Community Centers Research Articles

Intrinsic Capacity and Life Quality Among Taiwanese Older People: A Cross-Sectional Study.

Intrinsic capacity (IC), an internal composite ability proposed by the World Health Organization, is fundamental to older people's health. The present study examined potential models explaining the association between IC and quality of life (QoL) among older people in Taiwan. Frailty, basic activities of daily living (BADL), and instrumental activities of daily living (IADL) were hypothesized to be mediators in the association between IC and QoL. Older people aged 50 years or above from community or medical center (N = 1,235; Mage = 72.63 years [SD = 7.19]; 601 males [48.7%]) completed a series of self-report and functional measures assessing IC, frailty, ADLs, and QoL. Results showed that IC was significantly associated with frailty, BADL, IADL, and QoL in the mediation models. Frailty was found to be a significant mediator in the association between IC and QoL alone or together with IADL. The findings indicate that IC is an important factor for older people to maintain good health and live a fulfilling life.

Fostering Young Entrepreneurs: Family Support as the Cornerstone of Intentions

The present study investigates the influences of perceived family support (PFS), perceived desirability (PD), and perceived feasibility (PF) on entrepreneurial intentions (INT) among youth in both urban and rural settings. Grounded in the Entrepreneurial Event Model (EEM), this research highlights the complex interplay between individual and social factors that shape entrepreneurial aspirations. The EEM underscores the critical roles of PD and PF in predicting entrepreneurial intentions alongside the propensity to act. A quantitative research methodology was employed, utilizing a cross-sectional survey design with a diverse sample of 291 youth aged 16-24 years, including university students from both urban and rural areas. Data were collected through paper-based surveys distributed across educational institutions and community centers. The results reveal significant direct effects of PD (β = 0.318) and PF (β = 0.380) on INT, confirming the importance of cognitive factors in entrepreneurial decision-making. Furthermore, PFS positively influences both PD (β = 0.334) and PF (β = 0.469), highlighting the multidimensional role of family support. Notably, both PF and PD serve as mediators in the relationship between PFS and INT, underscoring the critical role of family dynamics in shaping the entrepreneurial aspirations of young individuals. This study contributes to the EEM by reaffirming PD and PF as crucial predictors of INT while illustrating how PFS enhances these perceptions. The findings emphasize the importance of family involvement in nurturing entrepreneurial intentions, suggesting that targeted programs to engage family support could strengthen the entrepreneurial ecosystem. Additionally, this research prompts future investigations into other external factors influencing perceived desirability and feasibility, thereby broadening the applicability of the EEM across diverse contexts.

Modern Typologies as Spaces of Inter-Religious Engagement in British-Mandate Jerusalem, 1917–1938

The architecture of Jerusalem has for centuries been defined by its being a space sacred to Judaism, Christianity, and Islam. The end of World War I marked the beginning of British Mandatory rule, which lasted until 1948. During this period, Jerusalem witnessed a proliferation of architectural projects that repositioned religion within modern typologies representing the city’s communities. This research investigates four such buildings: the British Rockefeller Museum, the Palestinian Palace Hotel, the American YMCA Building, which functioned as a community center and hostel, and the new Zionist Executive Building. The integration of religious elements into these edifices is examined using the concept of inter-religious engagement and by applying the theory of purification and hybridization. The research demonstrates that British and American Christians, Zionist Jews, and Muslim Palestinians, used different strategies to produce inter-religious engagement—either intentionally or because of British-dictated political constructs. British and American Christians embedded religious elements within modern typologies to reflect peaceful co-existence, while Zionist Jews and Muslim Palestinians used them to construct national identity. Although conceived as “purely” secular, these modern typologies were hybridized by the integration of religious spaces or emblems, revealing further dimensions to our understanding and assessment of 20th-century urban secular architecture and its intersection with religions.

