Areas Of Need Research Articles

Development and validation of a questionnaire to assess knowledge in patients with Atrial Fibrillation

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Centre for Heart Rhythm Disorders Background Education is critical to empower individuals to self-monitor and manage their condition. Significant variability exists in the provision of education for atrial fibrillation (AF), whilst individual patient factors including health literacy and education level attainment may impact on knowledge levels. Objective assessment of knowledge may help to target education to areas of need, and result in improved patient outcomes. Objective To describe the development and validation of a knowledge questionnaire for AF. Methods A multidisciplinary expert team of healthcare professionals developed the questionnaire, in conjunction with consumers, with question content based upon areas deemed most critical to AF and related self-management. The multiple choice questionnaire consists of 20 items, each worth 5 points, to give a total score out of 100. The questionnaire assesses five domains specific to AF: general knowledge, complications, medications, risk factors and action. The questionnaire was developed in English. The questionnaire was tested on 10 randomly selected patients with AF for face validity and 19 healthcare professionals for content validity. The final version was completed by 454 individuals with AF. Exploratory factor analysis was used to determine construct validity with factor loadings of 0.40 and above considered acceptable. Reliability was assessed using Cronbach’s alpha, with a value greater than 0.7 acceptable. Results Face and content validity were considered acceptable, after minor changes to wording. The cohort of 454 individuals with AF had a mean age of 66.9 ± 12 years and 43% were female. Mean (SD) total score was 57.7 ± 15.8. Exploratory factor analysis was undertaken using the principal components method. This resulted in a Kaiser–Meyer–Olkin Measure of Sampling Adequacy of .64 and a Bartlett"s Test of Sphericity being significant at 0.00. Seven factors were selected and analysed using principal component analysis with varimax rotation. All items loaded on one of the seven factors. Internal consistency demonstrated a Cronbach’s alpha of 0.65. Conclusion The Atrial Fibrillation Knowledge Questionnaire is a valid measure to assess knowledge in individuals with AF.

Torrefied Biomass and Where Is the Sector Currently Standing in Terms of Research, Technology Development, and Implementation

Torrefaction is a thermal conversion method of biomass used to produce a high-quality solid biofuel that can be used for combustion, gasification, and additional non–energy-related applications. Torrefied biomass has numerous advantages above today’s standard biomass fuels like log wood, wood chips, and white wood pellets (WWPs). This is known and promoted for long, and has been proven in numerous research and demonstration projects; however, large-scale industrial proof is still underway only in these days. First, project implementations with name plate capacity of 100 kmt/a or higher are in construction or hot commissioning. In this review, the main advantages of torrefaction are shortly described, and the latest industry developments and future opportunities for the products as well as areas of need for further R&D are presented.

Methods for identifying spatially referenced conservation needs and opportunities

Protected area coverage is expanding rapidly in response to threats such as habitat degradation, resource overexploitation, and climate change. Given limited resources, conservation scientists have developed systematic methods for identifying where it is most efficient to protect biodiversity. To improve the outcomes of protected areas, planners have also sought to incorporate non-ecological data into protected area design, including data on conservation opportunity. Our study expands this literature using expert elicitation, participatory mapping, and a case study of the Southern Ocean to identify areas of conservation need and opportunity. We consider the spatial variation between need and opportunity, examine how socioeconomic and political factors influence the selection of areas, and investigate barriers to reaching consensus and establishing marine protected areas along the Western Antarctic Peninsula. We found that, while experts readily identified areas of conservation need and opportunity, most did not easily distinguish between the different types of opportunity proposed in the literature (existing, potential, and fleeting). Geographically, there were significant areas of overlap between need and opportunity, but areas of need were more restricted and specific, whereas areas of opportunity were more expansive and general. Biophysical and socioeconomic factors were most important in motivating the selection of areas of opportunity, followed by geopolitical and then scientific factors. Our approach to data collection and planning can provide insights into tradeoffs between ecological needs and opportunities for taking action, and therefore aid in identifying and reducing barriers to designating effective marine protected areas.

Bilingual Supports for Clinicians: Where Do We Go From Here?

