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Preferences of women for maternal healthcare services in low-income and middle-income countries: a systematic review of discrete choice experiments
No full textBackground: Maternal healthcare service utilisation during pregnancy, childbirth and the subsequent postpartum periods could improve the health outcomes of women and newborns. However, women in low-income and middle-income countries (LMICs) have a lower uptake of these services, which is partly attributed to a lack of access to preferred maternal health services. This study systematically synthesised evidence on women’s preferences for maternal healthcare services in LMICs. Methods: A systematic search was undertaken from PubMed/MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus and Global Health databases, and supplemented with Google Scholar for grey literature. We have included published articles from 1 January 2000 to the date of the last search, 14 July 2023. Studies were included if they reported preferences of women for maternal health services in LMICs using the stated preference analysis methods. The quality of the included papers was assessed using the conjoint analysis applications in the healthcare checklist. We have thematically presented the attributes using a healthcare access framework (accessibility, availability, accommodation, affordability and acceptability). The first two most important and least important attributes in each study were identified based on the relative importance scores. Findings: Of the 54 articles identified for full-text review, 15 studies from eight LMICs met the inclusion criteria for the final review. Attributes related to the acceptability of healthcare services, such as a provider’s good attitude and rapport (47.1%), and the availability of services, such as medications and supplies (41.2%), were typically considered the most important by women. Conversely, accessibility attributes, such as increased distance or travel time to health facilities (29.4%), and affordability attributes, such as increased cost of services (23.5%), were generally less valued by women. Interpretations: The acceptability and availability attributes of healthcare services were considered the most important by women. Aligning maternal healthcare service provision with women’s preferences can promote person-centred care, leading to increased service uptake. PROSPERO registration number: CRD42023444415.Daniel Gashaneh Belay, Gizachew A. Tessema, Melaku Birhanu Alemu, Bereket Kefale, Jennifer Dunne, Richard Norma
Nucleolus credit assignment for effective coalitions in multi-agent reinforcement learning
No full textIn cooperative multi-agent reinforcement learning (MARL), agents typically form a single grand coalition based on credit assignment to tackle a composite task, often resulting in suboptimal performance. This paper proposed a nucleolus-based credit assignment grounded in cooperative game theory, enabling the autonomous partitioning of agents into multiple small coalitions that can effectively identify and complete subtasks within a larger composite task. Specifically, our designed nucleolus Q-learning could assign fair credits to each agent, and the nucleolus Q-operator provides theoretical guarantees with interpretability for both learning convergence and the stability of the formed small coalitions.
Through experiments on Predator-Prey and StarCraft scenarios across varying difficulty levels, our approach demonstrated the emergence of multiple effective coalitions during MARL training, leading to faster learning and superior performance in terms of win rate and cumulative rewards especially in hard and super-hard environments, compared to four baseline methods. Our nucleolus-based credit assignment showed the promise for complex composite tasks requiring effective subteams of agents
Happy work, happy life? a replication and comparison of the longitudinal effects between job and life satisfaction using continuous time meta-analysis
No full textCapturing the evolving journey of workers' well-being, our research unveils how the intertwined paths of job and life satisfaction shift and shape each other over time. We contribute to the field's understanding of the dynamic interplay between job and life satisfaction by exploring the time-bound nature of satisfaction, teasing apart the between- and within-person effects, and uncovering the relative strengths of these effects. Our findings (k = 28; N = 161 412) suggest that (1) job and life satisfaction are related to one another over time, (2) life satisfaction has a stronger effect (+32%) on future job satisfaction than the converse, (3) these effects peak around 17.2 months (between-person effects), and (4) effects peak at shorter intervals of 8.2 months when accounting for unobserved heterogeneity (within-person effects). In the latter case, the differences between the two effects were still significant, but the dominance of life satisfaction shrank from 32% to 8%. This investigation not only bridges critical gaps but also sets a new precedent for future research on the temporal dynamics of well-being, promising to transform theoretical perspectives and practical approaches alike
