assess the effects of reminiscence therapy using internet videos on the cognitive condition and apathy levels of elderly people who had mild dementia and lived in nursing homes. This randomly controlled experimental study was conducted between 25 May-25 August 2016 in the nursing home, elderly care and rehabilitation centers in Adana and Seyhan, Turkey. A total of 32 individuals participated in this study, 16 in the experimental group and 16 in the control group. Data were collected using a personal information form developed on the basis of the published literature, the Standardized Mini Mental Test (SMMT) and the Apathy Rating Scale (ARS). The Clinical Research Ethics Committee's approval, written institutional permission, and the written consent of the participants were obtained before data collection. The individuals in the experimental group received reminiscence therapy using internet videos for 60 minutes one day a week for three months. During the same period, 25-30 minutes of unstructured interviews on subjects unrelated to reminiscence were carried out with individuals in the control group. The SMMT and ARS were administered before the applications in the experimental group and at the end of the third month. The collected data were analyzed using descriptive statistics (means, standard deviations, and frequencies) as well as Student's t-test, the Mann-Whitney U-test, and Wilcoxon's signed ranks test. In this study, the total SMMT post-test scores of the experimental group were higher than those of the control group (p = 0.001; p < 0.01). There was a difference between experimental and control groups' total SMMT post-test scores (p = 0.001; p < 0.01). The experimental group's ARS total post-test scores were higher than those of the control group (p = 0.001; p < 0.01). This study found that group reminiscence therapy using internet videos improved the cognitive functions and apathy levels of elderly individuals with mild dementia.

Keywords: apaty, cognitive testing, dementia, elderly, reminisence threapy

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Authors: A. Bajek, J. Skopinska-Wisniewska, A. Rynkiewicz, A. Jundzill, M. Bodnar, A. Marszalek, T. Drewa

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Traumatic injury and age-related degenerative diseases associated with cartilage are major health problems worldwide. The articular cartilage is comprised of a relatively small number of cells, which have a relatively slow rate of turnover. Therefore, damaged articular cartilage has a limited capacity for self-repair. New clinical methods have been designed to achieve better repair of injured cartilage. However, there is no treatment that enables full restoration of it. The aim of this study was to evaluate how collagen gel with bone marrow mesenchymal stem cells (MSCs) and collagen gel alone will influence on the hip cartilage repair after injury. Collagen type I was isolated from rats’ tails and cross-linked with N-hydroxysuccinimide in 24-hour process. MSCs were isolated from rats’ bone marrow. The experiments were conducted according to the guidelines for animal experiments of Ethics Committee. Fifteen 8-week-old Wistar rats were used in this study. All animals received hip joint surgery with a total of 30 created cartilage defects. Then, animals were randomly divided into three groups and filled, respectively, with collagen gel (group 1), collagen gel cultured with MSCs (group II) or left untreated as a control (control group). Immunohistochemy and radiological evaluation was carried out 11 weeks post implantation. It has been proved that the surface of the matrix is non-toxic, and its porosity promotes cell adhesion and growth. However, the in vivo regeneration process was poor. We observed the low integration rate of biomaterial. Immunohistochemical evaluation of cartilage after 11 weeks of treatment showed low II and high X collagen expression in two tested groups in comparison to the control one, in which we observed the high II collagen expression. What is more, after radiological analysis, we observed the best regeneration process in control group. The biomaterial construct and mesenchymal stem cells, as well as the use of the biomaterial itself was not sufficient to regenerate the hip cartilage surfaces. These results suggest that the collagen gel based biomaterials, even with MSCs, are not satisfactory in repar of hip cartilage defect. However, additional evaluation is needed to confirm these results.

