Researching minoritised communities in palliative care: An agenda for change

Background: Palliative care access, experiences and outcomes of care disadvantage those from ethnically diverse, Indigenous, First nation and First people communities. Research into this field of inquiry raises unique theoretical, methodological, and moral issues. Without the critical reflection of methods of study and reporting of findings, researchers may inadvertently compromise their contribution to reducing injustices and perpetuating racism. Aim: To examine key evidence of the place of minoritised communities in palliative care research to devise recommendations that improve the precision and rigour of research and reporting of findings. Methods: Narrative review of articles identified from PubMed, CINAHL and Google Scholar for 10 years augmented with supplementary searches. Results: We identified and appraised 109 relevant articles. Four main themes were identified (i) Lack of precision when working with a difference; (ii) ‘black box epidemiology’ and its presence in palliative care research; (iii) the inclusion of minoritised communities in palliative care research; and (iv) the potential to cause harm. All stymie opportunities to ‘level up’ health experiences and outcomes across the palliative care spectrum. Conclusions: Based on the findings of this review palliative care research must reflect on and justify the classification of minoritised communities, explore and understand intersectionality, optimise data quality, decolonise research teams and methods, and focus on reducing inequities to level up end-of-life care experiences and outcomes. Palliative care research must be forthright in explicitly indentifying instances of structural and systemic racism in palliative care research and engaging in non-judgemental debate on changes required

Is Feedback All You Need? Leveraging Natural Language Feedback in Goal-Conditioned Reinforcement Learning

Despite numerous successes, the field of reinforcement learning (RL) remains far from matching the impressive generalisation power of human behaviour learning. One possible way to help bridge this gap be to provide RL agents with richer, more human-like feedback expressed in natural language. To investigate this idea, we first extend BabyAI to automatically generate language feedback from the environment dynamics and goal condition success. Then, we modify the Decision Transformer architecture to take advantage of this additional signal. We find that training with language feedback either in place of or in addition to the return-to-go or goal descriptions improves agents' generalisation performance, and that agents can benefit from feedback even when this is only available during training, but not at inference.Comment: Accepted at Workshop on Goal-conditioned Reinforcement Learning, NeurIPS 202

Consumer motivations for mainstream “ethical” consumption

Purpose: This paper aims to explore why consumers absorb ethical habits into their daily consumption, despite having little interest or understanding of the ethics they are buying into, by looking at the motivation behind mainstream ethical consumption. Design/methodology/approach: Fifty in-depth field interviews at point of purchase capture actual ethical consumption behavior, tied with a progressive-laddering interview technique yields over 400 consumption units of analysis. Findings: Ethical attitudes, values and rational information processing have limited veracity for mainstream ethical consumption. Habit and constrained choice, as well as self-gratification, peer influence and an interpretivist understanding of what ethics are being purchased provide the primary drivers for consumption. Research limitations/implications: Use of qualitative sampling and analysis limits the generalizability of this paper. However, the quantitative representation of data demonstrates the strength with which motivations were perceived to influence consumption choice. Practical implications: Ethical brands which focus on explicit altruistic ethical messaging at the expense of hedonistic messaging, or ambiguous pseudo ethics-as-quality messaging, limit their appeal to mainstream consumers. Retailers, however, benefit from the halo effect of ethical brands in store. Social implications: The paper highlights the importance of retailer engagement with ethical products as a precursor to normalizing ethical consumption, and the importance of normative messaging in changing habits. Originality/value: The paper provides original robust critique of the current field of ethical consumption and an insight into new theoretical themes of urgent general interest to the field

Effect of environmental and feedback interventions on pacing profiles in cycling: a meta-analysis

Insearchoftheiroptimalperformanceathleteswillaltertheirpacingstrategyaccordingtointrinsicandextrinsicphysiological,psychologicalandenvironmentalfactors.However,theeffectofsomeofthesevariablesonpacingandexerciseperformanceremainssomewhatunclear.Therefore,theaimofthismeta-analysiswastoprovideanoverviewastohowmanipulationofdifferentextrinsicfactorsaffectspacingstrategyandexerciseperformance.Onlyself-pacedexercisestudiesthatprovidedcontrolandinterventiongroup(s),reportedtrialvarianceforpoweroutput,disclosedthetypeoffeedbackreceivedorwithheld,andwheretime-trialpoweroutputdatacouldbesegmentedintostart,middleandendsections;wereincludedinthemeta-analysis.Studieswithsimilarthemesweregroupedtogethertodeterminethemeandifference(MD)with95%confidenceintervals(CIs)betweencontrolandinterventiontrialsfor:hypoxia,hyperoxia,heat-stress,pre-cooling,andvariousformsoffeedback.Atotalof26studieswithcyclingastheexercisemodalitywereincludedinthemeta-analysis.Ofthese,fourstudiesmanipulatedoxygenavailability,elevenmanipulatedheat-stress,fourimplementedpre-coolinginterventionsandsevenstudiesmanipulatedvariousformsoffeedback.Meanpoweroutput(MPO)wassignificantlyreducedinthemiddleandendsections(p 0.05).NegativefeedbackimprovedoveralltrialMPOandMPOinthemiddlesectionoftrials(p 0.05).Theavailabledatasuggestsexerciseregulationinhypoxiaandheat-stressisdelayedinthestartsectionoftrials,beforesignificantreductionsinMPOoccurinthemiddleandendofthetrial.Additionally,negativefeedbackinvolvingperformancedeceptionmayaffordanupwardshiftinMPOinthemiddlesectionofthetrialimprovingoverallperformance.Finally,performanceimprovementscanberetainedwhenparticipantsareinformedofthedeception

