Community Perspectives Research Articles

A systematic literature review on pancreas segmentation from traditional to non-supervised techniques in abdominal medical images

Abdominal organs play a significant role in regulating various functional systems. Any impairment in its functioning can lead to cancerous diseases. Diagnosing these diseases mainly relies on radiologists’ subjective assessment, which varies according to professional abilities and clinical experience. Computer-Aided Diagnosis (CAD) system is designed to assist clinicians in identifying various pathological changes. Hence, automatic pancreas segmentation is a vital input to the CAD system in the diagnosis of cancer at its early stages. Automatic segmentation is achieved through traditional methods like atlas-based and statistical models, and nowadays, it is achieved through artificial intelligence approaches like machine learning and deep learning using various imaging modalities. This study investigates and analyses the various state-of-the-art multi-organ and pancreas segmentation approaches to identify the research gaps and future perspectives for the research community. The objective is achieved by framing the research questions using the PICOC framework and then selecting 140 research articles using a systematic process through the Covidence tool to conclude the answers to the respective questions. The literature search has been conducted on five databases of original studies published from 2003 to 2023. Initially, the literature analysis is presented in terms of publication, and the comparative analysis of the current study is presented with existing review studies. Then, existing studies are analyzed, focusing on semi-automatic and automatic multi-organ segmentation and pancreas segmentation, using various learning methods. Finally, the various critical issues, the research gaps and the future perspectives of segmentation methods based on published evidence are summarized.

Community Perspectives on the Environmental, Social, and Economic Impacts of the Tomohon International Flower Festival

Purpose: The purpose of this research is to evaluate the perceptions of the local community regarding the economic, socio-cultural, and environmental impacts of the Tomohon International Flower Festival (TIFF). Specifically, the study aims to understand how the residents of Tomohon view the festival's contributions to their economic well-being, social cohesion, cultural preservation, and environmental sustainability. Research methodology: This research used an exploratory approach to analyse residents' perceptions of the economic, socio-cultural, and environmental impacts of festival activities in Tomohon. Results: The results of the research indicate that the Tomohon International Flower Festival (TIFF) is perceived positively by the local community across several dimensions. Economically, TIFF is seen as a significant contributor to local income, job creation, and regional revenue. Socio-culturally, the festival enhances social interactions, fosters cultural pride, and supports cultural and educational development. However, the community also expressed concerns about environmental sustainability, particularly regarding waste generation and its negative impact on the city’s aesthetics. Limitations: The data gathered reflects the views of the respondents at a specific point in time and may be influenced by personal experiences, biases, or limited knowledge about broader economic, socio-cultural, and environmental factors. Additionally, the sample size, though sufficient for exploratory analysis, may not be fully representative of the entire Tomohon population, potentially limiting the generalizability of the findings. Contribution: This article contributes to the broader understanding of the socio-economic and environmental impacts of large-scale cultural events like the Tomohon International Flower Festival (TIFF) from the perspective of local communities. This research also serves as a guide for event organizers and policymakers in optimizing the benefits of festivals while addressing community concerns, thereby promoting more sustainable and inclusive event planning.

Perceptions of Rural Access to Prenatal Care in the United States by Patients, Nurses, Midwives, and Physicians: An Integrative Review.

Despite substantial investments in maternity care, the United States continues to experience higher maternal mortality rates than most high-income countries. Rural regions lack adequate prenatal care services, a contributing factor to disparate maternal health outcomes. This integrative review on patient, nurse, midwife, physician, and community perspectives on accessing prenatal care in rural areas of the United States follows Whittemore and Knafl's integrative review framework, including a systematic literature search in various databases from January 1, 2010, to May 1, 2024. Eligible articles were published in English, peer-reviewed, and focused on subjective accounts of accessing prenatal care in rural areas of the United States. Seven articles met inclusion criteria and were assessed for quality using the Joanna Briggs Institute checklists. Three major categories influencing access to prenatal care in rural areas were developed. Individual factors included transportation, family support, motivation, and work commitments. Socioeconomic factors encompass health insurance, rurality, income, and housing. System factors involved the qualities of nurses, midwives, physicians, the clinic environment, and collaboration within the health care system. The findings emphasized the complexity of rural prenatal care access. Understanding patient and care giver perspectives on accessing prenatal care in rural areas is crucial for addressing the factors influencing maternal outcomes. Rural pregnant women face unique challenges, contributing to an increased risk of maternal morbidity and mortality. Further research is needed to explore their experiences and develop interventions to improve access and outcomes in rural areas.