A Shared Care Model between community and transplant centers facilitates access to allogeneic and autologous transplantation

Access to allogeneic and autologous hematopoietic stem cell transplantation (SCT) remains inadequate despite its curative potential across hematologic malignancies. In 2015, Hartford HealthCare (HHC) and the Memorial Sloan Kettering Cancer Center (MSK) established the Shared Care Model (SCM) with a primary aim of enhancing SCT access for HHC patients. The SCM comprises several components: an SCT-dedicated nurse-navigator, a health-information exchange for record sharing, telemedicine, and ongoing training of HHC clinicians in transplant patient selection and management. We evaluated the SCM’s impact on SCT access across 126 patients with acute leukemia, myelodysplastic syndrome, and multiple myeloma from 2016-2020. The SCM facilitated 34 referrals. Socio-economic status of HHC referrals by Area Deprivation Index was significantly inferior (38 vs. 14, p < 0.001) when compared to 3,108 non-SCM referrals to MSK during the same period. Allogeneic recipients spent 68-247 days away from home, and autologous recipients 15-48, both requiring few subsequent visits to MSK.

Reliability and Validity of Four Step Tests in Older Adults With Dementia.

To determine the test-retest and inter-rater reliability, concurrent and discriminative validity of the Four Square Step Test (FSST), the Choice Stepping Reaction Time Test (CSRTT), the Maximum Step Length Test (MSLT), and the Alternate Step Test (AST) in older adults with dementia. Thirty-seven older adults with dementia who could walk independently for at least 10m were recruited at community centers and day care centers for older adults. The participants completed the step tests conducted by two independent raters on three separate testing occasions within 3weeks. In addition, the physical and cognitive function of the participants were evaluated at baseline. The FSST, CSRTT, and MSLT showed good-to-excellent test-retest reliability (intraclass correlation coefficient [ICC]=0.83-0.91), and the AST exhibited fair test-retest reliability (ICC=0.70). All the step tests showed good-to-excellent inter-rater reliability (ICC=0.75-0.94). The step tests had moderate-to-strong correlations with various physical and cognitive measures (Pearson correlation coefficients=0.34-0.72). The MSLT side step and AST could differentiate between individuals who did and did not use a walking stick to ambulate (p≤0.046). The FSST, CSRTT, and AST could differentiate between individuals with and without a major neurocognitive impairment (p≤0.005). The FSST, CSRTT, and MSLT were reliable and valid for examining the stepping performance of older adults with dementia. Clinicians can use these tests to evaluate the physical and cognitive function of this population and identify those with significant cognitive impairment. Clinical Trial Registration number: NCT04296123.

Baškortostani udmurtide folkloor: žanriline iseloomustus, kogumislugu, käibimise iseärasused tänapäeval

The article discusses the peculiarities of the folklore genres of the Udmurts living in the Republic of Bashkortostan, Russian Federation, the history of the collection, publication and research of folklore, as well as its modern circulation. The folklore traditions of this ethnic group, separated from the motherland, have been subjected to Turkish influence, yet at the same time have preserved many archaic features. Loyalty to traditional folk beliefs adds uniqueness to their folklore. The folklore of this ethnic group has not been widely studied, and no collections or monographs have been published. Recently research into their folk prayers and ritual songs has started. Today, due to the shrinking of the authentic environment necessary for keeping it alive, folklore (mainly songs) has moved to the stage. Amateur ensembles, teachers of the Udmurt language and literature, staff of community centres, librarians, and local lore researchers play a significant role in the preservation of local folklore specimens.

Peran Hukum Adat dalam Penyelesaian Sengketa Agraria di Indonesia: Kajian Empiris dengan Metode Komparatif

Agrarian disputes are a crucial issue in Indonesia, particularly in areas that serve as the centers of indigenous communities, where conflicts often arise between customary law and formal law. This study aims to analyze and compare customary and formal law's effectiveness in resolving agrarian disputes, focusing on indigenous regions with strong customary norms. The methodology employed includes semi-structured in-depth interviews and an analysis of customary legal documents, aimed at exploring respondents' perspectives and collecting data from relevant documents. The findings reveal that customary law often proves more responsive to the needs of local communities and creates fairer resolutions, whereas formal law tends to operate within a more universal framework and often overlooks local cultural values. The conclusion of this study underscores the importance of collaboration between customary law and formal law to enhance the effectiveness of agrarian dispute resolution and provides policy recommendations for the government to strengthen harmony between these two legal systems.

