Community-based Institutions Research Articles

‘The way they treat us reflects how they see us’: Aspects contributing to social inequities in people with visual disability, a qualitative study

People with visual disabilities encounter multiple barriers in their life experiences, placing them at a social disadvantage compared to sighted individuals. These barriers manifest in a limited access to and exercise of their rights, situations perceived as unfair or inequitable. The present research aimed to understand how inequities are configured in people with visual disabilities, based on practices and perceptions of fairness/unfairness and their expression in relation to access to material goods and services. An instrumental ethnographic case study was conducted within a community-based institution in Bucaramanga, Colombia, focusing on rehabilitation and social inclusion processes for individuals with visual disabilities and their families. Twenty-two semistructured interviews and 37 participant observation exercises were carried out and documented in a field diary. The emerging categories were (1) the family can be an obstacle or an aid in overcoming social injustices; (2) visual disability is a label, it is in the environment, in the way society recognizes it; and (3) from social exclusion to willingly-given inclusion. Our results indicate that inequities are configured primarily in relation to how people close to those with visual disabilities perceive and act towards them, constituting scenarios of cultural injustice (non-recognition). Part of the meanings and practices that people uphold are based on the view of a body considered outside the canon of normality and the non-recognition of a full citizenship, conditioning discriminatory (such as charity and infantilization), stigmatizing and excluding practices. The inclusion of this population group is mediated by the sensibility of the sighted other, a situation that conditions that the access and full enjoyment of rights is a matter of will.

Variation in Psychiatric Hospitalisations: A Multiple-Membership Multiple-Classification Analysis.

The complexity of variation in healthcare, particularly in mental health, remains poorly understood. However, addressing this issue presents an opportunity to opti-mise the allocation of scarce healthcare resources. To explore this, we investigated the variation in psychiatric care measured as the number of psychiatric hospitalisations. We estimated multiple-membership multiple-classification models utilising Danish register data for 64,694 individuals and their healthcare providers, including 2101 general practitioners, 146 community-based care institutions, 46 hospital departments, and 98 municipalities. This approach recognised that data are not strictly hierarchical. We found that, among individuals attending a single healthcare provider, 67.4% of the total variance in the number of hospitalisations corresponds to differences between individuals, 22.6% to differences between healthcare providers' geographical location, 7.02% to differences between healthcare providers, and 3% to differences between the geographical locations of the individuals. Adding characteristics to the model ex-plained 68.5% of the variance at the healthcare provider geographical level, but almost no explanation of the variation was found on the three other levels despite the nu-merous characteristics considered. This suggests that medical practice may vary un-warrantedly between healthcare providers, indicating potential for optimisation. Streamlining medical practices, such as adhering to clinical guidelines, could lead to more efficient supply of mental health resources. In conclusion, understanding and addressing variation in psychiatric care may impact resource allocation and patient outcomes, ultimately leading to a more effective healthcare system.

Migration and Cultural Integration in Germany

Purpose: The aim of the study was to analyze the migration and cultural integration in Germany. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Migration and cultural integration in Germany present both achievements and hurdles. Successful integration hinges on factors like language skills, education access, and job opportunities. Yet, challenges persist due to cultural disparities, discrimination, and social exclusion. Though progress is evident, ensuring migrants' seamless integration remains a continual and intricate endeavor in Germany. Unique Contribution to Theory, Practice and Policy: Social identity theory, multiculturalism theory & transnationalism theory may be used to anchor future studies on analyze the migration and cultural integration in Germany. Community-based organizations, educational institutions, and government agencies should collaborate to provide tailored support services and resources that empower immigrants to fully participate in German society while preserving their cultural identities. Policymakers should enact policies that promote inclusive societies and remove barriers to immigrant integration in Germany.