Keywords: collafen gel, MSCs, cartilage repair, hip cartilage

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Authors: Rossukhon Makaramani, Supanan Sittilerd, Wipada Prasarnsaph

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The study aimed to 1) examine management status of a Program in Education at the Faculty of Education, Suan Sunandha Rajabhat University (SSRU); 2) determine main components, indicators and criteria for constructing quality assessment framework; 3) assess quality of a SSRU Program in Education; and 4) provide recommendations to promote academic excellence. The program to be assessed was Bachelor of Education Program in Education (5 years), Revised Version 2009. Population and samples were stakeholders involving implementation of this program during an academic year 2012. Results were: 1) Management status of the Program in Education showed that the Faculty of Education depicted good level (4.20) in the third cycle of external quality assessment by the Office for National Education Standards and Quality Assessment (ONESQA). There were 1,192 students enrolling in the program, divided into 5 major fields of study. There were 50 faculty members, 37 holding master’s degrees and 13 holding doctorate degrees. Their academic position consisted of 35 lecturers, 10 assistant professors, and 5 associate professors. For program management, there was a committee of 5 members for the program and also a committee of 4 or 5 members for each major field of study. Among the faculty members, 41 persons taught in this program. The ratio between faculty and student was 1:26. The result of 2013 internal quality assessment indicated that system and mechanism of the program development and management was at fair level. However, the overall result yielded good level either by criteria of the Office of Higher Education Commission (4.29) or the NESQA (4.37); 2) Framework for assessing the quality of the program consisted of 4 dimensions and 15 indicators; 3) Assessment of the program yielded Good level of quality (4.04); 4) Recommendations to promote academic excellence included management and development of the program focusing on teacher reform toward highly recognized profession; cultivation of values, moral, ethics, and spirits of being a teacher; construction of specialized programs; development of faculty potentials; enhancement of the demonstration school’s readiness level; and provision of dormitories for learning.

Keywords: quality assessment, education program, Suan Sunandha Rajabhat University, academic excellence

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Authors: Betül sönmez, Fatma Azizoğlu, S. Bilge Hapçıoğlu, Aytolan Yıldırım

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Background: Social innovativeness contains the procurement of a sustainable benefit for a number of problems from working conditions to education, social development, health, and from environmental control to climate change, as well as the development of new social productions and services. Objectives: This study was conducted to determine the correlation between the social innovation tendency of nursing and medical faculty students and value types. Methods and participants: The population of this correlational study consisted of third-year students studying at a medical faculty and a nursing faculty in a public university in Istanbul. Ethics committee approval and permission from the school administrations were obtained in order to conduct the study and voluntary participation of the students in the study was ensured. 524 questionnaires were obtained with a total return rate of 57.1% (65.0% in nurse student and 52.1% in physic students). The data of the study were collected by using the Portrait Values Questionnaire and a questionnaire containing the Social Innovativeness Scale. Results: The effect of the subscale scores of Portrait Values Questionnaire on the total score of Social Innovativeness Scale was 26.6%. In the model where a significance was determined (F=37.566; p<0.01), the highest effect was observed in the subscale of universalism. The effect of subscale scores obtained from the Portrait Values Questionnaire, as well as age, gender and number of siblings was 25% on the Social Innovativeness in nursing students and 30.8% in medical faculty students. In both models where a significance was determined (p<0.01), the nursing students had the values of power, universalism and kindness, whereas the medical faculty students had the values of self-direction, stimulation, hedonism and universalism showed the highest effect in both models. Conclusions: Universalism is the value with the highest effect upon the social innovativeness in both groups, which is an expected result by the nature of professions. The effect of the values of independent thinking and self-direction, as well as openness to change involving quest for innovation (stimulation), which are observed in medical faculty students, also supports the literature of innovative behavior. These results are thought to guide educators and administrators in terms of developing socially innovative behaviors.