Purpose The purpose of this study was to identify and define the support needs of bilingual speech-language pathologists working in one urban school district and to investigate the experiences of the clinicians engaged in a professional learning community (PLC) format within their public school system. Method Twenty-three bilingual speech-language pathologists met in a PLC over the course of 5 months, with a total of four sessions that were a mix of in person and virtual. The participants engaged in group discussions and activities alongside their peers to address self-identified areas of support and need. Additionally, initial and final focus group and exit slip data following the PLC were collected to inform the discussion topics of the PLC and gather final impressions. Constant comparative analysis was utilized to analyze focus group and exit slip data. Results When looking across the experiences of the clinicians in the district, the three themes that emerged from the data were systemic obstacles, professional obstacles, and supports. The three themes that emerged from the speech-language pathologists' experiences in the PLC included their positive experiences, the challenges with participation, and the positive outcomes from exposure to new techniques and earning platforms. Conclusion The findings of this study suggest that bilingual clinicians benefit from a PLC model when addressing specific areas of need.

"We Have to Be Strong Ourselves": Exploring the Support Needs of Informal Carers of Aboriginal and Torres Strait Islander People with Cancer.

Informal carers provide an important role in supporting people with cancer. Aboriginal and Torres Strait Islander peoples experience higher cancer mortality than other Australians. To date, very little is known about the support needs of carers of Aboriginal and Torres Strait Islander adults with cancer. This article explored these needs through a qualitative study. Twenty-two semi-structured qualitative interviews and one focus group were conducted with carers of Aboriginal and Torres Strait Islander adults with cancer (n = 12) and Aboriginal and Torres Strait Islander cancer survivors (n = 15) from Queensland, Australia. Half of the carers interviewed were Aboriginal or Torres Strait Islander Australians. Interviews were transcribed, coded and thematically analysed following an interpretive phenomenological approach. Thematic analysis of carer and survivor interviews revealed four key themes relating to carers’ needs: managing multiple responsibilities; maintaining the carer’s own health and wellbeing; accessing practical support and information; and engaging with the health system. Within these overarching themes, multiple needs were identified including specific needs relevant for carers of Aboriginal and Torres Strait Islander peoples, such as advocating for the patient; accessing Indigenous support services and health workers; and ensuring that the cultural needs of the person are recognised and respected. Identifying the needs of informal carers of Aboriginal and Torres Strait Islander cancer patients will enable greater understanding of the support that carers require and inform the development of strategies to meet these areas of need.

Abstract 19: Geospatial Analysis and Impact of Targeted Development of Breast Cancer Care in The Gambia: A Cross-Sectional Study

Abstract Purpose: To characterize the capacity of healthcare facilities to provide breast cancer care in The Gambia and calculate the proportion of the population with access to services. Methods: A facility-based service assessment tool was administered to all healthcare facilities in The Gambia. Proximity of service availability and population analysis were assessed using GPS coordinates and LandScan population density raster. Distance thresholds of 10km, 25km, and 45km were established to determine access to screening services, pathologic diagnosis, and surgical management, respectively. An additional population analysis was performed to observe the potential impact of targeted resource development. Results: All 102 healthcare facilities were included. Breast cancer screening was mainly performed through clinical breast examination and was available in 52 facilities. Seven facilities provided pathologic diagnosis and surgical management of breast cancer. The proportion of the Gambian population with access to screening, pathologic diagnosis and surgical management was 72%, 57%, and 62%, respectively. Patients living on the eastern side of the country have to travel up to 35 km for screening services and up to 300 km for pathologic diagnosis and surgical management. Widespread implementation of clinical breast examination for screening, and targeted expansion of diagnostic and surgical resources in two hospitals would increase the covered population to 95%, 67%, and 84%. This would decrease the maximum distance to access breast cancer care to 15 km for screening and 90 km for diagnosis and surgical management. Conclusion: Almost half of the Gambian population do not have access to pathologic diagnosis and surgical management of breast cancer within a reasonable travel distance, and all facilities offering these services are located in the capital city. Mapping and population analysis can identify key areas of need. This approach allows targeted development of resources to significantly increase access to breast cancer care in a low resource setting. Citation Format: Fidel Lopez-Verdugo, Meghan Mali, Moustafa Moustafa, Jonathan Nellermoe, Justin Sorensen, Mustapha Bittaye, Ramou Njie, Yankuba Singhateh, Alison Goldsmith, Nuredin I. Mohammed, Raymond R. Price, Edward Sutherland, Ousman Sanyang. Geospatial Analysis and Impact of Targeted Development of Breast Cancer Care in The Gambia: A Cross-Sectional Study [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 19.