IMPLEMENTATION OF ARTICLE 46 LAW NUMBER 18 OF 2019 CONCERNING ISLAMIC BOARDING SCHOOLS SIYASAH FIQIH PERSPECTIVE

Islamic boarding schools are community-based institutions and founded by individuals, foundations, Islamic community organizations, or communities that instill faith and devotion to Allah SWT, which creates noble morals and upholds the Islamic teachings of rahmatan lil'alamin which are reflected in a humble, tolerant, balance, moderation, and noble values of the Indonesian nation through education, Islamic preaching, example, and community empowerment. The data analysis method used is a qualitative descriptive method using an inductive thinking process. The implementation of Article 46 of Law Number 18 of 2019 concerning Islamic Boarding Schools (Studies at the Jabal An-Nur Al-Islami Islamic Boarding School, West Betung Bay, Bandar Lampung City) has been implemented with the efforts of Ustadz-Ustadz to provide facilities and infrastructure in the santri education process. The rules at the Jabal An-Nur Al-Islami Islamic Boarding School in terms of facilities and infrastructure are quite good, but the suitability of the Islamic Boarding School is not sufficient to be said to be good, such as the lack of a language lab and computer lab like other modern Islamic Boarding Schools so it is said to not be in accordance with Article 46 Law Number 18 of 2019 concerning Islamic Boarding Schools. Planning for educational facilities and infrastructure at the Jabal An-Nur Al-Islami Islamic Boarding School was created to support student educational facilities. Planning for program facilities and infrastructure is made by the Islamic boarding school with the coordination of the foundation through a series of stages, namely the Islamic boarding school coordination meeting which is held once a year. Fiqh Siyasah Review of the Implementation of Article 46 of Law Number 18 of 2019 concerning Islamic Boarding Schools at the Jabal An-Nur Al-Islami Islamic Boarding School was not carried out in accordance with Siyasah Tanfidziyyah because the Jabal An-Nur Al-Islami Islamic Boarding School and the Regional Government did not carry out their mandate. in Article 46 of Law Number 18 of 2019 concerning Islamic Boarding Schools.

Problems of forming new types of territorial social service centres

This article presents an analysis of the different forms of social service centres in Ukraine, ranging from permanent residence to community-based institutions. The publication aims to analyze the existing typology of social architecture in Ukraine, determine its relationship with legislation, and suggest new ways for its development. It delves into the analysis of territorial centres for social services, considering the regulatory documents governing social buildings and their role in the country's infrastructure. At the same time, the paper highlights the discrepancies between the regulations governing the provision of social services and architectural considerations, which leads to problems in the design and implementation of such facilities. The article emphasizes the importance of creating facilities adapted to the specific needs of older people and proposes a broader typology that includes private ownership models. Different types of social centres that have residential, hotel, medical, public and cultural and entertainment vectors, which can be combined in one institution depending on the needs of the local community, are also highlighted in the article. The author emphasizes the importance of creating unique spaces that take into account the needs and interests of older people and promote active and quality life at different levels. Despite cultural, social and financial factors, most of older people have the same needs for housing, healthcare and leisure. The study also looks at innovative forms of social centres, such as residential communities, where older people are actively involved in creating alternative living arrangements that provide mutual support. In general, the author insists on the need to harmonize architectural design with social welfare policy to meet the diverse needs of older people in Ukraine.

Low Rates of Colorectal Cancer Screening in First-Degree Relatives of Our Patients: Are We Failing Them?