Reclaiming Klungkung's Cultural Heritage: Navigating the Complexities of Repatriation in Post-Colonial Bali

This article examines the complexities of repatriating objects from Bali's Klungkung Court seized by Dutch forces in 1908. It argues that repatriation, often conducted as restitution between nations, fails to fully consider local communities' needs. Through a case study of five artifacts, the article explores historical, cultural, and ethical dimensions, highlighting repatriation challenges. It emphasizes engaging local stakeholders for an equitable process. Returning these artifacts can rectify historical injustices, uphold cultural sovereignty, and foster reconciliation between the Netherlands and Indonesia, despite challenges like provenance research and ownership disputes. Repatriation remains vital for addressing colonial legacies and promoting cultural justice by acknowledging wrongs, aiding healing, empowering descendants, and sustaining cultural practices. The study concludes that repatriation is a continual, complex process requiring commitment to justice, reconciliation, and cultural autonomy, focusing on the perspectives of communities from which objects were taken.

Strategies for Household Waste Management in Winong Village Waste Bank

Background: Legal frameworks are vital for guiding village autonomy and waste management practices. Specific Background: In Indonesia, laws such as Law No. 6/2014 and Law No. 18/2008 regulate these areas but face implementation challenges. Knowledge Gap: There is a lack of integration between community perspectives and local governance practices. Aims: This study analyzes the legal foundations of waste management in rural settings and assesses practical implementation through stakeholder input. Results: Using a normative legal approach alongside Focus Group Discussions with various stakeholders, the research identifies gaps in the application of waste management laws and emphasizes the need for tailored legal recommendations. Novelty: By merging legal analysis with empirical insights, the study provides a comprehensive view of waste management in rural contexts. Implications: Findings highlight the necessity for adapting legal frameworks to local systems and engaging communities, offering practical solutions for rural waste management that contribute to environmental governance. Highlights : Legal Foundations: Examines laws governing waste management and village autonomy. Stakeholder Input: Utilizes Focus Group Discussions to gather community perspectives. Contextual Adaptation: Emphasizes the need for tailored legal solutions for effective implementation. Keywords: legal frameworks, waste management, village governance, community engagement, empirical analysis

Participation of LPMD in Village Infrastructure Development

The general background infrastructure development is fundamental for enhancing the quality of life and economic prospects in rural communities. Specific background in Indonesia, institutions such as Lembaga Pemberdayaan Masyarakat Desa (LPMD) are pivotal in facilitating this process. Knowledge gap despite their critical role, there is a scarcity of research addressing the specific contributions of LPMD to infrastructure projects at the village level. Aims This study aims to bridge this knowledge gap by investigating the involvement of LPMD in the planning, implementation, and supervision of infrastructure development within a village context. The Results Utilizing a descriptive qualitative approach, the results indicate that LPMD actively engages in project implementation, proposes community-based programs, and oversees project execution to ensure accountability and transparency. Novelty This research contributes novel insights into the diverse roles played by LPMD, showcasing both active and passive participation in infrastructure initiatives. The implications highlight the necessity for local governments to recognize and strengthen the involvement of LPMD in development processes, ensuring that community perspectives are effectively integrated into planning and execution, which may lead to more sustainable and impactful infrastructure development in rural settings. Highlights: LPMD plays a crucial role in infrastructure planning and implementation. The study highlights both active and passive participation of LPMD. Community involvement is essential for sustainable development outcomes. Keywords: Infrastructure Development, LPMD, Community Empowerment, Village Participation, Sustainable Development