Right Upper Limb Salvage by Surgical Reconstruction with Autologous Tissue in a Machinery Crushed and Degloving Injury in a Post-COVID-19 Patient

Background: Crush injury occurs as a result of direct physical crushing of the muscles by a heavy weight and usually involves compression of the legs, arms, and/or trunk. Crush injuries are typically associated with accidents but can occur in nontraumatic patients as well. Crush injuries may result in permanent disability or death; therefore, early recognition and aggressive treatment are necessary to improve outcomes. Methods: Skin grafting is the transfer of cutaneous tissue from one portion of the body to another, often used to cover large wounds. The rationale of skin grafts is to take skin from a donor site that will heal and transfer the skin to an area of need. Results: After incorporation, skin grafts provide wounds with protection from the environment, pathogens, temperature, and excessive water loss like normal skin. Conclusion: The current study presents a case of Crush Injury with its entire course and final management in a 51 year old male who presented to ACHARYA VINOBHA BHAVE RURAL HOSPITAL, SAWANGI, (M), WARDHA, with traumatic amputation distal to level of metacarpals and degloving injury involving the arm proximal to elbow.

Through Privatisation, Government is Not Evading its Responsibility of Providing Health-Care to The Inhabitant

The strategy of price liberalisation and privatisation had been implemented in Sudan over the last decade, and has had a positive result on government deficit. The investment law approved recently has good statements and rules on the above strategy in particular to pharmacy regulations. Under the pressure of the new privatisation policy, the government introduced radical changes in the pharmacy regulations. To improve the effectiveness of the public pharmacy, resources should be switched towards areas of need, reducing inequalities and promoting better health conditions. Medicines are financed either through cost sharing or full private. The role of the private services is significant. A review of reform of financing medicines in Sudan is given in this article. Also, this communication highlights the current drug supply system in the public sector, which is currently responsibility of the Central Medical Supplies Public Corporation (CMS). In Sudan, the researchers did not identify any rigorous evaluations or quantitative studies about the impact of drug regulations on the quality of medicines and how to protect public health against counterfeit or low quality medicines, although it is practically possible. However, the regulations must be continually evaluated to ensure the public health is protected against by marketing high quality medicines rather than commercial interests, and the drug companies are held accountable for their conducts.

Person-centered Transition Planning for Youth on the Autism Spectrum: What are We Still Missing?

ABSTRACT The person-centered individualized education program (IEP) transition planning has emerged as a primary indicator of quality services, and as a predictor for successful post-school outcomes for transition-age youth with autism spectrum disorders (ASD). However, these person-centered transition practices are not uniformly implemented across the United States. Using a combined Self-Determination Theory and Ecological Systems Theory, we examined the facilitators and barriers of implementing the person-centered transition practices for youth with ASD. We conducted interviews with 21 stakeholders including youth with ASD, parents, and professionals. The current findings indicated that person-centered transition planning practices for youth with ASD showed inconsistencies and areas of need for improvement. Four key factor levels were identified based on a theoretical framework: individual level, microsystem, mesosystem, and exosystem. There were multifaceted and dynamic transactional relationships across multiple individual- and systemic-factors with respect to the person-centered IEP transition planning.

Robust Receptive Vocabulary Instruction for Students With Significant Cognitive Disabilities Who Use AAC

Robust vocabulary instruction is an important part of comprehensive English language arts (ELA) instruction. Vocabulary instruction supports students in learning the meaning of words to build a receptive vocabulary that they can rely on to comprehend the words they read and hear. Many students with significant cognitive disabilities (SCD) and complex communication needs (CCN) struggle to read or understand grade-level words, concepts, and texts. Explicit vocabulary instruction can play an important role in addressing this area of need. Addressing the vocabulary needs of students with SCD and CCN in a comprehensive way calls for a greater investment of instructional time to build their receptive vocabulary and conceptual understandings of new vocabulary. It calls for leveraging the high frequency expressive vocabulary students are likely to have available on their augmentative and alternative communication (AAC) systems to make meaningful connections and demonstrate their understanding of new vocabulary. The aim is successful comprehension across ELA and other academic domains through a robust and expanding receptive vocabulary that extends beyond the words commonly programmed onto AAC systems. Finally, vocabulary instruction should be one part of a comprehensive approach to ELA instruction, with substantial time and effort also devoted to reading and writing instruction so that one day students with SCD and CCN can use spelling and writing to bridge the gap between the words they know and the words they have access to use expressively.