Keywords: social innovativeness, portrait values questionnaire, nursing students, medical faculty students

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Authors: Natalie Rosales

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Based on an ethical vision which recognizes the vital role of human rights, shared values, social responsibility and justice, and environmental ethics, planning may be interpreted as a process aimed at reducing inequalities and overcoming marginality. Seen from this sustainability perspective, planning evaluation must utilize critical-evaluative and narrative receptive models which assist different stakeholders in their understanding of urban fabric while trigger reflexive processes that catalyze wider transformations. In this paper, this approach servers as a guide for the evaluation of Mexico´s urban planning systems, and postulates a framework to better integrate sustainability notions into planning evaluation. The paper is introduced by an overview of the current debate on evaluation in urban planning. The state of art presented includes: the different perspectives and paradigms of planning evaluation and their fundamentals and scope, which have focused on three main aspects; goal attainment (did planning instruments do what they were supposed to?); performance and effectiveness of planning (retrospective analysis of planning process and policy analysis assessment); and the effects of process-considering decision problems and contexts rather than the techniques and methods. As well as, methodological innovations and improvements in planning evaluation. This comprehensive literature review provides the background to support the authors’ proposal for a set of general principles to evaluate urban planning, grounded on a sustainability perspective. In the second part the description of the shortcomings of the approaches to evaluate urban planning in Mexico set the basis for highlighting the need of regulatory and instrumental– but also explorative- and collaborative approaches. As a response to the inability of these isolated methods to capture planning complexity and strengthen the usefulness of evaluation process to improve the coherence and internal consistency of the planning practice itself. In the third section the general proposal to evaluate planning is described in its main aspects. It presents an innovative methodology for establishing a more holistic and integrated assessment which considers the interdependence between values, levels, roles and methods, and incorporates different stakeholders in the evaluation process. By doing so, this piece of work sheds light on how to advance urban sustainability through the integration of evaluation methodologies into planning.

Keywords: urban planning, evaluation methodologies, urban sustainability, innovative approaches

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Authors: Tian Yi Du, Guan Rong Fan, Dong Dong Zou, Di Xue

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Background: The patient satisfaction survey is becoming of increasing importance for hospitals or other providers to get more reimbursement and/or more governmental subsidies. However, when the results of patient satisfaction survey are compared among medical institutions, there are some concerns. The primary objectives of this study were to evaluate patient satisfaction in tertiary hospitals of Shanghai and to compare the satisfaction rating on physician services between patients and observers. Methods: Two hundred outpatients were randomly selected for patient satisfaction survey in each of 28 public tertiary hospitals of Shanghai. Four or five volunteers were selected to observe 5 physicians’ practice in each of above hospitals and rated observed physicians’ practice. The outpatients that the volunteers observed their physician practice also filled in the satisfaction questionnaires. The rating scale for outpatient survey and volunteers’ observation was: 1 (very dissatisfied) to 6 (very satisfied). If the rating was equal to or greater than 5, we considered the outpatients and volunteers were satisfied with the services. The validity and reliability of the measure were assessed. Multivariate regressions for each of the 4 dimensions and overall of patient satisfaction were used in analyses. Paired t tests were applied to analyze the rating agreement on physician services between outpatients and volunteers. Results: Overall, 90% of surveyed outpatients were satisfied with outpatient care in the tertiary public hospitals of Shanghai. The lowest three satisfaction rates were seen in the items of ‘Restrooms were sanitary and not crowded’ (81%), ‘It was convenient for the patient to pay medical bills’ (82%), and ‘Medical cost in the hospital was reasonable’ (84%). After adjusting the characteristics of patients, the patient satisfaction in general hospitals was higher than that in specialty hospitals. In addition, after controlling the patient characteristics and number of hospital visits, the hospitals with higher outpatient cost per visit had lower patient satisfaction. Paired t tests showed that the rating on 6 items in the dimension of physician services (total 14 items) was significantly different between outpatients and observers, in which 5 were rated lower by the observers than by the outpatients. Conclusions: The hospital managers and physicians should use patient satisfaction and observers’ evaluation to detect the room for improvement in areas such as social skills cost control, and medical ethics.

