Law, ethics and pandemic preparedness : the importance of cross-jurisdictional and cross-cultural perspectives

Objective To explore social equity, health planning, regulatory and ethical dilemmas in responding to a pandemic influenza (H5N1) outbreak, and the adequacy of protocols and standards such as the International Health Regulations (2005). Approach This paper analyses the role of legal and ethical considerations for pandemic preparedness, including an exploration of the relevance of cross-jurisdictional and cross-cultural perspectives in assessing the validity of goals for harmonisation of laws and policies both within and between nations. Australian and international experience is reviewed in various areas, including distribution of vaccines during a pandemic, the distribution of authority between national and local levels of government, and global and regional equity issues for poorer countries. Conclusion This paper finds that questions such as those of distributional justice (resource allocation) and regulatory frameworks raise important issues about the cultural and ethical acceptability of planning measures. Serious doubt is cast on a ‘one size fits all’ approach to international planning for managing a pandemic. It is concluded that a more nuanced approach than that contained in international guidelines may be required if an effective response is to be constructed internationally. Implications The paper commends the wisdom of reliance on ‘soft law’, international guidance that leaves plenty of room for each nation to construct its response in conformity with its own cultural and value requirements.

An exploration of The Virtues Project: Ontological, educational and cross-cultural inquiries into a moral education program within a Mongolian school setting

This thesis explores The Virtues Project's ontological, educational and cross-cultural dimensions taking Charles Taylor's philosophical perspective of an anthropological account of the self and a phenomenological account of moral life and engagement. The experience of Mongolian schoolteachers implementing this moral education program is analyzed using a narrative inquiry method. The globally attractive project appears in moral education and virtues ethics research and surveys, yet no critical evaluation has been undertaken. Its conceptual features are appraised from a Taylorean perspective. The Listening Guide analysis of teacher experiences is presented in two narratives. The first is about the teachers' implementation experiences of moral flourishing as selves, in relationships and in community. The second is about their experience of becoming Mongolian in their modern day context. In conclusion, the project is coherent, constructive and potentially suitable cross-culturally.

Day Surgery in Finland : randomized and cross-sectional studies on treatment, quality, and outcome

The aims of this study were to describe Finnish day surgery practice at present and to evaluate quality of care by assessing postdischarge minor morbidity and quality indicators. Potential treatment options were approached by investigating the role of oral dexamethasone as a part of multimodal analgesia and the feasibility of day surgery in patients aged 65 years and older. Over a 2-month period, all patient cases at 14 Finnish day surgery or short-stay units were analyzed (Study I). Quality indicators included rates and reasons for overnight admission, readmission, reoperation, cancellations, and patient satisfaction. Recovery during the first postoperative week was assessed at two units (Study II). Altogether 2732 patients graded daily the intensity of predefined symptoms. To define risk factors of postdischarge symptoms, multinomial regression analysis was used. Sixty patients scheduled to undergo day surgery for hallux valgus were randomized to receive twice perioperatively dexamethasone 9 mg or placebo (Study III). Paracetamol 1 g was administered 3 times daily. Rescue medication (oxycodone) consumption during 0-3 postoperative days (POD), maximal pain scores and adverse effects were documented. Medically stable patients aged 65 years or older, scheduled for open inguinal hernia repair, were randomized to receive treatment either as day cases or inpatients (Study IV). Complications, unplanned admissions, healthcare visits, and patients’ acceptance of the type of care provided were assessed during 2 weeks postoperatively. In Study I, unplanned overnight admissions were reported in 5.9%, return hospital visits during PODs 1-28 in 3.7%, and readmissions in 0.7% of patients. Patient satisfaction was high. In Study II, pain was the most common symptom in adult patients (57%). Postdischarge symptoms were more frequent in adults aged < 40 years, children aged ≥ 7 years, females, and following a longer duration of surgery. In Study III, the total median (range) oxycodone consumption during the study period was 45 (0–165) mg in the dexamethasone group, compared with 78 (15–175) mg in the placebo group (P < 0.049). On PODs 0-1, patients in the dexamethasone group reported significantly lower pain scores. Following inguinal hernia repair, no significant differences in outcome measures were seen between the study groups. Patient satisfaction was equally high in day cases and inpatients (Study IV). Finnish day surgery units provide good-quality services. Minor postdischarge symptoms are common, and they are influenced by several patient-, surgery-, and anesthesia-related factors. Oral dexamethasone combined with paracetamol improves pain relief and reduces the need for oxycodone rescue medication following correction of hallux valgus. Day surgery for open inguinal hernia repair is safe and well accepted by patients aged 65 years or older and can be recommended as the primary choice of care for medically stable patients.