Developing Ecotourism Community Based Approach: A Sustainable Tourism Development Project o n Tanjung Surat Island

The Tanjung Surat Island Ecotourism Development Master Plan study was commissioned to support the Johor Southeast Development Authority (KEJORA) in creating a high-impact strategy to develop Tanjung Surat Island into a premier ecotourism destination for both local and international tourists. This study addresses the prevalent community misunderstanding regarding ecotourism development. The main objective of this study is to identify strategic planning through community engagement initiatives spearheaded by KEJORA on Tanjung Surat Island. Quantitative methods, including the distribution of questionnaires to 118 respondents, were employed to meet this objective. In addition to the questionnaires, the study incorporated several other data collection methods to ensure a thorough understanding of the community's perspective. These included structured interviews with key stakeholders, focus group discussions with community leaders, and participatory observation to gather qualitative insights that complemented the quantitative data. The study's findings will provide a comprehensive guide and reference for planning across economic, social, and environmental dimensions, aiding in the development of Tanjung Surat Island's ecotourism sector. This guide will benefit KEJORA and other stakeholders, including the private sector, interested in supporting and shaping the island's ecotourism future. Additionally, the study highlights the critical need for Technical and Vocational Education and Training (TVET) to enhance the quality of existing services, ensuring they meet current and future demands and standards.

Tackling a wicked problem: toward sustainable management of surplus dairy calves using a participatory framework

Early life killing of male and female dairy calves not needed as replacements for the lactating herd poses a threat to the social sustainability of the dairy industry. However, implementing sustainable alternatives to this common practice is a complex challenge exhibiting many characteristics of a ‘wicked problem’. Addressing these problems requires understanding the needs of stakeholders including farmers, their advisors, value chain stakeholders, the public, and the animals. The aim of this study was to describe how Australian dairy farmers and advisors understand the factors affecting surplus calf management and examine how this understanding changed following interventions where participants were exposed to community and value chain stakeholder perspectives. To achieve this, we utilized a participatory framework that included longitudinal focus groups, where the same groups were reconvened multiple times, periodically revisiting the same issue, as a practical method for achieving deliberative engagement. We analyzed participants’ responses before and after the interventions were applied using thematic analysis. Responses were organized into two themes: (1) economic and practical aspects of surplus calf management; and (2) social aspects of surplus calf management. We conclude that farmers and their advisors see surplus calf management as complex and without simple solutions. Farmers are faced with numerous challenges when it comes to breeding, rearing, and marketing calves for economically viable beef markets and are often impacted at a personal level by this burden. Participants often positioned the public as naïve to the plight of the farmer, requiring education to understand and accept farming practices. However, exposing participants to community views, particularly those which included some common ground with which participants could identify, resulted in some participants suggesting public trust may instead lay in changing practices to align production systems with public values. In contrast, sharing value chain perspectives had less impact. Our findings indicate that participatory processes offer a promising approach for working toward sustainable management of surplus dairy calves in a local and global context.

The COVID-19 experience through the lens of disability Twitter: A qualitative analysis.

The societal response and constraints of the COVID-19 pandemic reinforced ableism for disabled people who were yet again treated as an afterthought in society. Systemic ableism impacted their well-being, access, and ability to be active members of their community. Disabled experiences and voices must be heard and amplified to improve preparedness and address ableism. Disability Twitter is one avenue where the disability community can collectively listen and support one another. These voices can and should be used to influence policy and practice. This study used Disability Twitter to represent and honor the experiences of the disability community, using the COVID-19 pandemic as a moment in time. Qualitative thematic analysis of U.S.-based Twitter posts was conducted using retrospective social media posts. A total of 238 initial tweets from January 1, 2020 and September 30, 2022 were analyzed by the research team. Five themes were observed including ableism, devaluation, worthiness, act of reclaiming, and emotion. Disabled people reported instances of ableism, devaluation, and victimization by individuals, systems, and government entities throughout the pandemic. Disabled individuals utilized Twitter to share their collective experiences, urging society to address and respond to the needs of the disability community. Using social media to center the perspectives of the disability community can invoke system-wide change and inform policies. Implications for combating systemic ableism and promoting allyship for clinical professionals, research scholars, and educators are provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perception analysis of TCE holders about ownership, possession, use, misuse and misappropriation in India

