Community Work Approach in Addressing Social Problems: Three Community Case Studies from Sri Lanka

Human development is at the center of social work to intervene in diverse problems affecting humanity. Community work is a direct method of community development that attempts to serve many people at a macro level. A community case study documents a local experience about delivering services to meet an identified need. This paper aims to illustrate three examples of community case studies that were developed while working with three diverse communities in Sri Lanka. The first community case study describes efforts to efforts to promote social harmony through child engagement in a rural community with ethnoreligious diversity in the Polonnaruwa District. The second community case study documents prioritizing several problems faced by an urban, underserved community located close to the Kolonnawa Garbage dump in the Colombo District. The third case study is on women's engagement in community development and harmony in a peri-urban community in the Gampaha District. The paper provides evidence for the effectiveness of community work in addressing diverse social issues in communities.

Window to the Destination: Tourists’ Local Experience via “Online Experiences” on Airbnb Amid the Pandemic

This study aims to explore the composition of virtual guided tour experience on Airbnb and to develop a formation process of virtual guided tour experience. A case study based on the qualitative analysis was conducted with a dataset of online reviews towards an Online Experience in Beijing, China. A three-stage process of virtual guided tour experience was concluded, including experience encounter, experience evaluation, and behavioral intention. Experience encounter describes the experience composition from four dimensions: interpretation quality, host credibility, tourist-host social contact, and peer interaction; Experience evaluation is involved with benefits mainly gained from the enhanced understanding of local culture and the satisfaction attributed by the sense of telepresence; Further, behavioral intention covers both online and offline willingness to recommend or repurchase the virtual tour, or visit the destination in person after the pandemic. Theoretical and practical implications in navigating tourism recovery were discussed.

Determinants of Staff Localization in Headquarters-Subsidiary-Subsidiary Relationships

This paper investigates how cultural distance, the local experience of a foreign subsidiary, and the intensity of local competition jointly affect the staff localization of MNEs’ subsidiaries. While previous studies on the effects of cultural distance have mainly focused on the gap between home and host countries, we extend the existing “home-host” country perspective to the home-intermediary-host country relationship. This study regards Korea as an intermediary country and utilizes 520 observations from a unique survey conducted by the Export-Import Bank of Korea from 2006 to 2013. The results suggest that the impact of cultural distance on staff localization is a function of local experience and competitive environment in the home-intermediate-host relationship structure. This paper makes a theoretical contribution to our understanding of the behavior of multinational corporations by expanding the cultural distance perspective between the home and host countries explored in previous research to the home-subsidiary-subsidiary structure.

Experience of Radiology Technologists Performing Peripherally Inserted Central Catheters (PICC)

Purpose We conducted this study to review our local experience of performing peripherally inserted central catheters by interventional radiology technologists. Materials and Methods This is a retrospective study of peripherally inserted central catheters performed by interventional radiology technologists. These procedures were performed using ultrasound guidance for venous puncture and fluoroscopy or electrocardiography guidance followed by chest X-ray to confirm tip location. Results We reviewed all peripherally inserted central catheters performed in interventional radiology between May 2017 and July 2020. The review process included the success rate, number of venous puncture attempts, method of guidance, procedure time, fluoroscopy time, catheter duration to removal, and complications. Conclusion Interventional radiology technologists can perform peripherally inserted central catheters safely with high success rate. Extending interventional radiology technologists' role to perform peripherally inserted central catheters allow interventional radiologists to do more complex procedures. This enhances the workflow, increases the interventional radiology team efficiency, and improves the waiting time.

P-P49 Predicting Future Pathological and Operative Complexity in Pancreatoduodenectomy: 30 Years of Experience

Background Patient selection for pancreatoduodenectomy (PD) is largely based upon local experience and established practice. This study sought to observe changes in complexity and patient cohort over time with the aim of predicting future cohort characteristic of patients undergoing PD. Methods All PDs at our institution between 1988 and 2020 were reviewed (n = 1,878) to observe changing trends in patient demographic, pathological diagnosis, operative factors and postoperative outcomes. Coefficients from regression models were reported as gradients per decade, to quantify the rate of change over time. The resulting models were then plotted to illustrate the trend across the study period, as well as forecasts for subsequent years. Results The annual volume (7 to 128) and proportion of pancreatic ductal adenocarcinoma (PDAC) (28 to 53%) increased at a linear rate. The proportion of associated vein resection (3 to 25%) and technical difficulty (type 2-4; 5 to 28%) increased in a nonlinear way, increasing more rapidly in later times. The average age (48 to 67) increased in a log linear trend. Length of stay reduced by 9.3%, whilst mortality reduced with an odds ratio of 0.69, per decade. Furthermore, When performance at our institution was compared to recently established benchmarks, it was shown that our institution regularly performed within these standards with few exceptions. By 2030 our predictions indicate that the average age will increase to 69, PDAC will comprise 62% of pathology, 40% will have an associated venous resection and 43% will be graded 2-4 in technical difficulty. Length of stay will have reduced to 9.6 days and mortality to 2%. Conclusions Despite increasing complexity of surgery and patient age, length of stay and mortality after PD are reducing. Understanding changes over time permits an estimation of a future surgical cohort where complexity will increase. It is important that surgeons continue to push boundaries. Patient selection, based upon prior experience may inhibit progression and development of services.

