title: An Evaluation of Public Participation in the Environmental Impact Assessment Process of the Maldives

authors: Zuhair, Mohamed Hamdhaan

subjects: Sustainable Development

abstract: Environmental Impact Assessment (EIA) is a proactive tool that assesses and addresses the environmental and social impacts of development projects. It has been identified as a process that can potentially deliver the goal of sustainable development. Public participation is an important aspect of both EIA and sustainable development. In many countries EIA provides the only opportunity for the public to participate in decision-making processes. Nevertheless, research reveals that meaningful public participation in EIA in most countries remains a false promise, with consultations undertaken only as an administrative necessity and with the public having no real power to influence the decisions. It is argued here that, in order for public participation in the EIA process to be effective and promote sustainable development, the process needs to follow participatory principles promoted by deliberative democracy. 
This research investigates the EIA process of the Maldives, a developing island nation in the Indian Ocean. The low-lying nature of the country makes it extremely vulnerable to environmental change and, therefore, sustainable development is high on the agenda for the Maldives. It is a worthwhile case to study as the political context of the country is changing with the Maldives’ recent embracing of democracy. Moreover, the EIA regulations of the country were recently amended in an attempt to make the process more robust. These changes provide an interesting context for the research. In addition, there is very little prior literature on EIA in the Maldives and hence this research is an opportunity to contribute to a still limited body of scholarship. 
An interpretive phenomenological research paradigm was adopted in designing the research. A multimethod qualitative research design was selected, with documents and semi-structured interview being the primary data sources. A conceptual framework based on the reviewed literature was developed and used to direct the research design. In this respect, four aspects that ensure a deliberative participatory process were investigated: fairness, competence, willingness, and capacity. 
The findings reveal that the participatory procedure in the Maldives is neither fair nor competent. Moreover, several socioeconomic barriers that affect the capacity and willingness of the actors to participate were identified: namely, political influence, a lack of human and financial capacity, gender gap, a loss of community spirit, and a lack of environmental and procedural awareness.
This thesis contributes to the scholarship on public participation in the EIA process. It specifically helps to identify key challenges for effective public participation in the Maldives EIA process. In this regard, both procedural and socioeconomic barriers were identified. The recommendations proposed are based on the findings of the research, and, if adopted, can lead to more meaningful public participation and thus potentially help to achieve the goal of sustainable development through the EIA process.

text: An Evaluation of Public Participation in the Environmental Impact Assessment Process of the Maldives Environmental Impact Assessment (EIA) is a proactive tool that assesses and addresses the environmental and social impacts of development projects. It has been identified as a process that can potentially deliver the goal of sustainable development. Public participation is an important aspect of both EIA and sustainable development. In many countries EIA provides the only opportunity for the public to participate in decision-making processes. Nevertheless, research reveals that meaningful public participation in EIA in most countries remains a false promise, with consultations undertaken only as an administrative necessity and with the public having no real power to influence the decisions. It is argued here that, in order for public participation in the EIA process to be effective and promote sustainable development, the process needs to follow participatory principles promoted by deliberative democracy. 
This research investigates the EIA process of the Maldives, a developing island nation in the Indian Ocean. The low-lying nature of the country makes it extremely vulnerable to environmental change and, therefore, sustainable development is high on the agenda for the Maldives. It is a worthwhile case to study as the political context of the country is changing with the Maldives’ recent embracing of democracy. Moreover, the EIA regulations of the country were recently amended in an attempt to make the process more robust. These changes provide an interesting context for the research. In addition, there is very little prior literature on EIA in the Maldives and hence this research is an opportunity to contribute to a still limited body of scholarship. 
An interpretive phenomenological research paradigm was adopted in designing the research. A multimethod qualitative research design was selected, with documents and semi-structured interview being the primary data sources. A conceptual framework based on the reviewed literature was developed and used to direct the research design. In this respect, four aspects that ensure a deliberative participatory process were investigated: fairness, competence, willingness, and capacity. 
The findings reveal that the participatory procedure in the Maldives is neither fair nor competent. Moreover, several socioeconomic barriers that affect the capacity and willingness of the actors to participate were identified: namely, political influence, a lack of human and financial capacity, gender gap, a loss of community spirit, and a lack of environmental and procedural awareness.
This thesis contributes to the scholarship on public participation in the EIA process. It specifically helps to identify key challenges for effective public participation in the Maldives EIA process. In this regard, both procedural and socioeconomic barriers were identified. The recommendations proposed are based on the findings of the research, and, if adopted, can lead to more meaningful public participation and thus potentially help to achieve the goal of sustainable development through the EIA process.

