Community Centers Research Articles

User Evaluation of Satisfaction of Community Center in Revitalizing Rural Center in Jeollabuk-do

User Evaluation of Satisfaction of Community Center in Revitalizing Rural Center in Jeollabuk-do

Analysis and prediction of older adult sports participation in South Korea using artificial neural networks and logistic regression models

BackgroundKorea’s aging population and the lack of older adult participation in sports are increasing medical expenses.AimsThis study aimed to segment older adult sports participants based on their demographic characteristics and exercise practice behavior and applied artificial neural network and logistic regression models to these segments to best predict the effect of medical cost reduction. It presents strategies for older adult sports participation.MethodsA sample comprising data on 1,770 older adults aged 50 years and above was drawn from the 2019 National Sports Survey. The data were analyzed through frequency analysis, hierarchical and K-means clustering, artificial neural network, logistic regression, cross-tabulation analyses, and one-way ANOVA using SPSS 23 and Modeler 14.2.ResultsThe participants were divided into five clusters. The artificial neural network and logistic analysis models showed that the cluster comprising married women in their 60s who participated in active exercise had the highest possibility of reducing medical expenses.DiscussionTargeting women in their 60s who actively participate in sports, the government should expand the supply of local gymnasiums, community centers, and sports programs. If local gymnasiums and community centers run sports programs and appoint appropriate sports instructors, the most effective medical cost reduction effect can be obtained.ConclusionsThis study contributes to the field by providing insights into the specific demographic segments to focus on for measures to reduce medical costs through sports participation.

Landscape of loss: art therapy outdoors and traumatic bereavement

ABSTRACT Background This paper describes art therapy sessions outdoors with a six-year-old child following multiple adverse childhood experiences and a recent bereavement of a relative who died by suicide. Context Art therapy took place in a major city in Scotland. Sessions took place both at a local community centre and a nature reserve. Approach Sessions employed an outdoor approach to art therapy that was underpinned by artistic concepts and ecopsychology. Outcomes The child presented in this paper engaged notably differently when sessions were taken outside. He began to explore and communicate more coherently about his life experiences and the death of his relative. Conclusions Through interacting with the natural environment during outdoor sessions, this child was able to explore and express concerns much more freely than during indoor sessions. Implications for Research There is a need for further research focusing on outdoor art therapy due to a dearth of peer-reviewed research on this topic. Plain language summary This paper describes art therapy sessions which took place outdoors. The art therapy sessions were held at a local nature reserve in a major city in Scotland. The child who attended the sessions was six years old. He had previously lived through several traumatic life experiences, and a relative had recently died by suicide. Case examples present ways in which moving sessions outdoors may have helped him with exploring and expressing his experience of the death of his relative. There is potential that outdoor art therapy sessions may help children to talk about difficult experiences. Future research is needed to develop our knowledge of what is and is not helpful during outdoor art therapy, for which children and under what circumstances.

Rural health dialogue for the sustainability of help-seeking behaviors among older patients: grounded theory approach

BackgroundHelp-seeking behaviors (HSBs) are essential for disease prevention and health promotion. Dialogues with peers and medical professionals can improve HSBs, both qualitatively and quantitatively. Rural communities lacking healthcare resources require effective HSBs for healthcare sustainability. The current study aimed to investigate the effect of health dialogues between medical professionals and rural citizens on their HSBs.MethodsAll procedures complied with the Declaration of Helsinki and its subsequent amendments. The Unnan City Hospital Clinical Ethics Committee approved the study protocol (No. 20,220,002). A grounded theory approach was employed for the health dialogue participants in rural communities. Health dialogues with family physicians were conducted once a month at rural community centers. The dialogues and focus group interviews were recorded and coded to investigate changes in participants’ perceptions and behaviors regarding HSBs.ResultsTwenty-one dialogues were conducted in two rural community centers, with a total of 112 participants. The average age of the participants was 70.2 years (standard deviation = 5.4), with 24% being males. Analysis of the grounded theory approach revealed four themes, namely joy-driven dialogue driving the realization of HSBs, reflection on personal HSBs through learning from others, revising HSBs based on rural social resources, and familiarity with physicians, hence motivating safe and secure HSBs.ConclusionsMitigation of barriers between citizens and medical professionals and improvement of psychological safety in communities can drive effective HSBs in rural communities.