Recognition of mild cognitive impairment in older adults using a polynomial regression model based on prefrontal cortex hemoglobin oxygenation

AimThis study employed a three-minute game-based intelligence test (GBIT) to create a hemoglobin polynomial regression model for early identification of mild cognitive impairment (MCI) in older adults. Methods210 older adult participants were recruited from community centers in the central region of Taichung City. Working memory (WM) performance in older adults was assessed during GBIT, while hemoglobin responses were measured by near-infrared spectroscopy (NIRS). Variables included oxyhemoglobin (O2Hb) and deoxyhemoglobin (HHb). Data sequences underwent a fitting procedure using a transformed cubic polynomial function. The transformed coefficients were used as predictors of a logistic regression model to recognize MCI in older adults. ResultsThis study confirmed the relationship between age and cognitive performance. The findings demonstrate that the NIRS cubic polynomial function trends during the GBIT test showed significant changes in older adults, increasing with age. Logistic regression analysis identified age and the orientation (coefficient a) of HHb as the main factors for recognizing MCI. The model achieved an overall precision of 83.33 % (sensitivity = 75.00 %; specificity = 84.68 %) with the formula: ln (Odds [MCI]) = −1.64 + 0.57 × HHb_a + 1.40 × age. ConclusionsNIRS hemoglobin response characteristics during GBIT may serve as an efficient indicator of MCI in older adults. These findings may advance the field of cognitive health evaluation, resulting in earlier detection of cognitive deterioration in older adults.

MUSIC THERAPY STRATEGIES FOR IMPROVING COMMUNICATION SKILLS IN CHILDREN WITH AUTISM SPECTRUM DISORDERS NAIROBI CITY COUNTY, KENYA

The purpose of this study was to evaluate the impact of music therapy strategies on autistic children's communicative abilities (ASD). The study focused on how music therapy strategies affected the expressive and receptive abilities of children with Autism Spectrum Disorders. Additionally, it looked into how music therapy strategies affected how well children with autism spectrum disorders paid attention together. The study also evaluated the impact of tools and assistance used in music therapy on the communicative abilities of children with Autism Spectrum Disorders. At the Kenya Community Centre for Learning (KCCL) in Nairobi County, the researcher gathered data from the accessible population, which included the head teacher, classroom teachers, and students with ASD. The School of the Nations in Nairobi County hosted the pilot research. This study was based on B.F Skinner's Behaviorism theory of the mid-20th century, which centered on the observable behaviors of individuals interacting with the environment. To gather data for analysis, the researcher employed an experimental study design that triangulated observation, interviews, and questionnaires. This study comprised 15 participants selected purposively consisting of 1(one) head teacher, 4(four) classroom teachers, and 10 (ten) learners with ASD. A descriptive-analytic approach was used to examine the study's data. It was the use of music therapy strategies and the therapist himself to influence the change of behavior where music could be used as a reinforcer, as a contingent interruption, and as a reward. Descriptive statistics such as mean, variance, and standard deviation. Inferential statistics were used to summarize data in terms of mean differences at the significance level of p=0.05. Qualitative data from interviews and observations were first transcribed to determine what to choose, interpret, and present. These data were then organized, coded, and categorized based on responses and comments. Findings showed that the pre-test baseline assessment revealed varying levels of receptive skills among children with ASD, with the experimental group showing moderate abilities in following verbal instructions but lower comprehension of simple prepositions compared to other skills assessed. Music therapy strategies had a positive impact on improving expressive skills among children with Autism Spectrum Disorder. The t-test conducted before the test showed no significant statistical difference between the control and experimental groups (p = 0.77 &amp;gt; 0.05). However, after the test, there was a significant difference between the control and experimental groups, with the experimental group showing higher average scores (p = 0.001 &amp;lt; 0.05). The study concluded that while music therapy strategies may offer some benefits in enhancing certain aspects of social skills among children with ASD, additional interventions and support may be necessary to address the complex challenges associated with social skill development in this population. The study recommended promoting collaboration between researchers, clinicians, and educators to ensure that music therapy interventions are evidence-based and tailored to the specific needs of individuals with ASD. The Government should implement multidisciplinary interventions that combine music therapy with other evidence-based approaches, such as behavioral interventions and social skills training, to address the diverse needs of children with ASD.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0741/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