year: 2015

title: pH-sensitive Anticancer Model Prodrug: Amide of Kemp's Acid

authors: Brooks, Robert Turongo

subjects: Anticancer Model prodrug

abstract: Solid tumours are characterised by lower extracellular pH (as low as 5.8 pH) compared to normal healthy cellular pH (actively regulated at pH 7.3). This difference may be exploited with an acid-sensitive anti-tumour prodrug which releases a cytotoxin selectively in tumour tissue.
The research reported in this thesis was aimed at synthesising and performing rate studies on an amide prodrug with pH-sensitive rates of reaction in the pH 5 - 8 region. Amide hydrolysis is catalysed by neighbouring carboxylic acid groups in their fully protonated state but not in its ionised state (shown in the figure below), whereby pH sensitivity around pH 5 - 8 can be exploited. The current study was carried out on an amide of Kemp's acid which, due to enforced stereochemistry of carboxylic acid and amide functional groups, has the type of structure conducive to accelerated amide hydrolysis.
The rates for tertiary and secondary aliphatic amides of this Kemp's acid system have shown high reactivity at low pH and a large reduction in rate across pH 5.8 - 7.3, however an aryl amide had not previously been studied. It was thought that an aryl amide of Kemp's acid would provide a faster rate of reaction compared with the alkyl amides, and also aryl amine cytotoxins exist which could be attached as an amide.
A secondary aryl amide of Kemp's acid (58) was obtained via a potassium hydroxide ring-opening reaction on a synthesised imide of Kemp's acid (43).
Aliquots of the ring-opened amide (58) were added to buffered (phosphate and malonate) aqueous solutions (with ionic strength μ = 1 mol L-1) and the hydrolysis reaction followed at 30.0 oC across the pH range 0.48 - 8. First order rate constants were calculated from absorbance change with time and the pH-rate profile established. Absorbance changes were shown to be consistent with amide hydrolysis with no evidence of any imide reformation as evident in other studies. The rate data were analysed. There was no evidence from rates for the two successive acid ionisations with only a single rate plateau evident from pH 2 to 5, suggesting that both
ONHCOOHCOO-OMe(58)
iv
di- and mono-acid species have very similar hydrolysis rates or that the second ionisation is low due to stabilisation of the mono-ionised molecule by hydrogen bonding interactions. For this reason, the rate profile could be analysed only as if it were a single ionisation in the same way that Menger and Ladika analysed their aliphatic tertiary pyrrolidyl amide in an earlier study. This analysis gave a pKa value of 6.72   0.09 and a limiting rate constant of 7.1 x 10-5 s-1. The studies revealed a three fold rate differential between pH 5.8 (faster) versus 7.3 (slower), a difference which is probably too small a selectivity for possible prodrug application.
Separately, the second order rate coefficient for the reaction of potassium hydroxide solution to open the imide was also established (k2 = 0.00067 L mol-1 s-1 at 30.0 oC, μ = 1.00 mol L-1 with KCl).

text: pH-sensitive Anticancer Model Prodrug: Amide of Kemp's Acid Solid tumours are characterised by lower extracellular pH (as low as 5.8 pH) compared to normal healthy cellular pH (actively regulated at pH 7.3). This difference may be exploited with an acid-sensitive anti-tumour prodrug which releases a cytotoxin selectively in tumour tissue.
The research reported in this thesis was aimed at synthesising and performing rate studies on an amide prodrug with pH-sensitive rates of reaction in the pH 5 - 8 region. Amide hydrolysis is catalysed by neighbouring carboxylic acid groups in their fully protonated state but not in its ionised state (shown in the figure below), whereby pH sensitivity around pH 5 - 8 can be exploited. The current study was carried out on an amide of Kemp's acid which, due to enforced stereochemistry of carboxylic acid and amide functional groups, has the type of structure conducive to accelerated amide hydrolysis.
The rates for tertiary and secondary aliphatic amides of this Kemp's acid system have shown high reactivity at low pH and a large reduction in rate across pH 5.8 - 7.3, however an aryl amide had not previously been studied. It was thought that an aryl amide of Kemp's acid would provide a faster rate of reaction compared with the alkyl amides, and also aryl amine cytotoxins exist which could be attached as an amide.
A secondary aryl amide of Kemp's acid (58) was obtained via a potassium hydroxide ring-opening reaction on a synthesised imide of Kemp's acid (43).
Aliquots of the ring-opened amide (58) were added to buffered (phosphate and malonate) aqueous solutions (with ionic strength μ = 1 mol L-1) and the hydrolysis reaction followed at 30.0 oC across the pH range 0.48 - 8. First order rate constants were calculated from absorbance change with time and the pH-rate profile established. Absorbance changes were shown to be consistent with amide hydrolysis with no evidence of any imide reformation as evident in other studies. The rate data were analysed. There was no evidence from rates for the two successive acid ionisations with only a single rate plateau evident from pH 2 to 5, suggesting that both
ONHCOOHCOO-OMe(58)
iv
di- and mono-acid species have very similar hydrolysis rates or that the second ionisation is low due to stabilisation of the mono-ionised molecule by hydrogen bonding interactions. For this reason, the rate profile could be analysed only as if it were a single ionisation in the same way that Menger and Ladika analysed their aliphatic tertiary pyrrolidyl amide in an earlier study. This analysis gave a pKa value of 6.72   0.09 and a limiting rate constant of 7.1 x 10-5 s-1. The studies revealed a three fold rate differential between pH 5.8 (faster) versus 7.3 (slower), a difference which is probably too small a selectivity for possible prodrug application.
Separately, the second order rate coefficient for the reaction of potassium hydroxide solution to open the imide was also established (k2 = 0.00067 L mol-1 s-1 at 30.0 oC, μ = 1.00 mol L-1 with KCl).