Rusfertide for the treatment of iron overload in HFE-related haemochromatosis: an open-label, multicentre, proof-of-concept phase 2 trial

Hereditary haemochromatosis protein (HFE)-related haemochromatosis, an inherited iron overload disorder caused by insufficient hepcidin production, results in excessive iron absorption and tissue and organ injury, and is treated with first-line therapeutic phlebotomy. We aimed to investigate the efficacy and safety of rusfertide, a peptidic mimetic of hepcidin, in patients with HFE-related haemochromatosis. This open-label, multicentre, proof-of-concept phase 2 trial was done across nine academic and community centres in the USA and Canada. Adults (aged ≥18 years) with HFE-related haemochromatosis on a stable therapeutic phlebotomy regimen (maintenance phase) for at least 6 months before screening and who had a phlebotomy frequency of at least 0·25 per month (eg, at least three phlebotomies in 12 months or at least four phlebotomies in 15 months) and less than one phlebotomy per month, with serum ferritin of less than 300 ng/mL and haemoglobin of more than 11·5 g/dL, were eligible. Patients initiated 24 weeks of subcutaneous rusfertide treatment within 7 days of a scheduled phlebotomy at 10 mg once weekly. Rusfertide doses and dosing schedules could be adjusted to maintain serum transferrin iron saturation (TSAT) at less than 40%. During rusfertide treatment, investigators were to consider the need for phlebotomy when the serum ferritin and TSAT values exceeded the patient's individual pre-phlebotomy serum ferritin and TSAT values. No primary endpoint or testing hierarchy was prespecified. Prespecified efficacy endpoints included the change in the frequency of phlebotomies; the proportion of patients achieving phlebotomy independence; change in serum iron, TSAT, serum transferrin, serum ferritin, and liver iron concentration (LIC) as measured by MRI; and treatment-emergent adverse events (TEAEs). The key efficacy analyses for phlebotomy rate and LIC were conducted by use of paired t tests in the intention-to-treat population, defined as all patients who received any study drug and who had pretreatment and at least one post-dose measurement. We included all participants who received at least one dose of rusfertide in the safety analyses. This trial is closed and completed and is registered with ClinicalTrials.gov, NCT04202965. Between March 11, 2020, and April 23, 2021, 28 patients were screened and 16 (ten [63%] men and six [38%] women) were enrolled. 16 were included in analyses of phlebotomy endpoints and 14 for the LIC endpoint. 12 (75%) patients completed 24 weeks of treatment. The mean number of phlebotomies was significantly reduced during the 24-week rusfertide treatment (0·06 phlebotomies [95% CI -0·07 to 0·20]) compared with 24 weeks pre-study (2·31 phlebotomies [95% CI 1·77 to 2·85]; p<0·0001). 15 (94%) of 16 patients were phlebotomy-free during the treatment period. Mean LIC in the 14 patients in the intention-to-treat population was 1·4 mg iron per g dry liver weight (95% CI 1·0 to 1·8) at screening and 1·1 mg iron per g dry liver weight (95% CI 0·9 to 1·3) at the end of treatment (p=0·068). Mean TSAT was 45·3% (95% CI 33·2 to 57·3) at screening, 36·7% (24·2 to 49·2) after the pretreatment phlebotomy, 21·8% (15·8 to 27·9) 24 h after the first dose of rusfertide, 40·4% (27·1 to 53·8) at the end of treatment, and 32·6% (25·0 to 40·1) over the treatment duration. Mean serum iron was 24·6 μmol/L (95% CI 18·6 to 30·6), 20·1 μmol/L (14·8 to 25·3), 11·9 μmol/L (9·2 to 14·7), 22·5 μmol/L (15·9 to 29·1), and 19·0 μmol/L (15·3 to 22·6) at these same timepoints, respectively. Mean serum ferritin was 83·3 μg/L (52·2 to 114.4), 65·5 μg/L (32·1 to 98·9), 62·8 μg/L (33·8 to 91·9), 150·0 μg/L (86·6 to 213.3), and 94·3 μg/L (54·9 to 133.6) at these same timepoints, respectively. There were only minor changes in serum transferrin concentration. 12 (75%) patients had at least one TEAE, the most common of which was injection site pain (five [31%] patients). All TEAEs were mild or moderate in severity, except for a serious adverse event of pancreatic adenocarcinoma, which was considered severe and unrelated to treatment and was pre-existing and diagnosed 21 days after starting rusfertide treatment. Rusfertide prevents iron re-accumulation in the absence of phlebotomies and could be a viable therapeutic option for selected patients with haemochromatosis. Protagonist Therapeutics.

