Reconceptualising continuity in living heritage: the case of gers and their diverse communities

Minority ethnic patients are less likely to access timely and effective palliative and end-of-life care and, as a consequence, more likely to experience poorer symptom management and receive more intensive treatments at the end of life. Research activity has the potential to address the aforementioned barriers to improve access. However, there is a need to develop capacity and capability, particularly within underserved communities, to provide an infrastructure that can drive research activity informed by the community to benefit the community. To build and develop a robust, inclusive and representative research partnership to facilitate improved research activity committed to addressing inequity in access to palliative and end-of-life care among ethnically diverse communities. An inclusive and representative KEEch research Partnership NETwork was established, comprised over 80 partner organisations that represent the local diverse and multifaith communities. Interviews (n = 11) with service providers and face-to-face roundtable workshops with community stakeholders, service providers, informal carers and faith leaders were conducted to understand needs, challenges and research priorities. Bedfordshire, Hertfordshire and Milton Keynes, United Kingdom. Developing KEEch research Partnership NETwork required a flexible and agile approach to engage effectively with institutionalised and non-institutionalised stakeholders. Sharing a joint purpose of learning, managing partners' expectations and providing transparency and accountability within the network were all essential in building trust and equity within the research partnership. The overarching findings revealed a range of sociocultural and structural barriers that negatively impact access and experience among minority ethnic groups. Discussions centred on the disconnect between informal care and support within the community, which many ethnic minority communities rely upon, and 'institutional' medical services. KEEch research Partnership NETwork uncovered that while service providers and communities acknowledge they need to engage with each other more, they remain uncertain of the best way to achieve this. There was also consensus that services need to deliver more effective, culturally competent, person-centric care that promotes compassion and gives weight to non-medical needs to better meet the needs of the diverse population. These findings and priorities have informed the submission of a co-produced research funding proposal. Beyond that, KEEch research Partnership NETwork has also provided a platform for further unplanned spin-off research projects and collaboration, including the implementation of an innovative 'community connector' role to facilitate better integration of community and voluntary services in palliative and end-of-life care. KEEch research Partnership NETwork has provided valuable insight into factors that can facilitate the successful collaboration between multifaith and diverse community stakeholders. Through KEEch research Partnership NETwork, we offer our observations as an opportunity for shared learning for others who want to adopt a similar approach when in the planning stages of establishing a research partnership network. The mutual benefit of developing this partnership and working collectively with communities to address inequalities in accessing palliative and end-of-life care could provide a useful approach and way of solving other important priorities to reduce wider health inequalities. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research as award number NIHR135381.

This paper sheds further light on the role of quantification in corporate environmental disclosures. Quantification is an inherently social practice, which has attracted a fair amount of academic interest in recent years. At the same time, in the field of social and environmental accounting there is a paucity of research on quantification or the role it plays for organisations, for organisational communication and in societies more broadly. Accordingly, in this paper, we will draw on a qualitative case study to discuss the potential implications that might arise from the use of quantified information in corporate environmental disclosures. Our case study illustrates the diverse effects of quantification suggested in the prior literature by placing them in the context of corporate environmental disclosures. We discuss how quantification implies fake precisionism and promotes commensuration of incomparables, thereby limiting the discussion to themes and questions preferred by company management. We maintain that quantification, while appearing to produce neutral and value-free information, has a substantive ethical dimension through how it implicates accountability relationships as well as the respective power relations between diverse stakeholders in societies.