Architecture of Physalis Mottle Tymovirus as Probed by Monoclonal Antibodies and Cross-Linking Studies

Physalis mottle tymovirus (previously named belladonna mottle virus, Iowa strain) RNA was cross-linked to its coat protein by exposure of the intact virus to ultraviolet light. The site of cross-linking of the coat protein with the RNA was identified as Lys-10 by sequencing the oligonucleotide-linked tryptic peptide obtained upon HPLC separation subsequent to enzymetic digestion of the cross-linked and dissociated virus. Three monoclonal antibodies PA3B2, PB5G9, and PF12C9, obtained using denatured coat protein as antigen, cross-reacted effectively with the intact virus indicating that the epitopes recognized by these monoclonals are on the surface of the virus. Using the peptides generated by digestion with CNBr, clostripain, V-8 protease, or trypsin and a recombinant protein lacking the N-terminal 21 residues expressed from a cDNA clone, it was shown that PA3B2 recognizes the sequence 22-36 on the coat protein while PB5G9 and PF12C9 recognize region 75-110. These results suggest that Lys-10 is one of the specific sites through which the RNA interacts in the intact virus. The polypeptide segment (region 22-36) following this buried portion as well as the epitope within the region 75-110 are exposed in the intact virus. These observations are consistent with the canonical β-barrel structure observed in certain other plant viruses.

International Projects and Cross-Cultural Adjustment of British Expatriates in Middle East: A Qualitative Investigation of Influencing Factors

Increased globalisation within the British AEC (Architectural, Engineering and Construction) sector has increased the need for companies to transfer staff to manage their overseas operations. To be able to perform abroad, expatriates must harmonise themselves to the conditions prevailing in the host country. These include getting accustomed to living, working and interacting with the host country nationals. The process is commonly referred to as 'cross-cultural adjustment'. Various factors influence the process of adjustment. In order to identify these issues, a qualitative study was undertaken, which mainly comprised of comprehensive literature review, individual interviews and focus group discussion with British expatriates working on international AEC assignments in Middle Eastern countries. Through interpretative approach, the current study aims to understand the concept of cross-cultural adjustment of British Expatriates based in Middle East and their influencing factors.

The findings suggest that success of expatriation does not entirely rest on an expatriate's ability but also on organisational support and assistance that expatriates receive prior to and during the assignment. Organisational factors such as selection mechanisms, job design, training, logistical and social support, mentoring, etc., influence various facets of expatriate adjustment. Striking cultural contrasts between British and Arab culture both in work and non work situations also dictate the level of support required by the expatriate, suggesting that relocation to less developed, remote or politically unstable regions, demands additional support and consideration by the parent company. This study is relevant to the AEC companies employing British expatriates, who need to be cognisant of the issues highlighted above to make rational and informed decisions when handling international assignments in the Middle East.

'Research as dialogue' and cross cultural consultations : confronting relations of power

The 'rescuing' of Indigenous children (from their communities) through education, and the notions of assimilation associated with that, is an aspect of colonialism that has persisted into the so-called 'post-colonial' era. Recent national policy statements (eg. MCEETYA, 2000; NBEET, 1995) argue the importance of education/research that keeps the locus of control within the Aboriginal community as a means to further the goal of self determination and improve educational outcomes. In this paper, we report on the initial stage of a small empirical research project, Engaging Aboriginal Students In Education Through Community Empowerment.