Syrian refugees' experiences while receiving mental health services and psychiatric nursing care: A qualitative study.

This study examined the experiences of Syrian refugees in a community centre in Turkiye as they access mental health services and receive psychiatric nursing care. A qualitative design was adopted in the study. Data were collected from southern Turkiye between November and December 2021. The researchers conducted three semi-structured focus group interviews. Colaizzi's phenomenological method was followed to analyse the qualitative data. A total of 19 Syrian refugees participated in the focus group interviews. Three key themes related to immigrants' experiences of receiving mental health services and nursing care were identified: barriers to receiving mental health services, coping with negative experiences in Turkiye and satisfaction with mental health services. The participants identified the barriers they experienced while receiving health services as those pertaining to language, discrimination and stigmatization. They also mentioned the methods of coping with these negative experiences in Turkiye. Despite their negative experiences, they expressed satisfaction with the mental health services they received, especially psychiatric nursing care. This study determined that Syrian refugees face barriers in accessing and receiving mental health services. They stated that mental health professionals in Turkiye approach them with empathy, particularly those in psychiatric nursing. Healthcare professionals may be trained in culturally sensitive care to increase awareness. Studies have frequently examined the experiences of nurses providing care to refugees, but few have focused on evaluating nursing care from the perspective of refugees. Syrian refugees have reported various obstacles in accessing and receiving mental healthcare services. Health professionals, especially psychiatric nurses in mental health psychosocial support centres, must facilitate the processes to eliminate these obstacles. The consolidated criteria for reporting qualitative research (COREQ) were used. No patient or public involvement.

Analysis of active surveillance uptake for localized prostate cancer in Quebec in 2016: A Canadian bicentric study and comparison with 2010 data

IntroductionActive surveillance (AS) has emerged as a primary management strategy for low-risk prostate cancer (PC) patients. We aimed to assess AS uptake over a 1-year snapshot throughout Quebec and to compare it to 2010 multicentric Canadian data. MethodsA retrospective chart review and data collection was performed in 1 academic and 2 non-academic community centres from Quebec, among men identified in 2016 with localized T1c-T2c PC on biopsy, fulfilling NCCN criteria of low-risk (LR)-PC, including very-low-risk (VLR) and non-VLR-PC, and favourable-intermediate risk (FIR)-PC. AS adherence was defined when chosen as initial strategy, without any radical treatment within 6 months. ResultsOverall, 259 patients fulfilled the inclusion criteria with 50.2% of VLR-PC patients. At 6 months, 81% patients in the LR group and 65% in the FIR group were considered as adherent to AS, in both centres, but with an increased use of AS in the community centres compared to 2010 data. The rates of AS maintenance decreased at 12 months to respectively 69% and 58%. Among the VLR group, the rate of initiation was 98% and decreased to 85% at 12 months. ConclusionOur data suggest that the majority of low-risk PC patients indeed initiated an AS in 2016, with even a greater proportion of VLR-PC patients compared to 2010. This ideal strategy should be encouraged and improved at 12 months, and assessed with recent data and longer follow-up. Level of evidence4

Advocating for language equity: a community-public health partnership.