Guidelines recommend screening those with a family history of early-onset colorectal cancer at age 40 years or 10 years before the age of their relative's diagnosis. Currently, there is no literature reporting the screening rate in these individuals, and no protocols are in place to identify and target this population for screening awareness. This study aimed to assess adherence to current screening guidelines among first-degree relatives of patients with early-onset colorectal cancer. Retrospective and qualitative study involving a telephone survey where patients were asked about relative's screening status and barriers to screening. Two community-based institutions between January 2018 and December 2021. Individuals diagnosed with early-onset colorectal cancer who had undergone surgery at our institutions. Rate of screening in first-degree relatives of our patients with early-onset colorectal cancer. Other factors measured included demographics, clinicopathologic characteristics, and screening barriers. Thirty-six patients were identified. The survey response rate was 66.6% (n = 24). A total of 88 first-degree relatives who met the screening criteria resulted in 67.1% of patients (n = 59) having a known screening status. Of the 59 patients with known screening status, only 44% (n = 26) had undergone screening. Patients of Black race, having stage III/IV disease, having Medicare/Medicaid insurance, and living within Baltimore City County were more likely to have family members with unknown or no screening. Lack of insurance coverage was the most common barrier, which was noted in 12.5% of patients (n = 3), whereas 54.1% of patients (n = 13) reported no barriers to screening. Retrospective design. Most first-degree relatives of patients diagnosed with early-onset colorectal cancer do not undergo colorectal cancer screening. This could be attributed to the lack of protocols that could guarantee these individuals are informed of their elevated risk and the different options available for screening. Furthermore, our study suggests that racial and socioeconomic disparities exist among high-risk patients who should pursue screening. See Video Abstract . ANTECEDENTES:Las directrices recomiendan realizar pruebas de detección a las personas con antecedentes familiares de cáncer colorrectal de aparición temprana a los 40 años o 10 años antes de la edad del diagnóstico de su familiar. Actualmente, no hay literatura que informe la tasa de detección en estos individuos y no existen protocolos para identificar y dirigirse a esta población para concientizar sobre la detección.OBJETIVO:Evaluar el cumplimiento de las pautas de detección actuales entre los FDR de pacientes con cáncer colorrectal de aparición temprana.DISEÑO:Estudio retrospectivo y cualitativo que incluyó una encuesta telefónica en la que se preguntó a los pacientes sobre el estado de detección de sus familiares y las barreras para la detección.AJUSTES:Dos instituciones comunitarias entre enero de 2018 y diciembre de 2021.PACIENTES:Personas diagnosticadas con cáncer colorrectal de inicio temprano que habían sido intervenidas quirúrgicamente en nuestras instituciones.PRINCIPALES MEDIDAS DE RESULTADO:Tasa de detección en familiares de primer grado de nuestros pacientes con cáncer colorrectal de aparición temprana. Otros factores medidos incluyeron datos demográficos, características clínico-patológicas y barreras de detección.RESULTADOS:Se identificaron treinta y seis pacientes. La tasa de respuesta a la encuesta fue del 66,6% (n = 24). Resultaron un total de 88 familiares de primer grado que cumplieron con los criterios para la detección, y el 67,1% (n = 59) tenía un estado de detección conocido. De los 59 con estado de detección conocido, se informó que solo el 44% (n = 26) se había sometido a pruebas de detección. Los pacientes de raza afroamericana, enfermedad en etapa III/IV, Medicare/Medicaid y que vivían dentro del condado de la ciudad de Baltimore tenían más probabilidades de tener familiares con pruebas de detección desconocidas o sin ellas. La falta de cobertura de seguro fue la barrera más común observada por el 12,5% (n = 3); mientras que el 54,1% (n = 13) no informó ninguna barrera para el cribado.LIMITACIONES:Diseño retrospectivo.CONCLUSIONES:La mayoría de los familiares de primer grado de pacientes diagnosticados con cáncer colorrectal de aparición temprana no se someten a pruebas de detección de cáncer colorrectal. Esto podría atribuirse a la falta de protocolos que garanticen que estas personas estén informadas sobre su elevado riesgo y las diferentes opciones disponibles para el cribado. Además, nuestro estudio sugiere que existen disparidades raciales y socioeconómicas entre los pacientes de alto riesgo que deberían someterse a pruebas de detección. (Traducción-Dr. Francisco M. Abarca-Rendon).

Sustainable Fishery Value Chain (SFVC): Study Case in Tilapia Industry

This research is built on the concept of sustainable value chains, where a framework for sustainable value chain analysis emerges that covers not only economic aspects but also includes environmental and social impacts in a collaborative model of value chain management. It explores the dimensions on which value chain sustainability should focus. It illustrates how and why it is necessary to take a broader perspective in ensuring the internal economic sustainability of the chain in line with its external socio-environmental consequences. This research aims to analyze the sustainability of the tilapia processing value chain. This research uses the Multi-Dimensional Scaling analysis method supported by Rap-fish software. The Rapfish methodology is a flexible technique that rapidly assesses fisheries status by integrating ecological and human factors according to identified norms. The results of this research show that the sustainability of the tilapia processing value chain is considered entirely sustainable from economic, social, and environmental aspects, with a sufficient sustainability index of 74.40%. The sustainability of the value chain relies on four key actors: tilapia cultivators, collectors, processors, and distributors. The sustainable tilapia processing value chain strategy in North Sumatra can limit floating net cages by considering the environmental carrying capacity and supported by suitable policies and active stakeholder participation in community-based legal institutions. This research found this is a strong sustainability concept if implemented with better governance and policy management in the tilapia industry value chain.