Abstract The discussions at The Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore (IGC) under the World Intellectual Property Organization (WIPO) (WIPO IGC) are progressing towards formulating an international legal framework for the protection of traditional cultural expressions (TCEs). We anticipate that the successful conclusion of the 2024 Diplomatic Conference for the adoption of the WIPO Intellectual Property, Genetic Resources, and Associated Traditional Knowledge (GRTK) Treaty will accelerate the negotiations for an instrument for TCE. Proposals before the WIPO IGC indicate the possibility of adopting an IP-based framework to protect TCEs. This article aims to analyse the intricate relationships between TCE holders and their cultural expressions by exploring the conceptual issues in TCEs through an empirical study. The study focuses on seven selected TCEs from India and examines the perspective of communities regarding various aspects of TCE, such as ownership, possession, use, misuse and misappropriation. The objective of this investigation is to gain insights that will assist in designing a legal framework that is suitable for TCEs. The article emphasizes the importance of reassessing the current trajectory of negotiations concerning TCEs and stresses the need to further explore and gain a deeper understanding of TCEs.

은유분석을 통해 본 「교사-원장(감) 관계」에 관한 예비 영유아 교사의 인식: 교육공동체의 관점을 중심으로

The purpose of this study is to examine prospective early childhood pre-service teachers' perceptions of the teacher-(vice)principal relationship using metaphor analysis, and to provide implications regarding the desirable teacher-(vice)principal relationship that prospective early childhood pre-service teachers should form from an educational community perspective. For this purpose, data were collected from November 30 to December 22, 2023, targeting 135 students majoring in early childhood education and child studies at a 4-year university located in G Metropolitan City. The collected data were analyzed according to an 8-step metaphor analysis procedure and the results were presented. As a result of the study, childhood pre-service teachers' perceptions about the teacher-(vice)principal relationship were characterized into three categories and eight subcategories. The three categories are: ‘Relationship between leader and follower walking the same path’, ‘Relationship of cooperation based on trust and respect’, ‘Relationship of imbalance of power’. The eight subcategories are: ‘relationship of providing and receiving support for the driving force of educational implementation’, ‘relationship of cooperation as a member of the early childhood education community’, ‘relationship of suggesting and following direction’, ‘relationship of giving teaching and receiving learning’, ‘relationship between the strong and the weak’, ‘relationship in which we are emotionally embraced and supported’, ‘relationship in which we trust and respect each other’, ‘relationship in which we are different but must maintain a balance’ This study is expected to provide basic data for education and research to establish an educational community culture in the early childhood education field.

BALANCED SCORECARD DESIGN AS A MODEL FOR MEASUREMENT OF PUSKESMAS PERFORMANCE IN EAST LOMBOK DISTRICT

The objective of this study is to develop a performance measuring model based on the balanced scorecard framework at the UPT Puskesmas Suela in East Lombok Regency, using the Analytic Hierarchy Process (AHP) technique. This research employed qualitative approaches. Data were gathered with a paired comparison questionnaire employing the Analytic Hierarchy Process (AHP) scale. The performance evaluation of community health centers is conducted using four reference standards, including the financial perspective, community perspective, internal business process perspective, and development and learning perspective. Utilizing this technique for data processing is beneficial in making judgments based on many factors. The research findings indicate that the primary criterion of utmost importance for community health centers is finance, with a weight of 0.465450. The subsequent prioritization criterion is society, assigned a weight of 0.214555. Additionally, both the internal business process criteria and development and learning criteria hold equal significance, each with a weight of 0.112321. Related indicates that Puskesmas as a public sector agency focuses on improving performance on financial perspectives.