year: 2009

title: Patient-reported diagnostic intervals to colorectal cancer diagnosis in the Midland region of New Zealand: a prospective cohort study

authors: Blackmore, Tania Louise

subjects: Science & Technology

abstract: Background and objectives
New Zealand (NZ) has high rates of colorectal cancer (CRC) but low rates of early detection. The majority of CRC is diagnosed through general practice, where lengthy diagnostic intervals are common. We investigated factors contributing to diagnostic delay in a cohort of patients newly diagnosed with CRC.

Methods
Patients were recruited from the Midland region and interviewed about their diagnostic experience using a questionnaire based on a modified Model of Pathways to Treatment framework and SYMPTOM questionnaire. Descriptive statistics were used to describe the population characteristics. Chi-square analysis and logistic regression were used to analyse factors influencing diagnostic intervals.

Results
Data from 176 patients were analysed, of which 65 (36.9%) experienced a general practitioner (GP) diagnostic interval of >120 days and 96 (54.5%) experienced a total diagnostic interval (TDI) > 120 days. Patients reporting rectal bleeding were less likely to experience a long TDI (odds ratio [OR] 0.34, 95% confidence interval [CI]: 0.14–0.78) and appraisal/help-seeking interval (OR, 0.19, 95% CI: 0.06–0.59). Patients <60 were more likely to report a longer appraisal/help-seeking interval (OR, 3.32, 95% CI: 1.17–9.46). Female (OR, 2.19, 95% CI: 1.08–4.44) and Māori patients (OR, 3.18, 95% CI: 1.04–9.78) were more likely to experience a long GP diagnostic interval.

Conclusion
NZ patients with CRC can experience long diagnostic intervals, attributed to patient and health system factors. Young patients, Māori, females, and patients experiencing change of bowel habit may be at particular risk. We need to increase symptom awareness of CRC for patients and GPs. Concentrated efforts are needed to ensure equity for Māori in access to screening, diagnostics, and treatment.

text: Patient-reported diagnostic intervals to colorectal cancer diagnosis in the Midland region of New Zealand: a prospective cohort study Background and objectives
New Zealand (NZ) has high rates of colorectal cancer (CRC) but low rates of early detection. The majority of CRC is diagnosed through general practice, where lengthy diagnostic intervals are common. We investigated factors contributing to diagnostic delay in a cohort of patients newly diagnosed with CRC.

Methods
Patients were recruited from the Midland region and interviewed about their diagnostic experience using a questionnaire based on a modified Model of Pathways to Treatment framework and SYMPTOM questionnaire. Descriptive statistics were used to describe the population characteristics. Chi-square analysis and logistic regression were used to analyse factors influencing diagnostic intervals.

Results
Data from 176 patients were analysed, of which 65 (36.9%) experienced a general practitioner (GP) diagnostic interval of >120 days and 96 (54.5%) experienced a total diagnostic interval (TDI) > 120 days. Patients reporting rectal bleeding were less likely to experience a long TDI (odds ratio [OR] 0.34, 95% confidence interval [CI]: 0.14–0.78) and appraisal/help-seeking interval (OR, 0.19, 95% CI: 0.06–0.59). Patients <60 were more likely to report a longer appraisal/help-seeking interval (OR, 3.32, 95% CI: 1.17–9.46). Female (OR, 2.19, 95% CI: 1.08–4.44) and Māori patients (OR, 3.18, 95% CI: 1.04–9.78) were more likely to experience a long GP diagnostic interval.

Conclusion
NZ patients with CRC can experience long diagnostic intervals, attributed to patient and health system factors. Young patients, Māori, females, and patients experiencing change of bowel habit may be at particular risk. We need to increase symptom awareness of CRC for patients and GPs. Concentrated efforts are needed to ensure equity for Māori in access to screening, diagnostics, and treatment.

year: 2021