Ethical and practical considerations for HIV cure-related research at the end-of-life: a qualitative interview and focus group study in the United States

Background One of the next frontiers in HIV research is focused on finding a cure. A new priority includes people with HIV (PWH) with non-AIDS terminal illnesses who are willing to donate their bodies at the end-of-life (EOL) to advance the search towards an HIV cure. We endeavored to understand perceptions of this research and to identify ethical and practical considerations relevant to implementing it. Methods We conducted 20 in-depth interviews and 3 virtual focus groups among four types of key stakeholders in the United States (PWH, biomedical HIV cure researchers, HIV clinicians, and bioethicists) to obtain triangulated viewpoints because little was known about the ethics of this topic. Each group was queried as to ethical considerations, safeguards, and protections for conducting HIV cure-related research at the EOL to ensure this research remains acceptable. Results All four key stakeholder groups generally supported HIV cure-related research conducted at the EOL because of the history of altruism within the PWH community and the potential for substantial scientific knowledge to be gained. Our informants expressed that: (1) Strong stakeholder and community involvement are integral to the ethical and effective implementation, as well as the social acceptability of this research; (2) PWH approaching the EOL should not inherently be considered a vulnerable class and their autonomy must be respected when choosing to participate in HIV cure-related research at the EOL; (3) Greater diversity among study participants, as well as multi-disciplinary research teams, is necessitated by HIV cure-related research at the EOL; (4) The sensitive nature of this research warrants robust oversight to ensure a favorable risk/benefit balance and to minimize the possibility of therapeutic misconception or undue influence; and (5) Research protocols should remain flexible to accommodate participants’ comfort and needs at the EOL. Conclusion Because of the ethical issues presented by HIV cure-related research at the EOL, robust ethical safeguards are of utmost importance. The proposed ethical and practical considerations presented herein is a first step in determining the best way to maximize this research’s impact and social value. More much inquiry will need to be directed towards understanding context-specific and cultural considerations for implementing EOL HIV cure research in diverse settings.

The model of community empowerment in fire forest disaster prevention in Indonesia

This paper will look into the topic of community involvement in forest fire disaster prevention, specifically in Indonesia. To begin, the paper will discuss the problem of forest fires in Indonesia, which occur frequently. The study also addressed issues related to disaster management, such as a lack of competence and knowledge, which resulted in disaster management ineffectiveness. The paper's third portion discusses the government's involvement in catastrophe management. Several initiatives and support have been implemented.

Adaptation models, barriers, and facilitators for cultural safety in telepsychiatry: A systematic scoping review

Introduction: Indigenous peoples, and racial and ethnic minorities around the world experience significant mental health inequities. Telepsychiatry can contribute to addressing these inequities among these populations. However, it is first crucial to ensure the cultural safety of this tool as a critical step toward health equity. This review aimed to collate evidence regarding cultural adaptations, barriers, opportunities, and facilitators for telepsychiatry services supporting minority groups. Method: Using the PRISMA extension for scoping reviews (PRISMA-ScR) guideline, we conducted a systematic scoping review and thematic analysis. Six databases were searched using the PICO framework, i.e., population, intervention, comparison, and outcomes.. Additional literature was identified through reference lists screening. We developed a table for data extraction, and the extracted data were further analyzed following Braun and Clarke's approach for thematic analysis. Results: A total of 1514 citations were screened with a final total of 58 articles included in the review. The themes related to telepsychiatry cultural adaptations emphasize the crucial role of community involvement and quality service delivery. Identified barriers were associated with service and infrastructure, and service users’ socioeconomic and cultural contexts. Opportunities and facilitators for telepsychiatry were enhanced access and rapport, and multi-organizational collaborations and partnerships. Discussion: This review identified factors that can guide the adaptation of telepsychiatry evidence-based interventions to meet the needs of Indigenous peoples and racial and ethnic minorities. Telepsychiatry programs must be specifically designed for the population they seek to serve, and this review offers emerging insights into critical factors to consider in their development.

Innovative Adaptation of Training and Technical Assistance

The behavioral health workforce is pivotal to provide evidence-based services (EBPs) for patients with mental illnesses or substance use disorders. The COVID-19 pandemic has exacerbated existing healthcare issues for these patients and highlighted the need for a well-trained workforce. The stay-at-home orders compelled a rapid transition to delivering behavioral health services from traditional face-to-face encounters to telehealth/telecommunication services. Training and technical assistance (TTA) networks supporting the behavioral health workforce's educational needs quickly moved to virtual delivery. This shift has resulted in innovations and adaptations categorized into four areas: adapting is crucial, convening stakeholders is essential, resources (human and technological) are needed, and community involvement is integral. Future TTA efforts should focus on sharing the successful virtual adaptations to EBPs.