Efforts to Protect the Law of Sexual Violence Cases Against Children Relate to Law Number 35 of 2014 Concerning Child Protection

The Integrated Service Center for the Empowerment of Women and Children (P2TP2A) is expected to function as a community-based service institution. This community-based service acts as a crisis center unit by providing complaints, health, rehabilitation, social, counseling, legal assistance, repatriation, and social reintegration services (for trafficking victims). Sexual violence encompasses any action that diminishes, belittles, intimidates, or assaults an individual's body or reproductive capabilities, stemming from imbalanced power dynamics or gender inequalities. Such acts inflict psychological or physical harm, potentially disrupting reproductive health and impeding educational opportunities. Examples include rape and sexual abuse. This research focuses on examining legal protection efforts and identifying obstacles faced by P2TP2A (Integrated Service Center for Women and Children) in handling cases of sexual violence against children, utilizing an empirical juridical approach. The findings reveal that legal protection for children experiencing sexual violence is enshrined in Article 13 of Law Number 35 of 2014, which emphasizes the rights of children to be protected from various forms of harm, including discrimination, exploitation, neglect, cruelty, violence, abuse, and injustice. Supporting factors include the availability of financial assistance to fund P2TP2A activities, the dedication of officers and volunteers who prioritize the welfare of women and children, and the provision of office facilities by the government. However, there are inhibiting factors such as inadequate budget allocation, the unrealized Community-Free Integrated Child Protection Program (PATBN), insufficient human resources, the need for improvement in office facilities and infrastructure, and the lack of safe housing for victims who are still renting.

UPAYA PENINGKATAN KOMPETENSI PROFESIONAL GURU BAHASA ARAB

The difficulties faced by educators in their capacity as professionals are constantly developing and changing. As a result of growing their ability to compete globally, instructors face both internal and external problems. Both community-based and government-owned educational institutions expect a constant need for qualified teachers. The researcher hopes to shed light on the significance of comprehending the notion of teacher competence, the significance of teachers' endeavors to enhance their own competence, and the significance of the Quran and Islam's view of competence. The Quran is filled with many wise and inspirational stories, one of which being the one about the Prophet Yusuf who was asked to resolve the nation's financial issues. He made it clear that he had the ability to maintain and manage finances. Teachers also need to have the guts to say that they are the individuals who are best suited to preserve and advance knowledge, as well as the servants of the people and the state. Teachers must keep working to improve their expertise through participation in a variety of forums and activities, as well as networking with other professionals' groups.

Halal In The Contemporary Economic And Business Ecosystem

The increase in population will certainly increase the demand for halal products and services significantly. With this achievement where Indonesia is in the top five with a strong Islamic economic ecosystem and supported by a majority Muslim population, Indonesia can become a leading country in all sectors in the country's halal industry (Nasution, 2020).The Islamic economic ecosystem in Indonesia continues to grow which includes the existence of UMKM that can become producers of halal products, Islamic finance which is marked by the growing contribution of Islamic entities, both Islamic financial institutions and Islamic non-financial institutions, innovations in technology, and related regulations with the halal industry. Indonesia is the first place for consumers of halal food products in the world. Indonesia is the country with the largest Muslim population, reaching 209.1 million people or 87.2 percent of the total population of Indonesia (Mubarok & Imam, 2020). Objective: prevention of aspects of sharia obstacles in the financial aspect, MSME aspects, digitalization aspects, product quality, and regulatory aspects in realizing the strengthening of the halal industrial ecosystem? Indonesia, the world's most populous Muslim country, is a gold mine for the halal market with the potential to become not only a major market but also a major producer of halal products. Islamic finance in Indonesia has developed more than the banking sector, but also non-banking products have featured in baitul mal wa tamwil (community-based Islamic financial institutions), Islamic insurance, Islamic microfinancing, Islamic pawnshops and Islamic venture capital. The Islamic banking service has almost all complied with sharia principles as most Islamic banking products are dominated by murabahah (sales contracts). There is still a small number of Islamic banks in Indonesia which causes Islamic banks to not reach remote areas (Samsul, 2022). There is still a lack of Sharia banking education for the "lower class" people who incidentally play an important role in the UMKM sector Islamic banks are less active in financing. This can be seen from the still-difficult process of managing and applying for financing in Islamic banks. Aspects of Islamic Financial Innovation (Sharia Bank) Towards Competitive Advantage The role of Islamic banking is to become a reference through strategies and policies related to financing that will be channelled to consumers. Likewise, socialization for UMKM entrepreneurs, especially those engaged in the halal industry, both goods and services. Islamic bank strategy to enter the village as a place that has the potential to become halal tourism: Islamic banks must optimize internal and external resources. Finally, through a branchless banking system UMKM & Halal Industry in the Digital Economy Era, Challenges and Obstacles to UMKM Aspects in Strengthening the Halal Industry Ecosystem. Lack of understanding so that this is not optimal and has not been able to become a superior product in the midst of society.