What can we learn from the Jerusalem Community-Academic Partnership case study in an ultra-orthodox neighborhood?

Community-academic partnerships can be useful models for sustainable interventions. The Jerusalem Community-Academic Partnership (J-CAP) was established to address local health needs identified by a population survey. It engaged stakeholders and public health students as part of their training. We describe the establishment and processes of this partnership over a 3-year period.Part 1 of the program entailed mapping and undertaking a quality assessment of health promotion (HP) programs in Jerusalem. Part 2 (Years 2 and 3), described herein, entailed a participatory process wherein a particular neighborhood, with a predominantly Ultra-Orthodox population, was chosen for intervention. A local steering committee was set up, and students assessed assets and needs by direct observation, in-depth interviews, and focus groups, followed by the development of intervention programs using a participatory process. Neighborhood assets and needs identified in the first year served as a basis for the participatory process of developing intervention programs. Assets identified included the local community center and swimming pool. Barriers to a healthy lifestyle included a lack of health literacy, time constraints, socioeconomic factors, and local lifestyle and environmental characteristics. Students focused on public spaces, preschool children, and young women and mothers when designing, together with local leaders, intervention programs related to healthy nutrition and physical activity. The participatory process contributed to strengthening partnerships among several services and agencies investing in the health of Jerusalem residents. The students' critical service-learning contributed to their understanding of HP in the real world and the local community. The students' reports, which were submitted to the community center management, could serve to inform future interventions.

SELF-PERCEPTION OF HEALTH OF ELDERLY PEOPLE WHO ATTEND SOCIAL GROUPS

Introduction: Knowledge of self-perception of health in the elderly is of utmost importance, since it enables the analysis of the health conditions of this population and factors associated with their positive and negative aspects. It is currently considered a reliable way of assessing general health status, in addition to being a relevant indicator of quality of life and even mortality in the elderly. Objective: To understand self-perception of health and associated factors in elderly people who attend community groups. Methodology: A descriptive, cross-sectional study of a quantitative nature, carried out in a community center in the city of São Luís, MA. A questionnaire addressing biopsychosocial data was used as data collection instruments, while self-perception of health was assessed using the Old Age Schedule questionnaire, adapted for the Brazilian population. Results: the sample consisted of 30 elderly people aged 60 to 85 years, 76% female and 24% male. The level of education varied between incomplete high school (17%) and complete higher education (83%), with 47% having an income equal to or greater than 2 minimum wages. 73% of the elderly reported having a positive self-perception of health, while 27% reported a negative self-perception. When comparing their perception of their health in relation to people of the same age, 36% of the elderly considered themselves to be in better condition than most people they know, while 64% considered themselves to be in the same health condition as most people they know. Conclusion: the results allowed us to conclude that self-perception of health can be influenced by different factors, such as level of education, financial and clinical conditions, adherence to and practice of physical exercise, especially in groups. These elements can play an important role in the positive self-perception of the elderly, as was seen in the present study.

Comparative outcomes of operative treatment for two and three-part proximal humerus fractures with or without ipsilateral shaft fractures and head-split patterns: intramedullary nail versus open reduction internal fixation.