OR2. Exploring Experiences Associated with Hypertrophic Cardiomyopathy Diagnosis, Treatment and Life Impact Among Middle-aged and Older Adults: An Interview Study

<h3>Background</h3> Hypertrophic cardiomyopathy (HCM) is a clinically and genetically heterogeneous disorder and an important cause of sudden death and heart failure. Limited studies exist that describe diagnosis, treatment, and management experiences of patients with hypertrophic cardiomyopathy. The purpose of this investigation was to use qualitative data collection methodologies to characterize HCM patient experiences related to HCM diagnosis, treatment, self-management, and the life impacts of HCM. <h3>Methods</h3> Adults aged ≥18 years diagnosed with HCM ≥1-year prior were recruited to participate. Semi-structured interviews were conducted via teleconference using open-ended questions and question probes. Interview recordings were transcribed verbatim and inductive and deductive thematic analyses were conducted. <h3>Results</h3> A total of 32 interviews were conducted. The majority of participants were female (53.1%), aged ≥45 years (90.6%), white (96.9%), and non-Hispanic (96.9%). Time to diagnosis from symptom onset ranged from <1 week to 26 years. Participants with longer time to diagnosis described having atypical HCM symptoms, denial of their own symptoms, and experiences of misdiagnoses. Several sources of information about HCM and support for dealing with HCM were utilized, including patients' personal healthcare professionals, websites, conferences, and social media. Participants described experiencing anxiety, denial, and upset feelings about being diagnosed with HCM, but also reported feelings of gratitude, acceptance, and increased mindfulness toward healthy habits. Individuals reported making changes in daily activities because of reduced physical capacity and making changes in lifestyles (e.g. where to live or travel) because of desire to be close to HCM specialists. However, participants also described becoming less fearful over time through utilization of available resources and treatment options. <h3>Conclusion</h3> These results indicate that adults living with HCM can experience many involuntary physical and psychological limitations and restrictions on life. This study indicates a need for healthcare professionals to be aware of the potential impact of HCM on patients and to provide patient support focused on increasing resilience for patients in need. These findings provide information useful for developing strategies and resources for patients and their families. The negative consequences experienced by patients as a result of inaccurate and/or delayed diagnoses and suboptimal interdisciplinary communication between healthcare professionals indicate potential areas of need. Identifying interventions aimed at improving recognition of typical and atypical of HCM symptomology, adherence to clinical practice guidelines for HCM diagnosis and treatment, and collaborative and effective interdisciplinary communication, are critical for exceptional patient care for those with HCM.

Development of Goals and Objectives for Pediatric Hospital Medicine Fellowship Curricula.

Pediatric hospital medicine (PHM) has experienced incredible growth in the last 20 years, including the creation of >50 PHM fellowships since the first program in 2003. In 2013, a National Pediatric Hospital Medicine Leaders Conference concluded that the best path forward for the field would be subspecialty certification with a 2-year accredited fellowship.1 This process culminated in formal recognition of PHM as a subspecialty by the American Board of Medical Specialties in 2016 and the first American Board of Pediatrics (ABP) certification examination in 2019.2,3 Also, in 2019, the Accreditation Council for Graduate Medical Education (ACGME) published requirements for PHM fellowships and began accrediting programs.4 Established PHM fellowships and programs in development now need to implement standardized curricular components to improve the consistency and educational quality of training and be compliant with ACGME accreditation requirements. During the initial period of PHM fellowship expansion, before American Board of Medical Specialties recognition of PHM as a subspecialty, PHM fellowship program directors (PDs) mobilized and formed a national PHM Fellowship Directors’ Council to oversee the evolution of PHM fellowships and provide a community for collaboration and development of shared resources. In 2014, the council created subcommittees to address areas of need within PHM fellowship programs. These included the curriculum subcommittee, which was composed of both new and established PDs as well as 2 community hospitalist representatives, all with specific interest and skills in curriculum development. Between 2014 and 2016, the council, led by the curriculum subcommittee, created a standardized 2-year fellowship curricular framework to reflect the …

552-P: Impact of Stakeholder Engagement in Pediatric Type 1 Diabetes (T1D): Experience from the T1D High-Fidelity Wraparound Program (HFWP)