Addressing Economic Fragmentation: Modelling Regional Gambling Tourism In The Context Of Social Fields Theory

The trend in development is going from slow withdrawal from mass tourism to a growing demand for small-scale local, customer-tailored travel experiences. The main question is balancing two main tourism development models: mass tourism connected to gambling, on the one hand, and customer-oriented local experience on the other. How should policymakers proceed in shaping the development of policies supporting both models? We discuss case studies proposed to build a qualitative multi-criteria decision model to evaluate the appropriateness of the development of new models encompassing the two mentioned. Therefore, the multi-criteria decision method DEX and the DEXi software tool are practical options for decision support in gambling tourism management. This study quickly analyses basic concepts of the DEX method and possible applications on actual life decisions and valuation problems.

Urethral mobilization and advancement technique in distal types of hypospadias: short-term local experience

Background A prospective study was conducted on 65 cases with distal hypospadias operated using the urethral mobilization technique between July 2017 and December 2019. Patients with proximal hypospadias and those with distal hypospadias, but with a hypoplastic urethra, were excluded from the study. In this technique, the urethral tube was mobilized proximally in a ratio of 3–4:1 (the ratio of mobilized urethral length to the initial distance between the native meatus and the tip of the glans) then positioned distally after creating wide glans wings. The aim of this study was to assess the outcome of the urethral mobilization technique in distal hypospadias in our center. Results The age of patients was ranged 9 months to 7 years old (mean 37.5 months); 17 (26%) cases were already circumcised. During the postoperative follow-up, 62 (95.4%) patients had a good caliber neomeatus with a good and straight urinary stream; the remaining 3 (4.6%) cases developed meatal stenosis which responded well to urethral dilatation. One (1.5%) patient had a minor retraction of neomeatus but remained within the glans and not requiring further intervention. Four (6%) cases developed minor hematoma which was resolved on conservative measures. Six (9.2%) patients developed minor wound infection which was treated with daily dressing and antibiotic coverage. Conclusion The urethral mobilization technique is a good choice for repairing distal hypospadias especially for boys who are previously circumcised as the preputial flap is not required in this technique. It provides good cosmetic and functional results, with a fewer complication rate.

575. Local Experience of Breakthrough SARS-CoV-2 Infections After Full Vaccination

Background SARS-CoV-2 the etiology of COVID-19 has caused more than 33 million cases and almost 600,000 deaths in the United States alone. Vaccination is a vital tool in controlling the pandemic. With accelerated infection rates in various parts of the world, the incidence of variants has risen and threatens to set back the long sought after immunity, provided by available vaccines. The objective of this study was to evaluate the breakthrough infection rate after complete vaccination, in Sangamon County, with a rural and urban population of 195,000 in Central Illinois. Methods Data regarding breakthrough infections collected from the Sangamon County Department of Public Health, included the total number of infections, time after vaccination, age range of those infected and the type of vaccine used. Complete vaccination was defined as 14 days after the single dose of Johnson & Johnson/Janssen or the second dose of Pfizer-BioNTech or Moderna Inc. vaccine. Results The number of fully vaccinated individuals at the time of writing of this study was 87,086 which corresponded to 44.58 % of the total population. The breakthrough infection percentage was calculated as 0.036%. The mean time after vaccination to infection was 49.13 days with a standard deviation of 23.28. Conclusion Breakthrough infections among fully vaccinated individuals in our county, have been quite rare, which points to the high efficacy of the vaccines. A complex number of factors likely contribute to this including virus-related factors i.e. variant forms and specific patient-related factors which are not a part of this study. The afore-mentioned high efficacy rate of the vaccines provides further justification, to continue to pursue a persistent vaccination strategy to mitigate the effects of the SARS-CoV-2 virus. Disclosures All Authors: No reported disclosures

The management of a breast unit during the COVID-19 emergency: a local experience

Introduction: Since breast imaging requires very close contact with patients, a protocol is needed to perform safe daily screening activities during the COVID-19 pandemic. Materials and methods: Patients were triaged and separated into three different clinical scenarios by performing a telephone questionnaire before each diagnostic exam or a nasopharyngeal swab before every recovery. Specific procedures for each scenario are described. Results: From July to October 2020, 994 exams were performed. A total of 16 cancers and 7 suspected COVID-19 patients were identified. No medical were was infected. Conclusion: This protocol is an example of the practical use of guidelines applied to a breast unit to assist specialists in preventing COVID-19 infection and optimizing resources for breast cancer diagnosis.