In the United States, 21.5% of individuals aged 5 or older speak a language other than English at home and 8.2% have Limited English Proficiency (LEP). LEP individuals experience healthcare disparities, including lower access to healthcare services, poorer health outcomes, and higher levels of uninsurance. The COVID-19 pandemic highlighted and exacerbated these health disparities and unmet healthcare needs. In Alameda County (CA), where 46% of foreign-born residents speak a language other than English at home, community-based organizations have been crucial in providing translated materials and one-on-one support to ensure LEP residents receive critical COVID-19 updates and services. Refugee and Immigrant Collaborative for Empowerment (RICE) is a multilingual coalition of seven Alameda County community-based organizations led by the Korean Community Center of the East Bay (KCCEB). During the COVID-19 pandemic, RICE expanded its public health role to fill service and information gaps, advocate on behalf of LEP groups, and build a linguistically and culturally responsive public health safety network. This community case study describes a three-part advocacy-focused intervention that RICE undertook from September 2021 to October 2022. It included (1) a community needs survey, (2) a landscape assessment of the Alameda County Health Department's (ACPHD) communication materials and online platforms, and (3) relationship building with the ACPHD. The community survey revealed differences across LEP subgroups and highlighted the importance of gathering data disaggregated by language preference. The landscape assessment allowed RICE to understand the ACPHD's decision-making process and develop data-informed advocacy requests on behalf of LEP communities. Effective communication and coordination between RICE and the ACPHD shortened the feedback loop between public health authorities and LEP communities and laid the groundwork for the RICE organizations to be part of the ACPHD's future decision making. Data disaggregation, language equity-based advocacy, and cross-sector collaboration were critical ingredients in RICE's intervention. RICE's partnership and relationship of mutual accountability with the ACPHD may provide a useful model for other community-based organizations and public health departments seeking to form similar partnerships.

Good death for people living with dementia: a qualitative study

BackgroundEnsuring a good death is one of the primary objectives of palliative care and end-of-life care. There is insufficient evidence regarding what defines a good death for people living with dementia. Obtaining an understanding of what constitutes a good death could help improve dementia care. This study aimed to explore how multiple stakeholders perceive a good death for people living with dementia.MethodsThis qualitative study was carried out across six prefectures in Japan. Enrollment of participants took place within dementia outpatient clinics, hospitals, daycare centers, and community centers. A total of thirty-three in-depth interviews with people living with dementia, physicians, and nurses were conducted. Six focus group discussions were performed with family caregivers and care workers. Verbatim transcripts of the interviews were prepared, and inductive content analysis was used to examine the data.FindingsRegarding the perception of a good death, the following themes were derived: (1) painless death; (2) dying in a preferred environment; (3) family’s coping with loss; (4) maintaining regular life; (5) living with respect; and (6) preparation for death. All these themes are interrelated. Participants viewed a good death as a process rather than a single event.ConclusionThis study identifies crucial components of a good death for people living with dementia. The findings could be used to improve dementia care.

Transoral outlet reduction: Outcomes of endoscopic Roux-en-Y gastric bypass revision in 284 patients at a community practice.