To investigate whether the outcomes, including union rates, complications, reoperations, blood loss, operative time, and range of motion, differed following intramedullary nailing (IMN) or open reduction internal fixation (ORIF) of two- and three-part proximal humerus fractures with or without ipsilateral shaft fractures and head-split patterns. This was a retrospective multicenter study at three community centers and one level 1 trauma center. Inclusion criteria were two- and three-part proximal humerus fracture treated with either IMN or ORIF from 2015 to 2022 with at least three months of postoperative follow-up. 228 patients. No significant differences in preoperative subject characteristics were observed. IMN was significantly more common with ipsilateral shaft fractures (p = 0.011). The number of fracture parts was significantly associated with treatment (p < 0.001). IMN had significantly less blood loss in two-part fractures (p = 0.016) and concomitant shaft fractures (p = 0.029), but operative time was not significantly less in any group. Union rates, complications, reoperation, postoperative humeral neck shaft angle, and postoperative range of motion were not significantly different. IMN and ORIF result in similar outcomes for proximal humerus fractures. Both treatments result in high union rates, the potential for near anatomic postoperative humeral neck shaft angles, and sufficient postoperative range of motion. IMN has lower blood loss than ORIF. IMN is a viable option for two-part proximal humerus fractures and may be effective in select three-part fractures as well. Concomitant humeral shaft fractures can be treated with either IMN or ORIF. Head-split patterns should be treated with ORIF.

Beyond the Binary: Exploring the Lived Experiences of Gender Dysphoric Adolescents in Indonesia

Introduction: Gender dysphoria among adolescents is increasingly recognized globally, yet research on the lived experiences of transgender youth in Indonesia remains limited. This study aimed to explore the unique challenges, coping mechanisms, and support needs of Indonesian adolescents navigating gender dysphoria within a sociocultural context characterized by traditional gender norms and limited access to specialized healthcare. Methods: In-depth, semi-structured interviews were conducted with 15 adolescents (aged 13-19) who identified as experiencing gender dysphoria. Participants were recruited through LGBTQ+ youth organizations and community centers in Jakarta and Surabaya. Data were analyzed using thematic analysis to identify key themes and patterns within their narratives. Results: Four major themes emerged: (1) Early Recognition and Internal Conflict: Participants described an early awareness of their gender identity incongruence, often accompanied by feelings of confusion, shame, and fear due to societal expectations and potential rejection. (2) Navigating Disclosure and Social Support: Coming out to family and peers was a significant challenge, with varied responses ranging from acceptance to rejection. Support networks, primarily found within online communities and LGBTQ+ organizations, played a crucial role in fostering resilience. (3) Barriers to Accessing Healthcare: Participants reported significant obstacles in accessing gender-affirming care, including limited availability of specialized healthcare providers, financial constraints, and lack of family support. (4) Resilience and Hope for the Future: Despite the challenges, participants expressed resilience, hope, and a strong desire to live authentically. They emphasized the importance of self-acceptance, peer support, and advocacy for greater understanding and acceptance of gender diversity in Indonesia. Conclusion: This study provides valuable insights into the experiences of gender dysphoric adolescents in Indonesia. Findings highlight the urgent need for increased awareness, improved access to gender-affirming care, and supportive interventions to promote the well-being of this vulnerable population.

Protocol for a co-design study for the development of a chronotherapeutic mobile health behaviour change intervention targeting light exposure among older adults

Through its wide-ranging effects on human physiology and behaviour, daily light exposure is an important environmental modulator of healthy ageing. Integrating mobile health (mHealth) technology with behaviour change strategies offers a promising approach to optimise light exposure and positively impact sleep, rest-wake cycles, cognitive function, and mood at scale. This study aims to develop the LightSPAN mHealth behaviour change intervention to optimise light exposure across the lifespan. Employing a co-design methodology, the study comprises two distinct workstreams. The first focuses on conceptualising the theoretical framework and implementation strategies through a comprehensive review of light exposure interventions, behaviour change theories, mHealth user personas, and recommendations for designing mHealth interventions for older adults. The second workstream centres on co-designing the intervention, involving consultation with community service providers and engagement with older adults at ageing community centres (≥60 years of age). Community service providers will be consulted through open-ended discussions (target n=5). Older adult participants (n=20) will engage in telephone interviews, focus group discussions and prototyping workshops to explore older adult participants’ characteristics, needs, preferences, and mHealth intervention design elements and co-design the LightSPAN mHealth behaviour change intervention. The insights generated in these co-design components will ensure that the intervention addresses the needs of its future users.