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Within a dynamic global political arena, the economic ramifications of the COVID-19 pandemic, energy impoverishment, ever-increasing global awareness of climate change, energy justice and just energy transition have emerged as important aspects that require critical reflexive deliberation to ensure that those on the margins of the energy divide do not pay the price for such a transition. Existing models to ensure energy justice were described as failing to consider stakeholder perspectives and needs. It was therefore proposed that such models be inclusive and reflective of diverse stakeholders, including local households, communities, utilities and governments. To this end, the University of South Africa’s Institute for Social and Health Sciences has developed a Transformational Model of community engagement in collaboration with communities which can be applied to articulate and guide the community engagement processes in an inclusive just energy transition. In this article, I present the model which offers opportunities to integrate multiple perspectives, prioritise the needs of diverse community stakeholders, interrogate power imbalances, and enhance working collaborations and partnerships, while also facilitating ongoing oversight and sustainable programme implementation. This model is a viable framework to achieve energy justice through an inclusive equitable transition to renewable energy technologies and by extension to reduce energy poverty. It has been applied in diverse community contexts across two provinces (Gauteng and the Western Cape) to engage with and build lasting community–institutional relationships. It has also been used to design, develop and evaluate contextually applicable sustainable initiatives, including a community-wide campaign.

IntroductionGenomic/precision medicine offers a remarkable opportunity to improve health and address health disparities. Genomic medicine is the study of genes and their interaction with health. Precision medicine is an approach to disease prevention and treatment that considers individual variability in genes, environment and lifestyle. Conclusions from studies lacking diversity may hinder generalizability as genomic variation occurs within and between populations. Historical factors, such as medical mistrust, ethical issues related to decision making, and data sharing pose complex challenges that may further widen inequities in genomic/precision medicine if not appropriately addressed. Although few biomedical studies integrate priorities of community partners into their conceptual framework, effective implementation of genomic/precision medicine research calls for the involvement of diverse stakeholders to expand traditional unidirectional models of engagement in clinical research towards authentic bidirectional collaboration.MethodsA multipronged approach was used integrating an evidence‐based literature review and best practices in developing and evaluating the engagement of diverse stakeholders in genomic and precision medicine research. This was combined with expert consensus building to adapt a conceptual model from a community engagement framework to addressing genomics to be scalable to engagement science, which is challenging to genomic/precision medicine research.ResultsThe final enhanced conceptual framework is composed of four overarching dimensions now inclusive of domains in trust, exploitation, discrimination, privacy risk, stigmatization, prior harms/injustices, failure to recognize coexisting governments, intersectionality and research transformation. This conceptual framework proposes effective participant research engagement strategies for upstream relationship building, distinct from downstream recruitment strategies in which the goal is enrolment.ConclusionTo further shape the evolution of genomic/precision medicine research, it is important to leverage existing partnerships, engage participants beyond recruitment and embrace diverse perspectives.Patient or Public ContributionIn preparation of this manuscript, the perspectives of the community partners on the impact of engaging in genomic/precision medicine research beyond research participation were integrated into this conceptual framework from various guided listening sessions held in diverse communities.

Do we care about the <i>Societal Impact</i> of our research?

Theoretical Advances in the Ecology and Evolution of Mutualistic Interactions – Review of a Symposium (<scp>SYMP</scp> 14) Organized at <scp>ESA</scp> + <scp>CSEE</scp> 2022 Joint Meeting

Public markets play a critical role in the social and economic fabric of communities, serving as points of interaction between diverse stakeholders, including merchants, consumers, local authorities and non-profit organizations. This article presents a critical review of the literature on public markets, exploring their dynamics, challenges and impacts on sustainability and economic development. Sellers, as the main stakeholders, ensure the supply of varied products, while consumers seek quality, authenticity and social interaction. Local authorities regulate and promote cultural infrastructure and events, while non-profit organizations encourage ethical and sustainable practices. The complex relationship between these groups is marked by dynamic interactions and, often, conflicts, such as disputes over space, strict regulations and environmental impacts. From an economic point of view, public markets promote the livelihood of small traders, create jobs and boost tourism. They also generate significant revenue by attracting visitors, strengthening the local economy and revitalizing urban areas. However, overtourism can compromise cultural authenticity, drive up prices and put pressure on local residents. Public markets also play a crucial role in sustainability, promoting the sale of local products and practices such as organic farming and waste reduction.