Citizen science tools for engaged research: Waterquality monitoring in remote communities

Remote areas that lack conventional water-provisioning infrastructure often rely on rainwater harvesting, rivers, pans, reservoirs and borehole-extracted water to meet domestic water requirements. These water sources often have poor microbial quality and chemical composition, the quality of which is not routinely monitored. This study explored citizen science as a tool for Engaged Research and Responsible Research and Innovation, detailing the co-creation of a sustained community-based water quality monitoring program in collaboration with communities in villages in Amakhala Game Reserve (Eastern Cape, South Africa). Without access to other water sources, participants predominantly used rainwater for drinking and cooking (80%), while borehole water was mainly used for cleaning and gardening due to its salty or bitter taste. A hydrogen sulphide (H2S) water testing kit was used by the citizen scientists to monitor the water quality. The H2S kits were effective in estimating bacterial contamination, showing a proportional relationship with Colilert® test results conducted in a laboratory. The alignment observed between community-based monitoring results and those derived from scientist-led testing underscores the value of data produced through citizen science initiatives. Sustained participant engagement throughout this research reflected a sense of community empowerment through access to tools that inform their decision-making around water use and treatment as well as investment in the research, indicative of the perceived relevance of the research to community interests. This integration of transdisciplinary data sources holds promise for informing evidence-based decision-making processes, facilitating more effective and contextually informed water management strategies that value and integrate community perspectives alongside scientific insights.

Corporate Social Responsibility Performance of Oil Multinationals in the Niger Delta: From the Eyes of Host Communities

This paper examined CSR performance of oil companies from the perspective of host communities in the Niger Delta. A questionnaire instrument was employed to elicit the perceptions of host communities using 355 participants selected by random sampling from 48 communities across three states. The data were analyzed with descriptive method, Kendall’s W test and Mean Rank Statistics. The results showed a weighted mean score less than 3.0 performance score criterion for all specified CSR dimensions indicating a perception of poor performance in each dimension. The mean of the mean scores was also less than 3.0, indicating a perception of poor overall performance. The Kendall’s W was 0.831; X2 was 507.037 at p=.000, indicating a high level of concordance between the respondents from the communities in their perception about CSR performance by oil companies. The results indicated high level of dissatisfaction by host communities about the CSR performance of oil companies.

Dams, dams and more dams: Issues in evaluating business cases for dam expansion in Australia

Abstract Conventional interventions for mitigating flood risk and increasing water security often focus on large-scale engineering solutions despite evidence of significant cost overruns and negative environmental impacts. This study is an example of participatory research in water economics, motivated (and requested) by concerns from downstream communities and Indigenous stakeholders that impacts of a proposed dam upgrade and storage increase were not adequately considered. We reviewed the preliminary benefit-cost analysis (BCA) of the proposed AUD$2.1 billion investment to expand the Wyangala Dam in Australia and conducted a new BCA incorporating downstream community perspectives. The original economic analysis favoured the proposed investment, but it underestimated costs and overestimated benefits. Our economic analysis was complemented with a qualitative analysis of downstream community perspectives, plus a quantitative analysis indicating that project costs were underestimated by a minimum of 116%. In comparison, benefits were overestimated by 56%. Neglecting the potential impact of climate change also severely overestimated the original benefit-cost ratio. Based on our calculations, expanding the dam was unlikely to yield a net social benefit. In 2023, a new government decided the dam expansion was too expensive. We recommend policymakers prioritise independent evaluations and community engagement for BCAs on large-scale water infrastructure projects to ensure equitable investment decisions that maximise social welfare and adequate environmental assessment.

Translating the 2021 ESC heart failure guideline recommendations in daily practice: Results from a heart failure survey. A scientific statement of the ESC Council for Cardiology Practice and the Heart Failure Association of the ESC.