Experience of Caregivers for Older Adults in Rural Ethiopia: Challenges and Available Social Support for Family Caregivers in Co-Residential Living Arrangement.

Family and kinship care is a common way of caring for older adults, particularly in rural Ethiopia, where institutional care arrangements are nonexistent. Moreover, the majority of studies on family caregivers of older adults were conducted in western cultures, which makes it difficult to understand family caregivers in the Ethiopian context. This study aims at exploring the experience of family caregivers for older adults in a co-residential setting. Specifically, it focuses on answering caregiving challenges and available social supports for family caregivers in a co-residential living arrangement. This study used a qualitative research method employing phenomenology to understand the lived experience of family caregivers for older adults in rural northwestern Ethiopia. Data were collected through a semi-structured interview with eight purposefully selected family caregivers of rural older adults. Regarding family caregivers's challenges and available social supports, four themes emerged from the collected data. These are economic challenges, the incongruence of older adult needs and caregiving capacity, work-caregiving conflict, work-social life conflict, and the presence of social support from different individuals and community-based institutions. In addition to strengthening caregiver support environments, it's critical to develop the capacity of family caregivers through training, economic support, and the integration of family caregivers with health extension workers.

Resilience of the BUDS Community-based Rehabilitation Institutions during the COVID-19 Pandemic: Supporting Role of Local Governments

Background: BUDS (not an acronym) institutions are free and open special institutions established by Kudumbashree in Kerala for children from low-income households with intellectual or psychosocial impairments. We explored the impact of COVID-19 pandemic on BUDS beneficiaries and the organizational adaptation for continued operations during the period. Methods: We conducted telephonic in-depth interviews with eight BUDS teachers, three beneficiaries’ parents, and two local government (LG) representatives. We did a deductive analysis to describe two major themes: one pertained to the physical, mental, and social challenges faced by beneficiaries and families of BUDS institutions and other on organizational adaptation to the situation in terms of sustaining classes for children and continued support for meeting basic needs. Results: Beneficiaries lost some therapeutic gains, while parents faced financial hardships. Trainers and LGs made active efforts for sustaining contact with children and parents, distribution of necessities for children, and home visits. Some trainers displayed an exemplary level of dedication. LGs facilitated service provision by continuing remuneration to trainers, and collaborating with various stakeholders like education and health, and initiating locally suitable measures. The Thenkoodu app for continued training was deemed not very useful by trainers and parents. Conclusion: Committed human resources, acceptance of ground realities, quick decision–making, and collaboration across stakeholders were important aspects of the response of LGs for continued service provision to BUDS beneficiaries during the COVID-19 pandemic. Our findings suggest that decentralized space where BUDS institutions emerged and expanded is beneficial for organizational resilience of community-based rehabilitation institutions.

Institutional Analysis of Tourism Destination Development in Karst Landscape Area: Community-based Tourism in Ngelanggeran Village

The village of Nglanggeran in Gunungkidul possesses abundant natural and cultural tourism attractions. Through local wisdom and community-based tourism management, Nglanggeran has received numerous accolades as a Village Tourism destination. However, being part of the Karst Landscape Protection Area, Nglanggeran needs to consider a conservative and sustainable tourism development strategy that involves relevant stakeholders. This research aims to analyse the roles, positions, and interests of stakeholders within the community-based institution, which is the strength of Nglanggeran as a tourism village. The methodology combines literature study, content analysis, qualitative descriptive analysis, and Social Network Analysis using scientific articles and Regional Regulations (Perda) as data sources to map the institutional network patterns in Nglanggeran village. Aligning the institutional analysis results with the Perda containing tourism policy guidelines in the protected area, particularly the Karst Landscape Area in Nglanggeran village, yields recommendations to strengthen institutional functions in the effort to develop community-based and sustainable tourism in Nglanggeran village.