SATF: A scalable attentive transfer framework for efficient multiagent reinforcement learning
No full textIt is challenging to train an efficient learning procedure with multiagent reinforcement learning (MARL) when the number of agents increases as the observation space exponentially expands, especially in large-scale multiagent systems. In this article, we proposed a scalable attentive transfer framework (SATF) for efficient MARL, which achieved goals faster and more accurately in homogeneous and heterogeneous combat tasks by transferring learned knowledge from a small number of agents (4) to a large number of agents (up to 64). To reduce and align the dimensionality of the observed state variations caused by increasing numbers of agents, the proposed SATF deployed a novel state representation network with a self-attention mechanism, known as dynamic observation representation network (DorNet), to extract the dominant observed information with excellent cost-effectiveness. The experiments on the MAgent platform showed that the SATF outperformed the distributed MARL (independent Q-learning (IQL) and A2C) in task sequences from 8 to 64 agents. The experiments on StarCraft II showed that the SATF demonstrated superior performance relative to the centralized training with decentralized execution MARL (QMIX) by presenting shorter training steps, achieving a desired win rate of up to approximately 90% when increasing the number of agents from 4 to 32. The findings of our study showed the great potential for enhancing the efficiency of MARL training in large-scale agent combat missions
From didactic explanations to co-design, sequential art and embodied learning: challenges, criticisms and future directions of patient pain education
No full textPain Neuroscience Education (PNE) emerged over two decades ago in response to the incoherence between evidence-based pain management strategies, and consumer and clinician understandings of "how pain works". Many clinical trials have investigated the effects of PNE either as a standalone intervention or embedded within a more complex care package, with mixed results. A range of research methods have been used to explore the inconsistent effects of PNE. Together they (i) identify significant shortcomings and limitations of PNE and (ii) raise the possibility that gaining a broadly scientifically accurate understanding of "how pain works" may be critical for subsequent pain and disability improvements. Both learnings strongly suggest that we need to do better. Extensive research incorporating several interest-holders has led to updated content and language and criticisms of both are addressed. The method of PNE has also been updated, with integration of educational frameworks, teaching strategies and tactics, patient resources and clinical tools that all aim to promote the likelihood that patients will learn key concepts and operationalise them to improve their pain, function and quality of life. Pain Science Education is used to differentiate the new approach from PNE
Smallness of the Nuclear Polarization Effect in the Hyperfine Structure of Heavy Muonic Atoms as a Stimulus for Next-Generation Experiments
No full textThere is renewed interest in studies of muonic atoms, which may provide detailed information on nuclear structure. A major limiting factor in the interpretation of measurements is the nuclear polarization contribution. We propose a method to determine this contribution to the hyperfine structure in muonic atoms from a combination of theory and experiment for hydrogenlike ions and muonic atoms. Applying the method to ²⁰³’²⁰⁵ Tl and ²⁰⁹ Bi , for which there are H-like ion and muonic atom hyperfine experimental data, we find that the nuclear polarization contribution for these systems is small and place a limit on its size of less than 10% the total hyperfine splitting. We have also performed direct calculations of the nuclear polarization contribution using a semianalytical model, which indicate that it may be as much as two orders of magnitude smaller. Therefore, the nuclear polarization correction to the hyperfine structure of muonic atoms does not represent a limiting factor for next-generation experiments.J. Vandeleur, G. Sanamyan, O. R. Smits, I. A. Valuev, N. S. Oreshkina, J. S. M. Ginge
Reprocessing of Sulphide Flotation Tailings for Copper Recovery: Characterisation