Transoral outlet reduction (TORe) is a minimally invasive endoscopic revision of Roux-en-Y gastric bypass (RYGB) for weight recurrence; however, little has been published on its clinical implementation in the community setting. To characterize the safety and efficacy of TORe in the community setting for adults with weight recurrence after RYGB. This is a retrospective cohort study of argon plasma coagulation and purse-string suturing for gastric outlet reduction in consecutive adults with weight recurrence after RYGB at a single community center from September 2020 to September 2022. Patients were provided longitudinal nutritional support via virtual visits. The primary outcome was total body weight loss (TBWL) at twelve months from TORe. Secondary outcomes included TBWL at three months and six months; excess weight loss (EWL) at three, six, and twelve months; twelve-month TBWL by obesity class; predictors of twelve-month TBWL; rates of post-TORe stenosis; and serious adverse events (SAE). Outcomes were reported with descriptive statistics. Two hundred eighty-four adults (91.9% female, age 51.3 years, body mass index 39.3 kg/m2) underwent TORe an average of 13.3 years after RYGB. Median pre- and post-TORe outlet diameter was 35 mm and 8 mm, respectively. TBWL was 11.7% ± 4.6% at three months, 14.3% ± 6.3% at six months, and 17.3% ± 7.9% at twelve months. EWL was 38.4% ± 28.2% at three months, 46.5% ± 35.4% at six months, and 53.5% ± 39.2% at twelve months. The number of follow-up visits attended was the strongest predictor of TBWL at twelve months (R2 = 0.0139, P = 0.0005). Outlet stenosis occurred in 11 patients (3.9%) and was successfully managed with endoscopic dilation. There was one instance of post-procedural nausea requiring overnight observation (SAE rate 0.4%). When performed by an experienced endoscopist and combined with longitudinal nutritional support, purse-string TORe is safe and effective in the community setting for adults with weight recurrence after RYGB.

Disparities in outcomes and access to therapy options in hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) disproportionately impacts racial and ethnic minorities and patients with lower socioeconomic status. These social determinants of health (SDH) lead to disparities in access to care and outcomes. We aim to understand the relationship between SDH and survival and locoregional treatment options in HCC. Using the National Cancer Database, we evaluated survival and access locoregional treatments including non-transplant surgery, liver transplant (LT), and liver-directed radiation therapy (LDRT) in patients with HCC diagnosed between 2004 and 2017. Variables including clinical stage, age, sex, race, income, rurality, year of diagnosis, facility type (FT), Charlson-Deyo score (CD), and insurance were evaluated. Cox proportional hazards multivariable regression and dominance analyses were used for analyses. In total, 140 340 patients were included. Worse survival was seen with advanced stage, older age, Black race, rurality, public insurance, treatment at a nonacademic center, and lower income. The top predictors for survival included stage, age, and income. Completion of non-transplant surgery was best predicted by stage, FT, and insurance type, whereas LT was predicted by age, year of diagnosis, and CD score. LDRT utilization was most associated with year of diagnosis, FT, and CD score. For patients with HCC, survival was predicted primarily by stage, age, and income. The primary sociodemographic factors associated with access to surgical treatments, in addition to FT, were insurance and income, highlighting the financial burdens of health care. Work is needed to address disparities in access to care, including improved insurance access, addressing financial inequities and financial toxicities of treatments, and equalizing care opportunities in community centers.

Patterns of participation in summer programming among United States’ elementary children from low-income urban households: Results from the project SWEAT study

Food insecurity increases among marginalized children during the summer when school is out of session. Summer programming that offers access to healthy meals and snacks may reduce the risk. There is a national call in the US for more research to assure equitable access to summer programming. The objective of this prospective observational study was to characterize patterns of participation in summer programming among elementary children from low-income urban neighborhoods of metropolitan[Blinded]. Summer programming was broadly defined (e.g., church, school, recreation center, community center). Caregivers(n = 100) received weekly text messages via TextIt during the summer (Jun-Aug 2017). They were asked: “How many days this week did [ChildName] attend a summer program? Please respond with a number from 0 to 5, where 0 – no days, 2 – 2 days, etc.” Weekly counts were summed.Stepwise logistic and linear regression models were conducted to examine differences in patterns of attendance according to key sociodemographic characteristics. Mean age was 7.03 ± 0.23. 52 % identified as female, 70 % were low-income, and 80.0 % identified as Black. 51 % attended summer programming at least once; 49 % never attended. Those who attended at least once vs. not at all were more likely to be male(p < 0.01); 62.75 % males vs. 37.25 % females attended summer programming at least once, whereas 67.35 % females compared to 32.65 % males never attended.Overall mean attendance was 10.40 ± 1.43 days(out of 50). Mean + SE attendance was lower for females (7.52 + 1.76) vs. males (13.52 + 2.21)(p < 0.05), and non-Black (4.30 + 1.97) vs. Black (11.93 + 1.67)(p = 0.01) children. Future research is needed to understand barriers to participation in summer programming.