Compositional and physicochemical changes in waste materials and biogas production across 7 landfill sites in UK

The aim of this study was to evaluate the spatial distribution of the paper and fines across seven landfill sites (LFS) and assess the relationship between waste physicochemical properties and biogas production. Physicochemical analysis of the waste samples demonstrated that there were no clear trends in the spatial distribution of total solids (TS), moisture content (MC) and waste organic strength (VS) across all LFS. There was however noticeable difference between samples from the same landfill site. The effect of landfill age on waste physicochemical properties showed no clear relationship, thus, providing evidence that waste remains dormant and non-degraded for long periods of time. Landfill age was however directly correlated with the biochemical methane potential (BMP) of waste; with the highest BMP obtained from the most recent LFS. BMP was also correlated with depth as the average methane production decreased linearly with increasing depth. There was also a high degree of correlation between the Enzymatic Hydrolysis Test (EHT) and BMP test results, which motivates its potential use as an alternative to the BMP test method. Further to this, there were also positive correlations between MC and VS, VS and biogas volume and biogas volume and CH4 content. Outcomes of this work can be used to inform waste degradation and methane enhancement strategies for improving recovery of methane from landfills

Role of non-Markovianity and backflow of information in the speed of quantum evolution

We consider a two-level open quantum system undergoing pure dephasing, dissipative, or multiply decohering dynamics and show that whenever the dynamics is non-Markovian, the initial speed of evolution is a monotonic function of the relevant physical parameter driving the transition between the Markovian and non-Markovian behavior of the dynamics. In particular, within the considered models, a speed increase can only be observed in the presence of backflow of information from the environment to the system

The Arecibo Legacy Fast ALFA Survey: VI. Second HI Source Catalog of the Virgo Cluster Region

We present the third installment of HI sources extracted from the Arecibo Legacy Fast ALFA extragalactic survey. This dataset continues the work of the Virgo ALFALFA catalog. The catalogs and spectra published here consist of data obtained during the 2005 and 2006 observing sessions of the survey. The catalog consists of 578 HI detections within the range 11h 36m < R.A.(J2000) < 13h 52m and +08 deg < Dec.(J2000) < +12 deg, and cz_sun < 18000 km/s. The catalog entries are identified with optical counterparts where possible through the examination of digitized optical images. The catalog detections can be classified into three categories: (a) detections of high reliability with S/N > 6.5; (b) high velocity clouds in the Milky Way or its periphery; and (c) signals of lower S/N which coincide spatially with an optical object and known redshift. 75% of the sources are newly published HI detections. Of particular note is a complex of HI clouds projected between M87 and M49 that do not coincide with any optical counterparts. Candidate objects without optical counterparts are few. The median redshift for this sample is 6500 km/s and the cz distribution exhibits the local large scale structure consisting of Virgo and the background void and the A1367-Coma supercluster regime at cz_sun ~7000 km/s. Position corrections for telescope pointing errors are applied to the dataset by comparing ALFALFA continuum centroid with those cataloged in the NRAO VLA Sky Survey. The uncorrected positional accuracy averages 27 arcsec ~(21 arcsec ~median) for all sources with S/N > 6.5 and is of order ~21 arcsec ~(16 arcsec ~median) for signals with S/N > 12. Uncertainties in distances toward the Virgo cluster can affect the calculated HI mass distribution.Comment: 25 pages, 1 Table, 8 figures, Accepted by the Astronomical Journa

Collaborative care : primary health workforce and service delivery in Western New South Wales - a case study

Objective: To explore how four small towns in rural New South Wales known as the 4Ts are addressing challenges accessing quality care and sustainable health services through a collaborative approach to workforce planning using the collaborative care framework. Design: Descriptive case study approach. Setting: The collaborative care project was developed as a result of ongoing partnerships between 2 rural Local Health Districts, 2 Primary Health Networks and a non-governmental health workforce organisation. The collaboration works with 5 subregions each comprising 2 or more rural communities. This paper focuses on the 4Ts subregion. Participants: Stakeholders of the collaborative design including organisations and the community. Intervention: A place-based approach to co-designing health services with community in one sub-region of Western New South Wales. Main outcome measures: A synthesis of field observations and experiences of community and jurisdictional partners in implementation of the 4Ts subregional model. Mapping of implementation processes against the collaborative care framework. Results: The collaborative care framework is a useful planning and community engagement tool to build health workforce literacy and to impact on system change at the local level. We identify key elements of effectiveness in establishing the 4Ts model, including the need for coordinated health system planning, better integrating existing resources to deliver services, community engagement, building health workforce literacy and town-based planning. Conclusion: This study adds to the body of knowledge about how to successfully develop a collaborative primary health care workforce model in practice. The findings demonstrate that the implementation of a collaborative primary health care workforce model using the collaborative care framework can improve service access and quality, which in turn might facilitate workforce sustainability

Corruption and Conflagration: (In)Justice and Protest in Bucharest after the Colectiv Fire

The fire in the Colectiv nightclub in Bucharest, Romania in October 2015 led to sustained, nationwide protests that forced the resignation of the government. These protests drew on deep-seated feelings of injustice due to rampant corruption among the political elite. The capital city location provided an opening for spontaneous actions to present claims to power holders. We aim to identify how the urban space was used to initiate and scale up a meaningful challenge to the governing system by examining the evolution of these protests. Through analysis of interviews with protest participants and nonparticipants resident in Bucharest, we identify factors that mobilized participants and how these built and reinforced the developing movement. The findings emphasize the importance of (capital) cities in incubating social movements, by providing spaces to organize challenges to institutional actors from the local to the national level