Keywords: patient satisfaction, observation, quality, hospital

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Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

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The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

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Authors: Wogu Ikedinachi Ayodele Power, Agbude Godwyns, Eniayekon Eugenia, Nchekwube Excellence-Oluye, Abasilim Ugochukwu David

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Contemporary ethicists and writers on leadership, in their quest to address the problem of leadership crisis in Nigeria, have identified the absence of practical prudence -which manifests in variables such as corruption, ethnicity and greed- as one of the major factors which breeds leadership crises. These variables are further fuelled by the lack of a consistent theory of leadership among scholars that could guide the pertinent actions of political leaders, hence the rising cases of leadership crises in the country. The theoretical framework that guides this study emanates from Aristotle’s notion of prudence as contained in the Nicomachean Ethics, which states that prudence is a central moral resource for political leaders. The method of conceptual analysis shall be used to clarify the concepts of virtue, prudence and leadership. The traditional method of critical analysis and the reconstructive method of ideas in philosophy are used to conceptually and contextually analyze all relevant texts and archival materials in the subject areas of this study. The study identifies a high degree of ideological bias and logical inconsistencies inherent in the theories of leadership proposed by the realist and the moralist schools of thought. The conflicting ideologies regarding what political leadership should be among scholars of leadership is identified as one of the major factors militating against ascertaining a practicable theory of leadership, which has the capacity to guide the pertinent actions of political leaders all over the world. This paper therefore identifies the absence of practical prudence, ‘wisdom’, as the major factor associated with leadership crises in Nigeria. We therefore argue that only prudent leaders will have the capacity to identify salient aspects of political situations which leaders have obligations to consider before making political decisions. Seven frameworks were prescribed from Aristotle’s Notion of prudence to strengthen this position, they include: Disciplined reason and openness to experience; Foresight and attention to the long term, among others. We submit that leadership devoid of crisis can be attained through the application of the virtue of prudence. Where this theory is adopted, it should eliminate further leadership crises in Nigeria.

Keywords: Aristotle, leadership crisis, political leadership, prudence

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Authors: Joseph Falzon, Margaret Nelson

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Background: Policy makers at European Union (EU) and national levels address the re-use of historic buildings calling for sustainable practices and approaches. Implementation stages of policy are crucial so that EU and national strategic objectives for historic building sustainability are achieved. Governance remains one of the key objectives to ensure resource sustainability. Objective: The aim of the research was to critically examine policies for the regeneration and adaptive re-use of historic buildings in the EU and national level, and to analyse gaps between EU and national legislation and policies, taking Malta as a case study. The impact of policies on regeneration and re-use of historic buildings was also studied. Research Design: Six semi-structured interviews with stakeholders including architects, investors and community representatives informed the research. All interviews were audio recorded and transcribed in the English language. Thematic analysis utilising Atlas.ti was conducted for the semi-structured interviews. All phases of the study were governed by research ethics. Findings: Findings were grouped in main themes: resources, experiences and governance. Other key issues included identification of gaps in policies, key lessons and quality of regeneration. Abandonment of heritage buildings was discussed, for which main reasons had been attributed to governance related issues both from the policy making perspective as well as the attitudes of certain officials representing the authorities. The role of authorities, co-ordination between government entities, fairness in decision making, enforcement and management brought high criticism from stakeholders along with time factors due to the lengthy procedures taken by authorities. Policies presented an array from different perspectives of same stakeholder groups. Rather than policy, it is the interpretation of policy that presented certain gaps. Interpretations depend highly on the stakeholders putting forward certain arguments. All stakeholders acknowledged the value of heritage in regeneration. Conclusion: Active stakeholder involvement is essential in policy framework development. Research informed policies and streamlining of policies are necessary. National authorities need to shift from a segmented approach to a holistic approach.