Pharmaceutical indication pictograms for low literacy viewers: Health literacy and comprehension.

Poor comprehension of pharmaceutical pictograms used on medicine labels or leaflets can compromise understanding of medicine-taking information, potentially causing negative health outcomes. The aim was to assess association of health literacy (HL) with comprehension of pictograms displaying indication and side effect information in a lower literacy, limited English proficiency (LEP) population. Community centre, Makhanda, South Africa. This was a quantitative cross-sectional study using simple random probability sampling. Ninety isiXhosa-speaking adults with a maximum of 12 years schooling, attending primary healthcare clinics were interviewed using structured interviews. Health literacy was assessed using the Health Literacy Test for Limited Literacy populations. Comprehension of 10 locally developed pictograms was evaluated. The mean pictogram comprehension score was 7.9/10, with 8/10 pictograms complying with the International Organization for Standardization criterion of 66.7% correct comprehension. Only 15.6% of participants had adequate HL. A significant association of HL with pictogram comprehension was established (p = 0.002). Pictogram misinterpretation was higher in those with lower HL; adequate HL was associated with superior comprehension. Pictogram comprehension was negatively associated with age (p < 0.006), and positively associated with education (p < 0.001) and English proficiency (p < 0.001). Higher HL was associated with better pictogram comprehension. Low HL, LEP and low education levels are regarded as potential indicators for possible pictogram misinterpretation. This study observed the potential for misinterpretation of medication pictograms. Health professionals should be aware that low HL, limited schooling and limited English proficiency could signal difficulty in fully comprehending pictogram content.

Re-defining Transport for London’s strategic neighbourhoods from spatial and social perspectives

Neighbourhoods are fundamental spatial units to present social phenomena in urban studies. Many studies use administrative boundaries such as census tracts as representations of neighbourhoods, but such boundaries may poorly represent the underlying social structures and physical attributes which might help define more vernacular conceptions and dialectical evolution of these zones. In this paper, using the goal of creating a new set of ‘Strategic Neighbourhoods’ for Transport for London (TfL) as vehicle for analysis, we evaluate two contrasting spatially and socially focused methodologies of neighbourhood generation. In comparing the outputs of a tertiary-communities (T-Communities) method and a combined Principal Component Analysis (PCA) and Minimum Spanning Tree (MST) cluster analysis method with an earlier iteration of Strategic Neighbourhoods defined by TfL, indices including neighbourhood size, intra-class correlation coefficient (ICC), and the number of community centres are calculated to evaluate their relative performance which demonstrate that both methods create neighbourhood boundaries that can better capture intra-group social homogeneity and are more suitable for analysis than the original SNA boundaries. These results are discussed in the context of the dialectic relationship between neighbourhood outcomes, spatial structures, and social characteristics, leading to more widely relevant conclusions that neighbourhood boundary delineation should combine spatial structure, social attributes, and experimental knowledge to effectively sub-divide urban activity.

Classification of health needs: a cluster analysis of older adults in urban areas

BackgroundIn this study, a cross-sectional survey was used to understand and analyze the health status and health needs of the elderly in the community. The cluster analysis method was used to explore the relationship between health needs items and investigate the commonness among health demand items, to provide a reference for the development of health management of the elderly with chronic diseases.MethodsWe used convenience sampling to recruit the participants (aged 60 and above) from four urban community centers in Jinzhou City, Liaoning Province, China, in this study. This study uses the Medical Outcomes Study(MOS)36-Item Short-Form Health Survey. The self-designed questionnaire includes sociodemographic characteristics, chronic diseases, physical examination conditions, illness in the past two weeks, and a health needs questionnaire. SPSS 18.0 was used for data entry and analysis. Data analysis methods included descriptive statistical analysis, t-test, one-way analysis, cluster analysis, and linear multiple regression analysis.ResultsThe rate of health needs among the elderly in the community for various health services is 1.3–69.7%, of which the top three are: regular physical examination (69.7%), day Care Center (67.7%), the establishment of a Medical Alert Systems (66.1%). The health needs of the elderly in the community are divided into three categories: basic needs (24 items), health education (13 items), and first aid (2 items). The regression analysis found that the influencing factors of health status were age, revenue and expenditure, medical expenses, health education, basic needs, and first aid.ConclusionsThe community should strengthen the management of chronic diseases of the elderly and the publicity and education of related knowledge, and provide complementary health care services according to the health needs of the elderly, improve the health of the elderly, and improve the quality of life of the elderly.