Municipalities play a crucial role in population health due to their community connections and influence on health determinants. Community-campus engagement (CCE), that is, collaboration between academic institutions and communities, is a promising approach to addressing community health priorities. However, evidence of CCE's impact on population health remains limited. Measuring the impacts of CCE is inherently complex due to factors such as diverse stakeholders, context-specific variables, and dynamic interactions within a community. This study aims to develop robust evidence on the impacts of CCE on population health outcomes in Ottawa and Thunder Bay, Ontario, Canada, focusing on 5 shared health priorities: housing, discrimination, poverty, violence, and mental health. We will use a proven CCE model called CityStudio, which has been implemented in both cities. We will use Mayne's mixed methods contribution analysis in three stages: (1) formulating a theory of change that outlines the expected contributions of CCE to population health outcomes; (2) gathering qualitative and quantitative data in line with the established Theory of Change; the data will be collected from various sources, including case studies of existing CityStudio projects, a web-based CCE stakeholder survey, a literature review, and population and community health data; and (3) reviewing the gathered evidence to determine the extent of CCE impacts on population health. Ethical approval for this project was granted in May 2023. We have since initiated stage 1 by reviewing the literature to inform the development of the theory of change. We expect to complete this study by May 2026. This study will address two critical gaps about how improving health outcomes depends on CCE: (1) how academic institutions can best engage with their communities to improve population health outcomes, and (2) how municipalities can engage with academic institutions to address their community health priorities. Conducting our work in differing contexts will allow us to consider a broader range of other influences on outcomes, thus making our work applicable to various settings and outcomes. PRR1-10.2196/58546.

Healthcare is a complex system that involves high risk to patients, clinicians, manufacturers, and other stakeholders. Clinicians process inordinate amounts of data and synthesize these inputs to make critical decisions that affect patient health and safety. The unprecedented advancement in medical technology during the past half-century has contributed substantially to healthcare’s expanding complexity.1 Consequently, clinicians have more knowledge to synthesize, tasks to perform, and processes to manage than ever before.1 The delivery of care often is overly complex and unstandardized, thereby reducing rather than increasing safety. For example, new devices are being implemented in medical practice at an astounding pace, requiring clinicians to continuously expand their breadth of knowledge and expertise. Consequently, a main cause of adverse events is misuse of medical devices. Variation in medical devices among hospitals (and within a given hospital) is a key cause of these adverse events. Design improvements and standardization of equipment have been suggested as ways to reduce errors. Although new technologies usually are advantageous for the patient, health professionals often encounter difficulties in using devices. Furthermore, current healthcare systems are not designed to support the care of complex patients, such as populations with chronic conditions requiring care management across multiple providers and services. In 2005, a joint report from the National Academy of Engineering and Institute of Medicine advocated the extensive application of systems thinking to improve the delivery of healthcare.2 Systems thinking centers on the dynamic interaction, synchronization, and integration of people, processes, and technology.3 By gaining an understanding of the dynamics among people, processes, and technology, systems thinking aids in recognizing how to intervene (e.g., focusing on changes to device design, clinician training, and/or clinical practice) in the system successfully. Moreover, systems thinking helps identify the critical relationships and connections often missed or undervalued that are pivotal to a successful implementation effort. If the high-risk healthcare industry focuses on an enhanced application of systems-thinking approaches, it will benefit from opportunities to reform the care delivery system by reducing unnecessary complexities and unexplained practice variations. This article describes five ways in which systems thinking can be incorporated into healthcare organizations. Rather than providing an exhaustive list of information, this report is meant to serve as a starting point for exploring how to integrate systems thinking.

The Health Equity Advancement Lab (HEAL) at the University of Iowa College of Public Health began in 2012 to support students, researchers, and community members interested in tackling persistent health inequities through a community-based participatory research (CBPR) approach. Using concepts from critical consciousness theory, we developed an approach to building students', faculty members', and community partners' capacity to engage in CBPR to promote health equity that involved immersion in developing CBPR projects. Our paper describes the evolution of HEAL as a facilitating structure that provides a support network and engages diverse stakeholders in critical reflection as they participate in research to advance health equity, and resulting political efficacy and social action. We describe one HEAL-affiliated research project that employs a CBPR approach and has a strong focus on providing transformative learning experiences for students, faculty, and community members. We highlight challenges, successes, and lessons learned in the application of critical consciousness as a framework that engages diverse academic and community partners seeking to promote health equity. We argue that critical consciousness is a relevant theoretical framework to promote transformative learning among students, faculty, and community partners to promote health equity research in diverse communities.