Keywords: adaptive re-use, historic buildings, policy, sustainable

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Authors: Hasna Elalaoui Elabdallaoui, Abdelaziz Elfazziki, Mohamed Sadgal

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Outlines: The social economy is a moral approach to solidarity applied to the projects’ development. To reconcile economic activity and social equity, crowdfunding is as an alternative means of financing social projects. Several collaborative blockchain platforms exist. It eliminates the need for a central authority or an inconsiderate middleman. Also, the costs for a successful crowdfunding campaign are reduced, since there is no commission to be paid to the intermediary. It improves the transparency of record keeping and delegates authority to authorities who may be prone to corruption. Objectives: The objectives are: to define a software infrastructure for projects’ participatory financing within a social and solidarity economy, allowing transparent, secure, and fair management and to have a financial mechanism that improves financial inclusion. Methodology: The proposed methodology is: crowdfunding platforms literature review, financing mechanisms literature review, requirements analysis and project definition, a business plan, Platform development process and implementation technology, and testing an MVP. Contributions: The solution consists of proposing a new approach to crowdfunding based on Islamic financing, which is the principle of Mousharaka inspired by Islamic financing, which presents a financial innovation that integrates ethics and the social dimension into contemporary banking practices. Conclusion: Crowdfunding platforms need to secure projects and allow only quality projects but also offer a wide range of options to funders. Thus, a framework based on blockchain technology and Islamic financing is proposed to manage this arbitration between quality and quantity of options. The proposed financing system, "Musharaka", is a mode of financing that prohibits interests and uncertainties. The implementation is offered on the secure Ethereum platform as investors sign and initiate transactions for contributions using their digital signature wallet managed by a cryptography algorithm and smart contracts. Our proposal is illustrated by a crop irrigation project in the Marrakech region.

Keywords: social economy, Musharaka, blockchain, smart contract, crowdfunding

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Authors: Wonder Ngezimana, Benjamin Alex Madzivire

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As new public universities are being applauded for being promulgated in Zimbabwe, there is need for comprehensive plan for ensuring sustainable competitive advantages in their niche mandated areas. Unhealthy competition between university faculties for enrolment hinders growth of the newly established universities faculties, especially in the agricultural sciences related disciplines. Blue ocean metaphor is based on creation of competitor-free market unlike 'red oceans', which are well explored and crowded with competitors. This study seeks to explore the potential contribution of blue oceans strategy (BOS) for growth of universities with bias towards faculties of agriculture in public universities in Zimbabwe. Case studies with agricultural sciences related disciplines were selected across three universities for interviewing. Data was collected through 10 open ended questions on academics in different management positions within university faculties of agriculture. Summative analysis was thereafter used during coding and interpretation of the data. Study findings show that there are several important elements for making offerings more comprehendible towards fostering faculty growth and performance with bias towards student enrolment. The results points towards BOS form of value innovations with various elements to consider in faculty offerings. To create valued innovation beyond the red oceans, the cases in this study have to be modelled to foster changes in enrolment, modes of delivery, certification, being research oriented with excellence in teaching, ethics, service to the community and entrepreneurship. There is, therefore, need to rethink strategy towards reshaping inclusive enrolment, industry relevance, affiliations, lifelong learning, sustainable student welfare, ubuntu, exchange programmes, research excellence, alumni support and entrepreneurship. Innovative strategic collaborations and partnerships, anchored on technology boost the strategic offerings henceforth leveraging on various offerings in this study. Areas of further study include the amplitude of blue oceans shown in the university faculty offerings and implementation strategies of BOS.

Keywords: blue oceans strategy, collaborations, faculty offerings, value innovations

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Authors: Augustar Omoze Ehighalua, Itotenaan Henry Ogiri

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As a mono-product economy, Nigeria relies largely on oil revenues for its foreign exchange earnings and the exploration activities of firms operating in the Niger Delta region have left in its wake tales of environmental degradation, poverty and misery. This, no doubt, have created corporate social responsibility issues in the region. The focus of this research is the critical evaluation of the ethical response to Corporate Social Responsibility (CSR) practice by firms operating in Nigeria Delta Swamplands. While CSR is becoming more popular in developed society with effective practice guidelines and reporting benchmark, there is a relatively low level of awareness and selective applicability of existing international guidelines to effectively support CSR practice in Nigeria. This study, haven identified the lack of CSR institutional framework attempts to develop an ethically-driven CSR transparency benchmark laced within a regulatory framework based on international best practices. The research adopts a qualitative methodology and makes use of primary data collected through semi-structured interviews conducted across the six core states of the Niger Delta Region. More importantly, the study adopts an inductive, interpretivist philosophical paradigm that reveal deep phenomenological insights into what local communities, civil society and government officials consider as good ethical benchmark for responsible CSR practice by organizations. The institutional theory provides for the main theoretical foundation, complemented by the stakeholder and legitimacy theories. The Nvivo software was used to analyze the data collected. This study shows that ethical responsibility is lacking in CSR practice by firms in the Niger Delta Region of Nigeria. Furthermore, findings of the study indicate key issues of environmental, health and safety, human rights, and labour as fundamental in developing an effective CSR practice guideline for Nigeria. The study has implications for public policy formulation as well as managerial perspective.