Stroke Community Rehabilitation Centre (SCORE): A community transformation program

&#x0D; &#x0D; &#x0D; Stroke is the second most prevalent disease in Malaysia, so promoting awareness of stroke is essential as it is preventable and treatable if action is prompt. Long-term rehabilitation at the community level is also crucial to reducing congestion in acute care hospitals. Hence, establishing an evidence-based community rehabilitation centre would help educate the community and support the welfare of stroke survivors.&#x0D; This article discusses a community-engagement initiative launched by experts from University Malaya Rehabilitation Medicine in partnership with Pusat Pemulihan Kesihatan (PERKIM), a religious and social welfare organisation in Malaysia, to transform an existing non-functional community centre run by PERKIM into the Stroke Community Rehabilitation Centre (SCORE). This was achieved through the provision of expert input into how to improve service provision, knowledge transfer to the community, and implementation of more thematic and creative components to the model of care currently offered. Importantly, under this new model, stroke survivors and the wider community would be considered learners and active participants in their own care, not mere passive recipients of charity.&#x0D; Since its inception in 2016, the number of patients has almost doubled, increasing to over 100. Thus, the Stroke Community Rehabilitation Centre benefits the stroke community by providing resources and education to facilitate recovery at a reduced cost to hospital-based care. With its adherence to the recommended features of the community-based rehabilitation model, as outlined by WHO, the success of SCORE is an exemplary model for future stroke community rehabilitation centres in Malaysia.&#x0D; &#x0D; &#x0D;

THU513 Are Endocrinologists Using CTCAE Grading System For Endocrine Side Effects Of Cancer Treatment With Immune Checkpoint Inhibitors?

Abstract Disclosure: N. Arnouk: None. S. AbuOmar: None. A. Halik: None. A. Saif: None. P.R. Schroeder: None. Introduction: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of diverse types of cancer but can have serious endocrine system side effects. Common Terminology Criteria for Adverse Events (CTCAE) is a grading system for ICI side effects used by oncologists to aid in treatment decisions. We hypothesize that endocrinologists are not involved in managing immune-related adverse events (irAEs) and are not aware of the CTCAE grading system. Further, we hypothesize that endocrinologists in an academic setting are more likely to use CTCAE compared to endocrinologists in community setting. Methods: A retrospective review of 800 charts in our EMR from January 2018-July 2022 for patients seen in outpatient oncology and endocrinology clinics in our large Mid-Atlantic hospital system. Inclusion criteria were age ≥18 years; diagnosis of advanced melanoma, metastatic non-small cell cancer, head and neck squamous cell cancer, urothelial carcinoma, gastric adenocarcinoma, Hodgkin lymphoma, hepatocellular carcinoma, breast cancer, and renal cell carcinoma; and treatment with one or more ICIs. Patients with endocrinopathies due to chemotherapy or other classes of cancer treatment, no ICI treatment, or pre-existing endocrinopathies were excluded, thus 677 were analyzed.We also surveyed all endocrinologists practicing in our hospital network to determine whether they are involved in managing endocrinopathies associated with ICIs and whether they use the CTACE grading system. Results: Of the 677 reviewed 124 (18%) developed irAEs. In 74 (60%) of those cases, an endocrinologist was involved in management, 47 (70%) in community hospitals and 27 (47%) in academic centers. CTCAE was used in one case. Of 24 endocrinologists surveyed (14 practicing in academic centers and 10 practicing in community centers),12 (50%) responded, 3 (25%) at academic centers and 9 (75%) at community centers. Of the respondents, 9 (75%) said they sometimes are involved in managing irAEs due to ICIs, 11 (91%) had never used the CTCAE, 8 (67%) would participate in a multidisciplinary clinic to manage irAEs, and 6 (50%) preferred to see the patient in their regular clinic. Conclusion: In this study, 60% of the irAE cases resulting from ICI immunotherapy were managed by an oncologist and endocrinologist. CTCAE was used in only one case. More endocrinologists in the community were involved in management of these patients than those in academic centers. A majority of endocrinologists surveyed said they are sometimes consulted in these cases but only one had used CTCAE, thus CTCAE was not used more frequently in an academic versus community setting. More than half prefer to treat these patients in regular versus multidisciplinary clinics. More endocrinologists need to be aware of and use the CTCAE to foster a multidisciplinary team approach to treating endocrinopathies associated with ICIs. Presentation: Thursday, June 15, 2023