Smiling vs. Frowning Faces

Participatory development has become an integral strategy for achieving sustainable tourism in view of the varying impacts brought by mass tourism. Community participation ensures local control of the pace of tourism development and the creation of a more personalised tourism product. However, some studies have stated tension between governments and locals, which has hindered tourism development. This study, thus, sought to explore the extent to which communities are involved in decision-making and how useful the outcome has been. To achieve the study objectives, two tourism sites in Ghana implemented based on participatory principles, namely Kakum National Park and Afadjato Mountain, were compared. Results of the study suggest there is a fair degree of community involvement at the Gbledi Traditional Area (Afadjato) leading to satisfaction (smiling-faces), rather than Abrafo-Odumase (Kakum), which exhibited dissatisfaction (frowning-faces). The policy and research implications relate mainly to the challenge of achieving sustainable tourism development at the community level.

Examining the Role of NGOs in Community Water and Sanitation Improvement

This chapter examined the role of NGOs in water and sanitation improvement and the effects on the residence of Tunayilli in the Sagnarigu District. The design was descriptive. Questionnaires and interview guides were administered to household heads and key informants. Findings revealed that the water and sanitation condition in Tunayilli is generally poor. NGOs play diverse roles including the provision of water and sanitation facilities, community mobilization, and facility maintenance to ensure their sustained usability. However, inadequate funding, weak community mobilization, poor maintenance culture, and low education are challenges to water and sanitation improvement programmes of NGOs in the community. Measures to mitigate these includes increased central government funding, public education, community involvement, enforcement of sanitation by-laws, and regular maintenance of water and sanitation systems in the community. Stakeholders should intensify and sustain their educational campaigns. Meanwhile, by-laws on water and sanitation should be enforced and offenders prosecuted.

Multimodal and Community-Based Literacies

In recent decades, high-stakes school reforms and draconian budget cuts have constrained the autonomy of public school teachers in developing multi literacy approaches with emergent bilingual learners (e.g., English-only laws, high stakes testing). This chapter describes the community and multimodal instructional practices of two urban elementary school teachers/ researchers, developed in the context of a professional development initiative. Using critical, sociocultural conceptions of literacy and qualitative methods of investigation, the paper investigates different aspects of the teachers' writing instruction (i.e., community involvement; genre-based instruction; digital literacy; and multimodality); it also explores how the writing processes of focal bilingual students incorporated these practices. Findings show that this approach positioned bilingual learners as agentive text makers. In addition, the second-grade students developed a heightened awareness of audience and context. Implications are discussed, including the pressing need for teacher collaboration, robust school-university partnerships, and innovative multimodal approaches to literacy.

THE EFFECT OF ECOTOURISM DEVELOPMENT ON MARINE CONSERVATION AREA IN WEST SUMATERA, INDONESIA

Ecotourism is critical in conservation areas for the development of mutual relationships between the community, government and tourist in the marine conservation area. However, the community must be key stakeholders in maximizing benefits to local communities and obtaining environmental support to effectively manage conservation areas. This study aimed 1) to determine the socio-economic impact on fishermen community for the marine resource conservation, b) to investigate the socio-economic impact on the community's understanding and respect to support conservation. This research was conducted in the Ampiang Parak and Maligi villages. The research used a structured questionnaire and qualitative method using observation and interview to evaluate the fishermen community involvement in ecotourism management. The research discussed and explained the source, income, and employment allocation of ecotourism regulations and economic participation for community programs. The management of the Ampiang Parak and Maligi conservation areas is still not aligned with the local community's ecotourism management, and the conservation area and tourist attraction has not yet been beneficial for the local community economy. The relationships between ecotourism and sustainable growth, tourism, community, and natural resource conservation need to be improved.

Agribusiness development trends in Georgia: modern challenges and solutions

Introduction. The article substantiates the importance of agribusiness development in solving the problem of food security and food security of the population. Economic indicators of agribusiness development in Georgia and Adjara region are analized, the role of determining agribusiness development trends and perspective directions in strengthening the rural community, especially in terms of rural community involvement in business is assessed. Therefore, in order to overcome the problem of agribusiness development, it is of special importance to study the development trends of agribusiness, to identify the current challenges in this field and to develop perspective directions of development. Aim and tasks. The aim of the research is to identify modern challenges based on the study of agribusiness development trends and to make recommendations on promising development directions. Results. The paper analyzes the views of researchers on alternative models of development in the field of agribusiness, focusing on the components of the agribusiness sector as a model. The article presents the conclusions and develops recommendations on overcoming the factors hindering the development of agribusiness and ways of future development. The development of the cooperation process is also important for the growth of scale and its place in international markets. Quantitative research has shown that 86% of farmers are not united in cooperatives. Even those who are united from year to year with less turnover of financial and material resources are recorded in the respective organizations, indicating their less life skills. Conclusions. Quantitative and qualitative research on the example of Adjara region (Georgia) has been conducted to identify the trends and characteristics of agribusiness development and to determine future directions. A questionnaire has been developed for the quantitative research and beneficiaries have been selected from the database of employees in the field of agribusiness, while for the qualitative research a group of experts has been identified and focus groups have been formed from these groups to clarify some problems. Quantitative research has identified the current challenges of agribusiness development, while qualitative research has identified the specific causes of the problems and the characteristics that will determine the future priorities of agribusiness development in the Adjara region.