Despite recent advances, management of pediatric T1D remains extremely challenging, in part due to psychological distress and poor adherence to recommendations. The HFWP aims to adapt and test an innovative strategy, used in behavioral health, to improve self-management and self-efficacy in high-risk youth with T1D. Stakeholder engagement, with the integration of patient, family and community/system partners into the research team, is increasingly recognized as a critical component of patient-centered research. We describe the process and outcomes of stakeholder engagement to inform T1D HFWP research activities and resources. A total of 21 stakeholders, representing family, youth and community/systems partners (e.g., ADA, JDRF, Health Plan), were selected through a rigorous application process and participated in monthly meetings for 13 months. Measures of satisfaction with processes and experience were obtained via an anonymous survey completed after every meeting. On average, 70% consistently answered the survey over 13 months. Stakeholders strongly agreed that the meetings met their expectations (4.75/5), objectives were identified and followed (4.5/5), their voices were heard (4.64/5) and the Advisory Board was effectively molding the T1D HFWP (4.75/5). The majority (~70%) were satisfied with meeting frequency and duration. The Advisory Board proposed important outcome measures which were adopted, including evaluation of anxiety and distress in youth and caregivers. Concrete areas of need were identified, leading to systematic development of tools, including a guide for families to vet online T1D resources and design of a practical, patient-centered form outlining a medical summary for families (e.g., insurance, type of devices used, phone numbers, etc.). This experience illustrates the willingness and importance of partnering with stakeholders to help shape resources and programs in pediatric T1D intervention research. Disclosure A. G. Nevin: None. C. March: None. L. Jones: None. J. Schreiber: None. I. Libman: Advisory Panel; Self; Novo Nordisk. Funding Children’s Hospital of Pittsburgh Foundation

Keeping Pace With 21st Century Healthcare: A Framework for Telehealth Research, Practice, and Program Evaluation in Occupational Therapy.

The use of telehealth to deliver occupational therapy services rapidly expanded during the COVID-19 pandemic. There are frameworks to evaluate services delivered through telehealth; however, none are specific to occupational therapy. Therefore, occupational therapy would benefit from a framework to systematically evaluate components of telehealth service delivery and build evidence to demonstrate the distinct value of occupational therapy. The PACE Framework outlines four priority domains to address areas of need: (1) Population and Health Outcomes; (2) Access for All Clients; (3) Costs and Cost Effectiveness; and (4) Experiences of Clients and Occupational Therapy Practitioners. This article describes the development and expert reviewer evaluation of the PACE Framework. In addition, the PACE Framework's domains, subdomains, and outcome measure examples are described along with future directions for implementation in occupational therapy research, practice, and program evaluation.

Adherence to Public Health England (PHE) guidance for the use of personal protective equipment (PPE) in north Wales mental health unit- a regional audit

AimsTo ensure that the PPE guidance is strictly adhered to.To ensure that patient care is not compromised.To help us in areas of need in order to educate the staff regarding the techniques of PPE and thus ensure patient and staff safety and care during the pandemic.MethodNovel coronavirus 2019 was first described in December 2019 in Wuhan in China. Since those initial few cases, it has rapidly proliferated to a global pandemic, putting an inordinate amount of strain on healthcare systems around the world. We believe that the technique of donning and doffing if followed as per PHE guidelines would be of help in both preventing the infection and improve the care and safety of both patients and staff.This Audit includes both In-patient and Out-patient units in Psychiatric services across North Wales. Data were collected from 19 units out of 39. We observed covertly 325 staff members belonging to various cadres. Apart from the Donning and Doffing techniques, we also observed the availability of designated areas for this purpose and the availability of PPE as well.Data collection was by junior and senior doctors from various sites of the mental health unit in North Wales. A proforma was provided, the standards were based on PHE guidelines.ResultIt was noted that just about 50% of the staff followed donning as per guidance. Amongst all three sites, the Central team showed a better adherence with 85% of them donning PPE correctly. whereas only 22% adhered to donning in the West team.Only 21% of them managed to doff PPE as per guidance amongst all 3 centres in North Wales.It was also noted that there are no designated areas to Don and Doff in outpatient units. Staff, in general, seem to not adhere to the guidance of utilising a mask, especially when within 2 meters distance of other staff.ConclusionWe will be presenting the Audit at the regional meeting. After discussion with the infection prevention control team and Health and safety lead, we intend to improvise the wards with designated areas for donning and doffing. Teaching sessions for the staff in all three sites, reminders in various areas of the community mental health units and inpatient units.We are hoping that these recommendations will help us in achieving our aim of health and safety during this pandemic.