Keywords: corporate social responsibility, CSR, ethics, firms, Niger-Delta Swampland, Nigeria

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Authors: P. Dhesi, R. Burns

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Background: The UK has one of the largest immigration detention estates in Europe and is under increasing scrutiny, particularly regarding the lack of transparency over the use of detention and the conditions. Therefore, this research seeks to explore the professional perceptions of the ability of immigration detention in the UK to promote health and dignity. Methods: A phenomenological approach to qualitative methods were used, with social constructivist theorisations of health and dignity. Seven semi-structured interviews were conducted using Microsoft Teams. Participants included a range of immigration detention stakeholders who have visited closed immigration detention centres in the UK in a professional capacity. Recorded interviews were transcribed verbatim, and analysis was data-driven through inductive reflexive thematic analysis of the entire data set to account for the small sample size. This study received ethical approval from University College London Research Ethics Committee. Results: Two global themes were created through analysis: apathetic place and hostile space. Apathetic place discusses the lack of concern for detainees' daily living and healthcare needs within immigration detention in the UK. This is explored through participants' perceptions of the lack of ability of monitoring and evaluation processes to ensure detainees are able to live with dignity and understand the unfulfilled duty of care that exists in detention. Hostile space discusses immigration detention in the UK as a wider system of hostility. This is explored through the disempowering impact on detainees, the perception of a failing system as a result of inadequate safeguarding procedures, and a belief that the intention of immigration detention is misaligned with its described purpose. Conclusion: This research explains why the current immigration detention system in the UK is unable to promote health and dignity, offering a social justice and action-orientated approach to research in this sphere. The findings strengthen the discourse against the use of detention as an immigration control tool in the UK. Implications for further research include a stronger emphasis on investigating alternatives to detention and culturally considerate opportunities for patient-centred healthcare.

Keywords: access to healthcare, dignity, health, immigration detention, migrant, refugee, UK

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Authors: Rebecca E. Dalli Gonzi, Joseph Falzon

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Background: Islands in the Mediterranean region offer opportunities for various industries to take advantage of the facilitation and use of versatile floating structures in coastal areas. In the context of dense land use, marine structures can contribute to ensure both terrestrial and marine resource sustainability. Objective: The aim of this paper is to present and critically discuss an array of issues that characterize the design process of a floating structure for coastal areas and to present the challenges and opportunities of providing such multifunctional and versatile structures around the Maltese coastline. Research Design: A three-tier research design commenced with a systematic literature review. Semi-structured interviews with stakeholders including a naval architect, a marine engineer and civil designers were conducted. A second stage preceded a focus group with stakeholders in design and construction of marine lightweight structures. The three tier research design ensured triangulation of issues. All phases of the study were governed by research ethics. Findings: Findings were grouped into three main themes: excellence, impact and implementation. These included design considerations, applications and potential impacts on local industry. Literature for the design and construction of marine structures in the Maltese Islands presented multiple gaps in the application of marine structures for local industries. Weather conditions, depth of sea bed and wave actions presented limitations on the design capabilities of the structure. Conclusion: Water structures offer great potential and conclusions demonstrate the applicability of such designs for Maltese waters. There is still no such provision within Maltese coastal areas for multi-purpose use. The introduction of such facilities presents a range of benefits for visiting tourists and locals thereby offering wide range of services to tourism and marine industry. Costs for construction and adverse weather conditions were amongst the main limitations that shaped design capacities of the water structures.