A non-randomized pilot study protocol of a novel social support intervention for individuals in early recovery from hazardous alcohol use.

Connecting individuals to recovery support services such as recovery community centers and mutual help organizations can be crucial for sustaining recovery from addiction. However, there may be barriers to engagement with recovery support services on individual (e.g., limited motivation) and structural (e.g., limited information on recovery resources) levels. This pilot study will determine the feasibility and acceptability of a novel online social support intervention (Let's Do Addiction Recovery Together!, abbreviated as LDART) that uses pre-recorded videos created by members from several recovery support services to help individuals in early recovery from hazardous alcohol use sustain motivation during recovery and introduce them to freely available recovery support services in the community. This will be a non-randomized mixed-method pilot study. We will recruit 30 adults who engaged in past-year hazardous alcohol use and have some desire to cut down or quit to use LDART every night for a month. A subset of these participants will be invited to participate in a semi-structured qualitative interview after completing the study. Primary outcomes will be feasibility parameters such as recruitment and retention rates, and acceptability measures such as frequency of intervention use. Secondary outcomes will include self-reported changes in alcohol use, engagement in recovery support services, and quality of life at one-month post-intervention relative to baseline. Results of this pilot study will inform a randomized controlled trial to examine efficacy of this intervention, with the goal of creating an accessible and scalable intervention that has direct benefits on individuals who want to cut down or quit problematic alcohol use. ClinicalTrials.gov ID: NCT06022107.

“And This Was the Exhibition”: Launderettes, Buses and Canteens as Gallery Spaces in 1970s Britain

In the absence of photographic galleries in Britain in the early 1970s, aspiring documentary photographers turned to ordinary places to show their work, transforming launderettes, buses, canteens and community spaces into temporary galleries. This generation of photographers renewed social documentary in self-initiated projects driven by a sense of social change and a desire to create alternative approaches to photographic representation. Nick Hedges produced exhibitions in the canteens of factories where he had spent time photographing the workers. Daniel Meadows converted a double-decker bus, into a mobile darkroom and exhibition space, travelling across England and Wales. Meanwhile, Paul Trevor used a launderette in Brick Lane, London, to show his work done locally. Active in the neighboring borough of Hackney, the feminist collective the Hackney Flashers had their first exhibition “Women and Work” in the local town hall and in community centers. More than pragmatic initiatives, these resourceful exhibition practices challenged the elitism of high art institutions, while reinforcing the photographers’ engagement with a renewed documentary ethos, combining personal expression and a commitment to specific communities and their cultures. The history of these unusual exhibitions highlights currents of change in British photography, rooted in the cultural politics of the period.

Evaluation of US oncology electronic health record real-world data to reduce uncertainty in health technology appraisals: a retrospective cohort study

ObjectivesExamine whether data from early access to medicines in the USA can be used to inform National Institute for Health and Care Excellence (NICE) health technology assessments (HTA) in oncology.DesignRetrospective...