572-P: Impact of Isolation during the COVID-19 Pandemic on the Care of Older Adults with Type 1 Diabetes: A Qualitative Study

Background: Older adults with type 1 diabetes (T1D) face unique challenges, especially when their support structure is disrupted, as happened during the Covid-19 lockdown. We evaluated the clinical and psychological impact of this imposed isolation on the older population with T1D. Methods: We conducted semi-structured interviews with older adults with T1D who were part of an ongoing study, which was paused from March - August 2020. The interviews were performed between May - August 2020, and were transcribed, coded, and analyzed using content analysis to derive theme. A multidisciplinary team of 12 individuals coded the interviews to identify the themes and included geriatricians, endocrinologists, a nurse educator, infomaticists, an economist, a methodologist, and research assistants. Results: We have analyzed 12/35 interviews at this time; mean age 74±4 years, 50% female, 92% non-Hispanic white, mean duration of diabetes 37±18 years, and A1C 7.3±0.7%. Three main themes have emerged. The challenges related to diabetes care included fear of hypoglycemia, interruption in supply chain related to diabetes technology (insulin pump and continuous glucose monitoring (CGM) supplies), use of telehealth, diabetes-related distress, and adapting to new routines in self-care (diet and exercise). Challenges related to the Covid-19 pandemic included fear of getting Covid-19 infection, and a lack of reliable information on pandemic. The challenges related to psychological well-being included a feeling of isolation, loneliness, inability to spend time with family and friends, lack of in-person communication, and lack of recreational activity. Conclusion: The results of this qualitative study help to understand critical areas of need when social support structures are unavailable to older adults with T1D. Our results will help develop intervention strategies to overcome barriers in maintaining support for this vulnerable population. Disclosure M. Munshi: Consultant; Self; Sanofi. S. Neuwahl: None. S. Cummings: None. S. L. Brown: Stock/Shareholder; Self; Pfizer Inc., Siemens Corporation. K. Weinger: None. E. Toschi: Consultant; Self; Medtronic. C. Slyne: None. K. Sifre: None. D. J. Davis: None. R. Dewar: None. S. M. Sy: None. A. Atakov-castillo: None. A. Michals: None. S. N. Haque: None. Funding National Institutes of Health (1DP3DK112214-01)

Setting a prioritized agenda to drive speech-language therapy research in health.

Prioritized research agendas are viewed internationally as an important method for ensuring that health research meets actual areas of clinical need. There is growing evidence for speech-language therapy-prioritized research agendas, particularly in disorder-specific areas. However, there are few general research priority agendas to guide speech-language therapy research. To collaboratively develop a prioritized research agenda for an Australian public health context with clinical speech-language therapists (SLTs), academic SLTs and consumers of speech-language therapy services. An initial stimulus list of potential research areas for prioritization was collected from SLTs via an online survey. Two categories (service delivery and expanded scope of practice) were selected from this list for prioritization due to their relevance across multiple health services. The Nominal Group Technique (NGT) was used to develop a prioritized research agenda for each of the two categories. One NGT session was conducted with each of the three participant groups (clinical SLTs, academic SLTs, consumers) for each category (total NGT sessions = six). The prioritization data for each group within each category were summed to give a single, ranked prioritized research agenda for each category. Two prioritized research agendas were developed. Within each agenda, SLTs and consumers prioritized a need for more research in areas related to specific practice areas (e.g., Alternative and Augmentative Communication, Communication Partner Training), as well as broader professional issues (e.g., telehealth, working with culturally and linguistically diverse families). The current findings support the need for funding proposals and targeted projects that address these identified areas of need. What is already known on this subject Evidence-based practice is a critical component of SLT practice. There is often a disconnect between the research evidence generated and areas of clinical need, and in some areas a lack of evidence. Prioritized research agendas can help drive research in areas of clinical need. What this paper adds to existing knowledge A collaborative, prioritized SLT research agenda was developed using the NGT according to the views of clinical SLTs, academic SLTs and consumers of speech-language therapy services in a conglomerate of public health services. SLTs and consumers identified a need for further research in specific areas of SLT practice as well as broader emerging professional issues What are the potential or actual clinical implications of this work? Targeted research projects funded on a large scale are required to address these identified areas of need. Other health services around the world could replicate this prioritization process to drive research in areas of clinical need.