Children's perspectives of learning through play in the majority world: Findings from Bangladesh, Colombia and Uganda

AbstractAs efforts to use learning through play (LtP) expand globally, it is important to explore how children's perspectives impact the efficacy and experience of this pedagogical approach. LtP has been conceptualized as a spectrum from free play to guided play to teacher‐directed play. This spectrum describes different ways in which play happens—with varying levels of adult support—and acknowledges that children's agency is characterized by choice and the ability to direct, participate in, and/or initiate play. Previous research has primarily focused on adult perceptions of LtP for preschool children in high‐resource contexts. We present the perspectives on LtP of children (3–12 years) in Bangladesh, Colombia and Uganda. We photographed learning activities in community centres and schools that incorporated play‐based practices. In group discussions, we used these photographs to elicit children's perspectives on the difference between play and learning in the classroom, the factors that influence their construction of play and learning, and the role that teachers play in these activities. Conceptualizations across the three research sites and ages were similar: Children associated learning with play if the activity was fun and social; distinctions between play and learning were defined by content, modality, materials and location; and teachers were seen as involved in play under limited conditions. We discuss the implications of our findings for the implementation of LtP in majority‐world contexts. By moving teachers from a primarily teacher‐directed approach to more guided‐play approaches, we are not only asking teachers to give up some control but are also asking children to think about adults in fundamentally different ways. This research highlights that we may need to couple professional development for teachers with approaches that support children to change their perceptions of agency and choice in the classroom.

Treatment Patterns and Attitudes Among US-Based Physicians in Using BTK Inhibitors to Treat Relapsed/Refractory CLL and MCL

Background: The clinical management of chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) continues to evolve. FDA-approved BTK inhibitors (BTKis), including the covalent BTKis acalabrutinib and zanubrutinib and the noncovalent BTKi pirtobrutinib, are recommended by guidelines and experts as options for first- and/or later-line treatment. However, with rapid advances in therapy, healthcare professionals (HCPs) may be challenged to remain current with optimal use of these agents. Here, we report treatment patterns and attitudes of US-based physicians in using BTKis to treat relapsed/refractory (R/R) CLL and MCL. Methods: Physicians practicing in the US and actively treating patients with CLL and/or MCL were invited to participate in a survey on the management of patients with R/R CLL or MCL followed by a workshop in which participants could discuss cases from the survey with an expert/high-volume treater of CLL and MCL. Invitees were identified through a database of HCPs with an interest in CME on hematologic malignancies. Respondents to the invitation were vetted for eligibility based on NPI numbers and enrolled in the study on a first-come-first-served basis and offered an honorarium for their participation. Data from survey responses and anecdotes from workshop discussions were analyzed to determine treatment trends in the management of R/R CLL and MCL, with a focus on BTKi therapy. Results: Among the 59 US-based physicians participating in this study from October 2023 to April 2024, 66% reported practicing at a community center and 44% in an academic setting. Most (75%) reported treating ≥11 patients with CLL and/or MCL per month. Data from the survey showed that for a patient with CLL with mutated TP53/unmutated IGHV/del11q and relapse after first-line venetoclax plus obinutuzumab, most participants recommended zanubrutinib (55%) or acalabrutinib ± obinutuzumab (34%). In a patient with CLL with the above higher-risk features and an acquired BTK C481 mutation after relapse with both venetoclax-based therapy and a covalent BTKi, most participants (80%) recommended pirtobrutinib. Continuing with this patient, most participants recommended lisocabtagene maraleucel in the fourth-line setting after relapse with pirtobrutinib (70%). In the workshops, the most frequently asked questions surrounding R/R CLL centered on when to use an anti-CD20 antibody with acalabrutinib, factors impacting choice of acalabrutinib or zanubrutinib, resistance testing, utility of MRD testing, and best practices in transitioning to pirtobrutinib. For R/R MCL, preferred treatment for relapsed disease after induction R-CHOP/R-AraC and consolidation autologous stem cell transplant was evenly split between acalabrutinib (46%) and zanubrutinib (39%). For a patient who experienced problematic diarrhea and bleeding/bruising with a covalent BTKi and wished to discontinue therapy, the most common recommendations were distributed between continuation of the covalent BTKi (25%), switch to pirtobrutinib (33%), and observation (34%). For adverse event management, most participants (70%) recommended dose reduction for a case patient who started a covalent BTK inhibitor and experienced progressive joint aches with associated decline in quality of life consistent with guideline and expert recommendations. However, there was disagreement among participants in how to treat MCL in a case of a covalent BTKi hold for atrial fibrillation that was subsequently resolved, with participants split among strategies that included resuming the BTKi with counseling (29%), resuming the BTKi at a reduced dose (14%), transitioning to another BTKi (30%), or observation (16%). In the workshops, frequently asked questions focused on optimal use of BTKis in patients with thrombocytopenia and hypertension risk with available BTKis. Conclusions: These data suggest that many US-based physicians who manage patients with R/R CLL and MCL provide therapy in line with expert and guideline recommendations. However, areas of disagreement and uncertainty exist, including scenarios of therapy transitions in the presence of comorbidities or adverse events, indicating ongoing educational needs.

