The Two Worlds of Palliative Care: Bridging the Gap with Nepal
Bibliographic record
Abstract
Despite past geo-political turbulence, Nepal has made significant progress in societal and economic initiatives, particularly in relation to social determinants of health. These improvements, however, belie the suffering of those with life-limiting disease due to pain, stigma, social and financial distress, consequent upon low patient, caregiver and health professional awareness of the need for, and availability of, appropriate care and support. Two Worlds Cancer Collaboration (INCTR-Canada) has been working with partners in Nepal to build capacity for palliative care by: (a) organizational and administrative support – establishing the Nepal Association of Palliative Care (NAPCare), and the creation of the Nepal Strategy for Palliative Care, approved by government in 2017; (b) “twinning” between 2 hospital palliative care units in Nepal and the Nanaimo Hospice and Victoria Hospice, BC, Canada; (c) sustainable growth of palliative care according to WHO foundational measures, implementing facility-based clinical programs, and home-based care aligned with the cultural, social, and economic environment of Nepal; (d) training of health professionals in adult and paediatricpalliative carethrough interactive on-line “distance learning” (Extension of Community Healthcare Outcomes, ECHO);(e) leveraging palliative care training and expertise across the government health system, and (f) local and international support to build a newfacility for Hospice Nepal to provide more support for more patients in a rural ambience on the outskirts of Kathmandu. Palliative care needs to become standard-of-care, providing peace, comfort and dignity for adults and children. Working collaboratively with partners in Nepal, the collective vision is a capable professional Nepali community leading palliative care services for all in need, wherever in need.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.016 | 0.013 |
| Scholarly communication | 0.013 | 0.028 |
| Open science | 0.002 | 0.031 |
| Research integrity | 0.006 | 0.018 |
| Insufficient payload (model declined to judge) | 0.013 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".