Keywords: coastal areas, lightweight, marine structure, multi purpose, versatile, floating device

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Authors: Kalpana Gupta

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Sexually transmitted infections (STIs) are infections that are spread primarily through sexual contact. In our daily practice, we see gonorrhea, chancroid, syphilis, and chlamydial infections that can be cured, as well as HIV, genital herpes, HPV, and hepatitis B infections that cannot be cured but can be managed with available treatments. Many people in India are infected with Sexually transmitted diseases (STDs), and the figures are quite high because of a lack of awareness and communication, as well as a taboo against these diseases. Numerous taboos and associated stigma shape patients’ lives and have a significant impact on health care policies, medical research, and current issues in medical ethics. Current statistics emphasize the importance of delivering sex education to this important demographic promptly. The long-standing tradition of girls marrying very young, especially in rural areas, and often too much older men, causes a slew of STIs. Stigma and HIV have a cyclical relationship; people who experience stigma and discrimination are marginalized and made more vulnerable to HIV/STDs, while those living with HIV are more vulnerable to stigma and discrimination. As urban pressures have grown, so have slums - and they have fast become ideal breeding grounds for STDs. In developed countries, strict laws have been enacted requiring people suffering from STDs to seek immediate treatment as well as contact the health department. Unfortunately, because of the stigma associated with the disease, patients in India are reluctant to reveal the source of infection. With various schemes, India is attempting to promote sex education and awareness. For example, the Ministry of Health and Family Welfare developed the National Adolescent Health Programme (also known as the Rashtriya Kishor Swasthya Karyakram) in partnership with the United Nations Population Fund (UNFPA). Whereas, National AIDS Control Organisation was set up so that every person living with HIV has access to quality care and is treated with dignity and breaking all taboos. It becomes clear that research and healthcare policies will not be effective in assisting patients with STDs unless these "nonscientific" elements are taken into account.

Keywords: sexually transmitted diseases, sexually transmitted infections, taboo, stigma, HIV/STDs, sex education and awareness, treatment, quality care, medications, healthcare policies

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Authors: Song Hung Chi, Lee Chun Benn

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Follow by the “A Research on Types of Settlement Housing Alterations of Chinese New Village in Malaysia- A Study in Ampang New Village, Selangor” preliminary informed that the main factors for expansion and enlargement suitably due to the needs of user's life and restoration purpose. The alterations behavior generally derived at the rear position of main house with different types of derivatives, the averages expansion area are not exceeding of 100㎡, while building materials used were wooden, wooden structure, and zinc which are non-permanent building materials. Therefore, a subsequent studies taken in this paper, further to analyze the drawing with summarize method, to explore the derived forms and the constituted rules of housing alterations in Ampang Village, as a more complete presentation of housing alterations in New Village. Firstly, classified the existing housing alterations into three types by using summarize method, which are Type 1, Additional of Prototype House; Type 2, Expansion of Prototype House; and Type 3, Diffusion of Additional. The results shows that the derivative mode of alterations can be divided into the use of "continuous wall" or "non-continuous wall," this will affects the structural systems and roof styles of alterations, and formed the different layers of interior space with "stages" and "continuity". On the aspects of spatial distribution, sacrificial area as a prescriptive function of space, it was mostly remains in the original location which in the center of living area after alterations. It is an important characteristic in a New Village house, reflecting the traditional Ethics of Hakka Chinese communities in the settlement. In addition, wooden as the main building materials of constituted rules for the prototype house, although there were appeared other building materials, such as cement, brick, glass, metal and zinc after alterations, but still mostly as "wooden house" pattern. Result show because of the economy of village does not significantly improve, and also forming the similarity types in alterations and constructions of the additional building with the existing. It did not significantly improve on the quality of living, but only increased the area of usage space.

Keywords: Ampang new village, derived forms, constituted rules, alterations

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