Exploring and enhancing the accessibility of children's oral health resources (called HABIT) for high risk communities.

Within the city of Bradford in West Yorkshire, South Asian and Eastern European communities have an increased risk of childhood tooth decay, especially among families with Limited English Proficiency. Tooth decay is preventable, with national guidelines advocating home-based behaviours (toothbrushing with fluoride toothpaste and reducing sugar intake). In England, Health Visitors have opportunities to undertake oral health conversations during universal visits for children aged 0-24 months. The HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing) intervention provides structured oral health conversations, underpinned by complex intervention methodology. A feasibility study found HABIT acceptable to parents, feasible to deliver and led to improvements in home-based behaviours. However, the reach of this original study was limited to those proficient in English. This new study focused on exploring and enhancing the accessibility of the HABIT intervention to parents with Limited English Proficiency. Twenty-four parents participated in interviews and focus groups, with 21 requesting support from interpreters. Community centres and WhatsApp were used to maximise inclusivity. Interviews and focus groups, followed a topic guide and the "Think Aloud" technique, were professionally transcribed, managed in NVivo, and thematically analysed. Team discussions facilitated analytical rigour. Recruitment continued until data saturation. Three themes were developed: (1) Navigating linguistic barriers; (2) Engagement through visuals; and (3) Addressing oral health challenges. Parents employed diverse strategies to interpret resources, including Google Translate, as well as family and wider community members. Consequently, the HABIT resources were modified to include simple text, subtitles, and translation tools. Parents highlighted the benefits of shorter oral health messages with clear visuals to help understanding, and this strategy was applied across all resources. Challenges surrounding children's resistance to toothbrushing, high sugar intake within their wider families and communities, and limited dental access were all raised. The HABIT resources were updated to address these challenges. Collaborative community engagement has enhanced the HABIT resources, enabling access for high-risk communities to preventive oral-health programmes thereby promoting health equity.

Navigating the Path to Inclusion: Understanding Barriers and Facilitators to Clinical Trial Participation Among Chinese Older Adults in the United States with Multimorbidity.