Abstract A029: LGBTQ+ health navigation panel: Discussing barriers and facilitators in navigation to services for immigrant and non-immigrant LGBTQ+ community members in New York City area

Abstract Background: Patient navigation plays a crucial role both in patient care management and overcoming barriers to care. Navigating the complexities of US healthcare is difficult for everyone, including individuals who are native to the US as well as newly arrived immigrants and refugees from across the world. The LGBTQ+ community is greatly affected by a multitude of health disparities. Discrimination, stigma, bias, and prejudice towards the LGBTQ+ community contribute to those health disparities, which makes the role of LGBTQ+ health navigation even more essential. Patient advocacy and support in finding proficient clinical and social services is the core of LGBTQ+ patient navigation. The authors of this abstract will create a discussion-based panel to share experiences and tailored approaches that have successfully helped in navigating LGBTQ+ patients, addressing social determinants of health, creating inclusive environments, and contributing to LGBTQ+ proficient care. Methods: LGBTQ+ Health Navigation Panel will consist of several LGBTQ+ health advocates, navigators, and/or policymakers from healthcare and community-based institutions from across New York City area. They will participate in a discussion-based session model, which will be moderated by one of the authors of this abstract. Discussion: This LGBTQ+ patient navigation panel will focus on discussing healthcare services and navigation support for immigrant and non-immigrant LGBTQ+ community members in the New York City area. Services that we would focus on will be physical, mental, and social health, as well as patient advocacy and community education. In addition, a significant portion of our discussion will include topics of cancer prevention, screening, diagnosis, treatment, and survivorship in the LGBTQ+ community. Citation Format: Alexandr Trifonov, Kevin Moore, Megan C. Haseltine, Jason Domogauer. LGBTQ+ health navigation panel: Discussing barriers and facilitators in navigation to services for immigrant and non-immigrant LGBTQ+ community members in New York City area [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A029.

The fragile springs, unnoticed: lessons from water policy in dry islands of Flores Indonesia

The Indonesian government has maintained the SDGs’ priorities by establishing targets and projects. This paper examines the way how programs and targets are designed and implemented by considering the reality of community-based water management (CBWM) on the ground. Using Critical Institutional Analysis Framework (CIAD), this study analyzes the actual CBWM particularly by taking in depth interviews with the representation of community members in 6 villages of dry-land area in the northern part of Manggarai District, East Nusa Tenggara Province. The study also undertakes the spatial analysis of the springs area. The analysis on site will be complemented by a portrait of bigger context in the political economy analysis of district and country. The finding indicates that although most land use and water policies have some formulation to protect water sources, including springs, the CBWM are detached from policy agenda. Without direct support to CBWM, the water policy is weak to challenge land use changes including the mining policies from the past and the current trend for commodity expansion. The study suggests that the water policies have to deal with mining policies if the jurisdiction is willing to indicate the water priority of the area. Moreover, the protection for the springs should not be relying on community-based institutions alone. The policies have to be there to enable the water institutions to anticipate the pressures on the springs.

Delivery of a community-based peer mentorship program for people with spinal cord injury at a rehabilitation center

IntroductionCommunity-based spinal cord injury (SCI) organizations deliver peer mentorship programs in rehabilitation settings. Little is known on how these programs are delivered through the collaboration between community-based SCI organizations and rehabilitation institutions. This study aimed to identify barriers, facilitators, and collaboration processes within a SCI peer mentorship program provided by a community-based organization at a rehabilitation center.MethodsA qualitative case study design was applied. Seven participants were recruited, including two mentees, two mentors, one program director of the community-based SCI organization, and two healthcare professionals of the rehabilitation center. Each participant completed a one-on-one interview. Data were analyzed inductively and deductively based on the Consolidated Framework for Implementation Research (CFIR).ResultsTen factors were identified to influence the delivery of the peer mentorship program, including nine CFIR constructs. Successful delivery of the program required strong, collaborative inter-professional relationships between health professionals and community organizational staff (e.g., peer mentors) as facilitators; whereas potential cost, minimal patient needs, and limited mentor resources were found to be barriers. Engaging health professionals by initiating communications, reflecting and evaluating the program collectively with health professionals were important collaboration processes for the community-based organization to maintain effective partnership with the rehabilitation center.DiscussionThe collaboration processes and strategies to addressing/leveraging the barriers and facilitators may inform evidence-based practice to establish and optimize the delivery of SCI peer mentorship programs in various rehabilitation settings.