'Research as dialogue' was a guiding principal and a primary aim was to listen actively to all key stake holders in the remote community setting, particularly to Indigenous parents, teachers and service providers, in order to identify current

strengths and concerns regarding the provision of culturally inclusive schooling; and then, to develop, on the basis of these consultations and in collaboration, community-based education projects that engage non-attending Aboriginal students.

In this paper, we critically analyse the difficulties as well as potential strengths of trying to form collaborative partnerships as researchers, across cultural differences and with diverse community groups. For example, what does 'acknowledging' very different cultural perspectives actually mean to/in this kind of research process? The ways in which relations of power amongst all parties are played out in/through such an approach is also opened up for scrutiny and further discussion.

Ethical structures and processes of corporations operating in Australia, Canada and Sweden : A longitudinal and cross-cultural study

Based on the ‘Partnership Model of Corporate Ethics’ (Wood, 2002), this study examines the ethical structures and processes that are put in place by organizations to enhance the ethical business behavior of staff. The study examines the use of these structures and processes amongst the top companies in the three countries of Australia, Canada, and Sweden over two time periods (2001–2002 and 2005–2006). Subsequently, a combined comparative and longitudinal approach is applied in the study, which we contend is a unique approach in the area of business ethics. The findings of the study indicate that corporations operating in Sweden have utilized ethical structures and processes differently than their Canadian and/or Australian counterparts, and that in each culture the way that companies fashion their approach to business ethics appears congruent with their national cultural values. There does, however, appear to be a convergence of views within the organizations of each culture, as the Swedish companies appear to have been more influenced in 2005–2006 by an Anglo-Saxon business paradigm than they have been in the past.

Sustaining collaborations : creative research and cross-cultural engagement

Increasingly, the linear, instrumentalist and culturally hegemonic character of dominant sustainability discourse is under critique, with the term accruing new or expanded associations that challenge the its future-oriented, temporally stable, and ontologically determinate history. In Australia, these shifts take in a recognition that indigenous Australian understandings of and relationships with the environment profoundly challenge the generic claims of sustainability applied to both theory and practice. But how do these radically different and still marginal understandings actually enter into the process of producing sustainable designs on the world? This paper will report on the beginnings of a collaborative project that seeks to advance a proposal for an Aboriginal cultural precinct in the heart of Melbourne. This project's intention is to develop innovative methods for consultation and participation through collaborative creative research between Aboriginal artists and academic architects. The paper will discuss this method as a strategy for moving beyond traditional modes of cross-cultural engagement in the design and construction of sustainable cultural precincts.

Place branding and cross-cultural visual communication : how do the theories and practices of place branding inform our understanding of cross-cultural visual communication design?

In a globalised environment, visual communication designers are now required to understand their audience’s needs, values and unique methods of communication, creating a new focus on the recipient. In a cross-cultural design context, the visual communication also needs to appeal to a broad range of stakeholders and multiple recipients who hold a strong emotional investment in the message being sent. Our understanding of the complexities of designing in this environment can be informed by recent developments in the research of place branding where the focus is on the increased possibility for failure, the strong potential for criticism and the issues associated with a broad range of stakeholders.

The outcomes of this connection are explored further in a case study involving eight countries as diverse as Australia, Brazil, Mexico, South Africa, Turkey, Qatar, United States of America and Zimbabwe. More than 140 student and lecturer participants reviewed a student driven cross-cultural visual communication project that produced over 560 designs. The increased potential for failure and strong, emotional criticism raised questions about the role of images and symbols in cross-cultural visual communication. The impact these have on the reception of the design, challenge our views on the use of stereotypical imagery. This paper will discuss the movement towards designing visual images that are generic and lacking in cultural representation presenting the view that stereotypical imagery is important to the recipient who relies on these cultural references to effectively read the message.