No full textThis study characterises low-grade copper ore tailings from a conventional flotation circuit to evaluate their feasibility for further processing. A suite of advanced analytical techniques, such as X-ray fluorescence (XRF), inductively coupled plasma (ICP), X-ray diffraction (XRD), and the quantitative evaluation of minerals by scanning electron microscopy (QEMSCAN), was employed to assess the elemental, chemical, and mineralogical composition of the tailings. Chalcopyrite was identified as the dominant copper-bearing mineral phase, predominantly locked within iron oxides and silicate gangue minerals. The QEMSCAN results showed that chalcopyrite was only partially liberated, which highlights the complex mineral intergrowths that hinder efficient recovery. Based on the mineralogical characteristics, the applicability of various processing techniques, including conventional froth flotation, advanced flotation methods [including HydrofloatTM, Jameson, and the Reflux Flotation Cell (RFC)], magnetic separation, and gravity separation, was evaluated. Overall, this study indicates that incorporating HydroFloat™, the Jameson Cell, and the RFC into the flotation circuit could greatly improve copper recovery from tailings. This study also identified rare earth elements (REEs) as potential by-products of copper recovery, so it is an additional opportunity for resource recovery. This paper contributes to sustainable mining practices and resource optimization by highlighting the characteristics and recovery of valuable minerals from tailings.</jats:p
Healthcare professional perspectives on digital health-related quality-of-life assessment in paediatric radiation therapy: a qualitative study
No full textData source: Supporting Information, https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fjmrs.880&file=jmrs880-sup-0001-AppendixS1.docxIntroduction: Health-related quality of life (HRQoL) is not routinely evaluated using patient-reported outcome measures (PROMs) in paediatric radiation therapy (RT). This study aimed to identify barriers and facilitators to HRQoL implementation in paediatric RT clinical practice and requirements for a digital PROM platform, from the perspectives of healthcare professionals.
Method: Exploratory semi-structured interviews were conducted with multidisciplinary clinicians from two hospitals providing care to paediatric RT patients. Interviews were transcribed verbatim, descriptively coded and analysed using content analysis. Consolidated Framework for Implementation Research (CFIR) was used as a theoretical framework for data collection, analysis and interpretation.
Results: Nine interviews were held with nurses (n = 3), radiation therapists (n = 3), radiation oncology registrars (n = 2) and a consultant family therapist. Participants identified digital, clinical and child-friendly features to inform platform development. All participants recognised the proposed digital platform to be of value by generating new information to support patient care. The perceived alignment with clinical workflows, potential to provide staff satisfaction and individual scope to act on PROM results were key facilitators. Clinical time pressures, transient staffing and reluctance for change were identified as potential barriers. Engagement of clinical staff and training in addressing psychosocial concerns were recommended to support clinical actioning of results and foster successful clinical uptake.
Conclusion: This study used CFIR to systematically identify requirements for a digital platform and barriers to routine patient-reported HRQoL collection in the paediatric RT setting. The facilitators and complexities of PROM implementation can inform platform development and future implementation strategies
Teaching intellectual humility in doctoral education in nursing to improve empathic engagement and impact
No full textAn injectable IPN nanocomposite hydrogel embedding nano silica for tissue engineering application
No full textGelatin methacrylate (GM) and sodium alginate (SA) are two biomaterials that have been widely employed in tissue engineering, particularly in 3D bioprinting. However, they have some drawbacks including undesirable physico-mechanical properties and printability, hindering their application. This work developed an interpenetrating polymeric network (IPN) of GM and SA reinforced with silica nanoparticles (SNPs) to deal with hydrogels’ drawbacks. Besides, for cross-linking, visible light is used as an alternative to UV light to prevent disruptions in cellular metabolism and immune system reactions. Four GM/SA/SNP hydrogels different in SNPs concentration (0, 0.5, 1, and 2 w/w%) are studied. The performance of the hydrogels is evaluated in terms of physico-mechanical properties (viscoelasticity, compressive modulus, degradation, and swelling), rheological properties, and biological properties (fibroblast cell growth and adhesion, and MTT assay). The results demonstrated that the GM/SA/SNP hydrogel with 1% SNPs provided desirable physical (645% swelling and 59.3% degradation), mechanical strength (270 kPa), rheological (tan δ of almost 0.14), and biological performances (≈98% viability after 3 days) while maintaining appropriate printability. The findings suggest that the GM/SA/SNP hydrogel holds great potential for applications in soft tissue regeneration