Learning curve for robotic rectal cancer resection at a community-based teaching institution

The surgical management of rectal cancer is shifting toward more widespread use of robotics across a spectrum of medical centers. There is evidence that the oncologic outcomes are equivalent to laparoscopic resections, and the post-operative outcomes may be improved. This study aims to evaluate the learning curve of robotic rectal cancer resections at a community-based teaching institution and evaluate clinical and oncologic outcomes. A retrospective review of consecutive robotic rectal cancer resections by a single surgeon was performed for a five-year period. The cumulative sum (CUSUM) for total operative time was calculated and plotted to establish a learning curve. The oncologic and post-operative outcomes for each phase were analyzed and compared. The CUSUM learning curve yielded two phases, the learning phase (cases 1–79) and the proficiency phase (cases 80–130). The median operative time was significantly lower in the proficiency phase. The type of neoadjuvant therapy used between the two groups was statistically different, with chemoradiation being the primary regimen in the learning phase and total neoadjuvant therapy being more common in the proficiency phase. Otherwise, oncologic and overall post-operative outcomes were not significantly different between the groups. Robotic rectal resections can be done in a community-based hospital system by trained surgeons with outcomes that are favorable and similar to larger institutions.

The interactive effect of endogenous and exogenous institutions on forest use practices in socio-culturally diverse landscapes of Cameroon

AbstractIn resource-dependent communities of sub-Saharan Africa, it is widely held that endogenous institutions either countervail or complement exogenous institutions, indicating inconsistency in empirical evidence. This has re-ignited interest to establish the independent and/or interactive effect of both endogenous and exogenous institutional structures. This paper quantitatively analyses the independent and interactive effects of community-based (endogenous) and state-based (exogenous) forest management institutions (FMIs) on the exploitation of forest resources, drawing from a representative sample of 446 households from three socio-culturally diverse landscapes of Cameroon. The paper introduces a multiplicative interaction term and used the heteroscedasticity-based instrumental variables approach to estimate the direct and indirect effects of exogenous and endogenous institutions on the behaviour of users of forest-based resources. The results indicate that: (i) Both exogenous structures of FMIs and the interaction term significantly constrain the extractive behaviour of forest resource users; (ii) endogenous structures and not rules are vital in improving the role of exogenous structures in forest resource management; (iii) while traditional rules are less significant in shaping forest resource exploitation, their effectiveness is highly significant across the study sites and (iv) institutional compatibility and complementarity was observed in landscapes that were formerly shaped by British colonial influence (Bakossi and Kilum-Ijim). This paper does not only establish the relative influence of exogenous and endogenous FMIs, it also highlights future research pathways on institutional change in the context of environmental resource management in sub-Saharan Africa.

Sexual Well-being Among Medical Residents at a Community-Based Academic Institution

Sexual Well-being Among Medical Residents at a Community-Based Academic Institution

Researcher-Practitioner Partnerships to Implement and Evaluate Sexual and Relationship Violence Prevention Programs for Boys and Men.

Although male-focused sexual and relationship violence (SRV) prevention programs are widely promulgated, limited guidance concerning how programs should be implemented for rigorous evaluation exists. To help develop evidence for such guidance, this paper reports on 20 interviews with leaders at youth-serving community-based organizations (CBOs) and educational institutions, which are sites for male-focused SRV prevention programs. This study examined: (1) how programs can be designed to engage male participants; and (2) how youth-serving CBOs and educational institutions can partner with researchers for evaluations. Findings underscore the importance of attending to the unique needs of program participants, their parents/guardians, and host organizations.