Real-world data show that guidelines are insufficiently implemented, and particularly guideline-directed medical therapies (GDMT) are underused in patients with heart failure and reduced ejection fraction (HFrEF) in clinical practice. The Council for Cardiology Practice and the Heart Failure Association of the European Society of Cardiology (ESC) developed a survey aiming to (i) evaluate the perspectives of the cardiology community on the 2021 ESC heart failure (HF) guidelines, (ii) pinpoint disparities in disease management, and (iii) propose strategies to enhance adherence to HF guidelines. A 22-question survey regarding the diagnosis and treatment of HFrEF was delivered between March and June 2022. Of 457 physicians, 54% were general cardiologists, 19.4% were HF specialists, 18.9% other cardiac specialists, and 7.7% non-cardiac specialists. For diagnosis, 52.1% employed echocardiography and natriuretic peptides (NPs), 33.2% primarily used echocardiography, and 14.7% predominantly relied on NPs. The first drug class initiated in HFrEF was angiotensin-converting enzyme inhibitors/angiotensin receptor-neprilysin inhibitor (ACEi/ARNi) (91.2%), beta-blockers (BB) (73.8%), mineralocorticoid receptor antagonists (MRAs) (53.4%), and sodium-glucose cotransporter 2 (SGLT2) inhibitors (48.1%). The combination ACEi/ARNi + MRA+ BB was preferred by 39.3% of physicians, ACEi/ARNi + SGLT2 inhibitors + BB by 33.3%, and ACEi/ARNi + BB by 22.2%. The time required to initiate and optimize GDMT was estimated to be <1 month by 8.3%, 1-3 months by 52%, 3-6 months by 31.8%, and >6 months by 7.9%. Compared to general cardiologists, HF specialists/academic cardiologists reported lower estimated time-to-initiation, and more commonly preferred a parallel initiation of GDMT rather than a sequential approach. Participants generally followed diagnostic and treatment guidelines, but variations in HFrEF management across care settings or HF specialties were noted. The survey may raise awareness and promote standardized HF care.

Adapting citizens’ jury methodology for use in Uganda: use of creative arts as a tool in deliberative, participatory research

ABSTRACT A citizens’ jury is a method of deliberative action research to determine the perspectives of community members regarding complex healthcare issues. This approach is a novel paradigm in settings such as Uganda. Implementation of electronic medical records brings the potential to use routinely collected data for health research. It is important to understand community perspectives. A two-day citizens’ jury was hosted in Kampala. ‘Expert witnesses’ provided topical evidence. Three creative arts techniques were implemented to enable interaction and reflection. First, a local Ugandan film team produced summaries. Secondly, a local artist painted emerging themes. Finally, a drama team comprised community members living with HIV developed an interactive sketch highlighting key points. This creative methodology enabled vibrant interaction. Jurors reached a unanimous verdict that with appropriate consent and data protection, electronic medical data could be used for research. This adapted citizens’ jury methodology could be used in other similar settings.

Abstract B107: Community scientist research advocacy program: Training our research community