Mauritius is a multicultural nation where diverse communities have coexisted for centuries, shaping a complex linguistic and cultural landscape. Among these, the Tamil community has maintained a distinct identity rooted in ancestral language, religious practices, and cultural traditions. This paper explores how Tamil identity is preserved and negotiated amidst the island’s multilingual environment, characterised by Creole, French, and English dominance. Drawing on sociolinguistic theories of language maintenance and shift, and supported by educational statistics and cultural observations, the study examines how Tamil festivals, temple rituals, and community-led initiatives serve as key domains for symbolic language use and cultural continuity. The study highlights the paradox of high ritual visibility versus low academic uptake of Tamil among youth. By situating Tamil preservation within the broader context of African postcolonial identity formation, the paper argues that the Tamil community’s efforts represent both resilience and adaptation in a creolised, multilingual society. These findings contribute to discussions on diaspora, heritage language sustainability, and minority identity in African multicultural states.

Local museums can no longer simply wait for visitors to come and see their exhibited interiors. They are tasked with community engagement and cultural continuity. They must remain relevant to their communities, but how? Recently, local museums, especially those promoting local history, have struggled to relate to rapidly changing and diverse communities. To ensure museums are community-centred spaces, this research suggests that their spatial components need rethinking. While exhibitions in local museums should be designed through a collaboration and co-creation process between museum staff and locals, semi-outdoor and exterior spaces could be organised to host community gatherings, cultural events, and public conveniences. The paper explores the spatial dialogue between exhibited interiors, semi-outdoor multifunction spaces, and cultural exteriors of four local museums in Thailand, including how they build communities and support cultural heritage. The paper elucidates that while the exhibited interiors of these local museums represent pride in treasures of the past, semi-outdoor multipurpose spaces and cultural exteriors support heritage continuity. With a combination of the three spatial components: exhibited interior, semi-outdoor multifunction space, and cultural exterior, local museums can look forward to a promising future.

In robot-assisted surgery, exploration and manipulation tasks can be achieved through collaboration among robotic and human agents. Collaboration models can potentially include multiple agents working towards a shared objective—a scenario referred to as multilateral manipulation. We present a flexible software framework to expedite development of various multilateral manipulation strategies. We demonstrate the effectiveness of an implementation of the framework in a palpation task. Five different collaboration models were tested in which the goal of the multilateral manipulation system is to segment a stiff inclusion from its surrounding soft tissue: three of these collaboration models used machine learning methods for segmentation, and two required human operator segmentation. The collaboration models tested were: 1) fully autonomous exploration of the tissue; 2) shared control between a human and robotic agent; 3) supervised control where the operator dictates commands to the robot; 4) traded control between the two agents; and 5) bilateral teleoperation. Results indicate tradeoffs in sensitivity, maximum force applied, safety implications, and duration of experiment among the five models.

Upon attaining independence on 18 April 1980, the Zimbabwean government was faced with the challenge of eradicating prejudices, which had been constructed during the colonial era. Whilst it is correct to accept that colonial Zimbabwe was beset with racial prejudices, which inhibited interracial interactions, it is also essential to recognise that post-colonial events triggered socialisation processes devoid of nation building. Therefore, by exploring the dynamics of interactions within Zimbabwe’s minority communities in Britain, the paper will unravel the impact of memories constructed during the different phases of Zimbabwe’s history. By focusing exclusively on Whites, Coloureds (mixed-race) and Asians, it will demonstrate that the Zimbabwean immigrant community in Britain is not a monolithic group of Blacks, but a racially diverse community. Analysing the diaspora interactions of communities considered more privileged than Blacks during the colonial era provides a perspective on the complexities of eradicating historically constructed racial prejudices.