Older adults with multimorbidity are underrepresented in clinical trials, with enrollment of Asians particularly low. Understand perspectives of US Chinese older adults regarding clinical trial participation. Focus group interviews analyzed using thematic analysis. Community/senior centers, academic health systems in Northern and Southern California, and a nationwide registry of Asian Americans/Pacific Islanders. Mandarin- and English-speaking Chinese adults aged ≥ 65years with multimorbidity. Themes related to barriers and facilitators of enrollment in clinical trials of medications. We conducted 12 focus groups: 7 with non-US-born and 5 with US-born Chinese older adults (n = 83 total). Mean age was 74years (SD = 5.9), 43 (51.8%) were female, and 47 (56.6%) Mandarin-speaking. US-born participants had greater educational attainment than non-US-born participants. Participants took a mean of 6.1 prescriptions (SD = 1.5). Barriers to participation in clinical trials of medications included lack of awareness of/exposure for patients and community-based Chinese physicians, preference for natural/traditional medicine, risk aversion and safety concerns, desire for privacy, and inconvenience. Trusted influences included physicians, hospitals/health systems, Asian/Chinese community centers, and family (for non-US-born participants). Suggestions to enhance participation included using language and culturally concordant materials/personnel, educating community-based Chinese physicians about clinical trials, involving patient-trusted physicians in recruitment, promoting trials on conditions common in Chinese people or for an existing condition, and financial incentives. US-born participants expressed greater understanding and willingness to join trials. All groups attributed low clinical trial enrollment to non-US-born Chinese adults. Chinese older adults perceived obstacles to clinical trial participation that could be mitigated by involving trusted physicians in recruitment, using language and culturally concordant materials/staff, and educating patients and community-based physicians. Recognition of differences in attitudes among US- and non-US-born Chinese people may be important to tailoring recruitment strategies.

Detecting muscle fatigue among community-dwelling senior adults with shape features of the probability density function of sEMG

BackgroundPhysical exercise is an important method for both the physical and mental health of the senior population. However, excessive exertion can lead to increased risks of falls, severe injuries, and diminished quality of life. Therefore, simple and effective methods for fatigue monitoring during exercise are highly desirable, particularly in community settings. The purpose of this study was to explore the possibility of real-time detection of exercise-induced fatigue using surface Electromyogram (sEMG) features, including the kurtosis and skewness of the Probability Density Function (PDF) in the community settings to solve the issues of low sensitivity and high computational complexity of commonly used sEMG features.MethodssEMG signals from six forearm muscles were recorded during hand grip tasks at 20% maximal voluntary contraction (MVC) task-to-failure contractions from 30 healthy community-dwelling elders at their respective community centers. PDF shape features of the sEMG, namely kurtosis and skewness, were computed from 25 s of non-fatigue stable phase and 25 s of fatigue data for comparison. Statistical tests were conducted to compare and test for the significance of these features. We further proposed a novel fatigue indicator, Temporal-Mean-Kurtosis (TMK) of channel-averaged kurtosis, to detect fatigue with relatively low computational complexity and adequate sensitivity in community settings. ANOVA and post-hoc analyses were performed to examine the performance of TMK.ResultsStatistically significant differences were found between the non-fatigue period and the fatigue period for both kurtosis and skewness, with increasing values when approaching fatigue. TMK was shown to be sensitive in detecting fatigue with respect to time with lower computational complexity than the Sample Entropy.ConclusionThis study investigated PDF shape features of sEMG signals during a handgrip exercise to identify muscle fatigue in older adults in community experiments. Results revealed significant changes in kurtosis upon fatigue, indicating that PDF shape features were suitable convenient detectors of muscle fatigue in community experiments. The proposed indicator, TMK, showed potential sensitivity in tracking muscle fatigue over time in community-based settings with limited computational complexity, highlighting the promise of sEMG’s PDF features in detecting muscle fatigue among the elderly.

Collaborating for Health Equity: A Perspective of an Federally Qualified Health Center's Community Partnerships and Initiatives.

Collaborating for Health Equity: A Perspective of an Federally Qualified Health Center's Community Partnerships and Initiatives.