Abstract Community Scientist Research Advocacy (CSRA) training programs serve as fundamental bridges between communities and researchers. By engaging community members, these programs leverage networks, knowledge, and community perspectives to enhance research endeavors. This approach facilitates trust-building between disadvantaged populations and cancer researchers, particularly in the context of clinical trials participation and tissue donation. The purpose of our program was to develop and evaluate an innovative, bi-coastal, and bilingual program to inform, educate and encourage community members to become cancer research advocates in Florida (FL) and California (CA). Our program was culturally tailored for Black/African American and Hispanic/Latino/a adults. Primary objectives were to increase manpower for cancer research advocacy and increase multi-directional communication between cancer advocates with cancer patients, survivors, caregivers, community members, academic scientists, and policy makers. The CSRA program is a 13-week hybrid program implemented by the CaRE2 Health Equity Center, a bi-coastal partnership between the Florida A&amp;M University, University of Florida, and University of Southern California in Los Angeles. Participants studied into cancers disproportionately affecting Black/African American and Hispanic/Latino/a groups, completing pre- and post-surveys to measure knowledge, self-efficacy, and program satisfaction. Additionally, participants concluded mentored advocacy projects for community implementation, with follow-up implemented at three months post-program completion. To date, a total of 45 adults have graduated from our CSRA program. We present data from the 2023 CSRA cohort (pre, N=21, post, N=19) that included participants from FL and CA, which are among the top five states in the U.S with the largest Black/African American and Hispanic/Latino/a populations. Regarding race and ethnicity, 6 participants were Black/African American, 13 Hispanic/Latino/a, 1 Asian, 1 Native Hawaiian or Pacific Islander, and 9 White, with 95% female participants. This cohort had 90% program completion and 7 advocacy projects: 2 on lung cancer, 2 on pancreas cancer, and 3 on prostate cancer. Participants showed an increased in knowledge, from pre- mean 68.1 to post- mean 74.0, and a p-value of 0.018. There was an increased in self-efficacy; program satisfaction and evaluation were rated as high. In summary, our study depicts the effectiveness of a unique CSRA program tailored for Black/African American and Hispanic/Latino/a adults, fostering robust communication channels between cancer research advocates and diverse stakeholders. We emphasize the potential of such initiatives in addressing cancer health disparities and advocating to address specific inequalities by imparting educational initiatives in cancer research advocacy. We look forward to evaluating and enhancing our training program with an additional 21 research advocates in our cohort of 2024. Citation Format: Brooke Hensel, Ileana Guzman, Carolina Aristizabal, Eduardo Ibarra, Rosa Barahona, Lourdes Baezconde-Garbanati, Mariana C. Stern, Sandra Suther, Fern J. Webb. Community scientist research advocacy program: Training our research community [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B107.

Healthcare Provision for the LGBT Community: A Scoping Review of Service Providers and User Perspectives

Objective: This scoping review aimed to explore available literature on the knowledge, attitudes, and practices of healthcare professionals on providing care to the lesbian, gay, bisexual, or transgender (LGBT) community as well as the experiences and perspectives of the LGBT community on their healthcare. Material and Methods: The following electronic databases were searched in December 2020: MEDLINE/PubMed, CINAHL, Web of Science, ProQuest, SCOPUS, and Embase for English-language publications; from 2010 to 2020.Results: This review included 59 studies that were selected from 5,318 studies. This review revealed that there was an increase in publications regarding this topic across the world. This review identified four themes: (I) the current healthcare landscape for the LGBT community, (II) facilitators of and (III) barriers to healthcare access and utilization among the LGBT community, and (IV) varied facets of healthcare of relevance for LGBT healthcare users – communication, space, education and training, research, and policies.Conclusion: This review serves as a valuable compass for future researchers seeking areas for deeper exploration and understanding. Nevertheless, the limitations of the study underscore the significance of exercising caution when interpreting its findings concerning challenges within LGBT healthcare.

Extractivism triggering new forms of governance for the rights of nature: The case of Northwest Ecuador

The intensification of resource extractivism around the world poses multiple challenges and fosters the development of new governance structures, especially among communities on the frontlines of resource extraction. Through a narrative inquiry based on narrative interviews with local actors and experts, this article centres on governance as a resistance strategy of local, frontline, communities in the Ecuadorian Northwest Pichincha and Imbabura provinces. The narratives give insights into: a) How new processes of governance are triggered by mining conflict and, in particular, how governance is shaped and manifested; b) Governance challenges faced by local governments and communities; and c) Lessons and recommendations for governance and how these contribute to the discussion of post-extractivism alternatives. New governance processes are shaped through socio-organisational processes and the strengthening of associations and civil society organisations; the institutionalisation of private, civil society, and community conservation initiatives; as well as the actions of the organised community to successfully invoke the Rights of Nature (RoN) through legal litigation. Institutional gaps that reflect competing visions of development are seen as governance challenges by local government and community members. Overall, this study highlights the critical role of governance structures and instruments rooted in frontline community perspectives, offering pathways for the development of post-extractivism alternatives.