Eyes Open, Ears On: Supporting Hearing Technology Use in Children with Hearing Loss

Eyes Open, Ears On: Supporting Hearing Technology Use in Children with Hearing Loss

Loss of C2 Domain Protein (C2CD5) Alters Hypothalamic Mitochondrial Trafficking, Structure, and Function

Introduction: Mitochondria are essential organelles required for several cellular processes ranging from ATP production to cell maintenance. To provide energy, mitochondria are transported to specific cellular areas in need. Mitochondria also need to be recycled. These mechanisms rely heavily on trafficking events. While mechanisms are still unclear, hypothalamic mitochondria are linked to obesity. Methods: We used C2 domain protein 5 (C2CD5, also called C2 domain-containing phosphoprotein [CDP138]) whole-body KO mice primary neuronal cultures and cell lines to perform electron microscopy, live cellular imaging, and oxygen consumption assay to better characterize mitochondrial alteration linked to C2CD5. Results: This study identified that C2CD5 is necessary for proper mitochondrial trafficking, structure, and function in the hypothalamic neurons. We previously reported that mice lacking C2CD5 were obese and displayed reduced functional G-coupled receptor, melanocortin receptor 4 (MC4R) at the surface of hypothalamic neurons. Our data suggest that in neurons, normal MC4R endocytosis/trafficking necessities functional mitochondria. Discussion: Our data show that C2CD5 is a new protein necessary for normal mitochondrial function in the hypothalamus. Its loss alters mitochondrial ultrastructure, localization, and activity within the hypothalamic neurons. C2CD5 may represent a new protein linking hypothalamic dysfunction, mitochondria, and obesity.

YAP1 transcription factor expression to define subsets of cancers with T-cell inflamed phenotype in a pan-tumor analysis across 33 tumor types.

2610 Background: Immune checkpoint blockade (ICB) has become an established treatment option for the majority of solid tumors. PD-L1 expression, tumor mutation burden (TMB) and mismatch repair (MMR) deficiency are established but suboptimal predictive markers to select patients for ICB therapy. The identification of better predictive biomarkers to complement existing biomarkers is an area of need. We previously identified Yes Associated Protein 1 (YAP1) gene expression as a marker of inflamed tumor phenotype in small cell lung cancer. We sought to elucidate the role of YAP1 as a tumor agnostic biomarker of inflamed tumor phenotype. Methods: We obtained the publicly available TCGA normalized RSEM expression data (version dated September 29, 2019) from the GDC legacy archive (https://portal.gdc.cancer.gov/legacy-archive) for this analysis. We used the shinySISPA method ( https://bbisr.shinyapps.winship.emory.edu/shinySISPA/ ) to classify the primary tumor samples into YAP1 high or low on the basis of the normalized expression profile for YAP1 gene. The T-cell–inflamed gene expression profile score for each sample was calculated as weighted sum of the normalized expression values of the 18 genes ( PSMB10, HLA-DQA1, HLA-DRB1, CMKLR1, HLA-E, NKG7, CD8A, CCL5, CXCL9, CD27, CXCR6, IDO1, STAT1, TIGIT, LAG3, CD274, PDCD1LG2, CD276) as originally published in the Patent filed under “WO201609437” and validated as a predictor of clinical efficacy in patients treated with anti PD1 immunotherapy drug, pembrolizumab. Results: A total of 11283 samples from 33 different histologic tumor types contained in the TCGA database were included in this analysis. A small but meaningful subset of cases 271 (2%) were classified as YAP1 high with a wide range in proportion of YAP1 high tumors of 0.67% to 12.09% across the 33 histologic tumor types. Adrenocortical, cholangiocarcinoma, chromophobe RCC, DLBCL, and mesothelioma had a high rate of YAP1 high tumors (&gt; 10% of cases). Overall trend showed a higher median interferon gamma GEP score in YAP1 high versus YAP1 low tumors with a GEP score of 11.2 vs. 10.7 respectively. A minority of histologic tumor subtypes (HNSCC, clear cell RCC, sarcoma, uterine carcinosarcoma, testicular GCT, melanoma, mesothelioma and ovarian cancer) showed a reverse trend of lower GEP score in association with YAP1 high status. Ongoing validation of these findings in an independent cohort of clinical samples and correlation of YAP1 status with other predictive biomarkers (TMB, PD-L1 and MSS status) will be presented at the meeting. Conclusions: YAP1 is highly expressed in a small but meaningful subsets of cancers and is associated with the inflamed phenotype in the majority of cancers. YAP1 expression is most common in rarer tumor types and in histologic types where currently available biomarkers have not been shown to predict the benefit of ICB.