Cultural adaptation and validation of the Sinhala version of the spiritual needs assessment for patients (S-SNAP) questionnaire.

BACKGROUND: Spiritual support for patients and caregivers of critically ill patients is associated with improved quality of life. This aspect, however, is not incorporated into the current care pathways in Sri Lanka. The Spiritual Needs Assessment for Patients (SNAP) questionnaire, comprised of 3 domains: psychosocial, spiritual and religious, gives a platform for clinicians to assess the spiritual needs of those patients. This study presents the results of validation of the Sinhala version of the SNAP (S-SNAP) questionnaire. METHODS: The SNAP was translated from English to Sinhala using the standard forward and backward translation process. After verifying the content validity, unambiguity and clarity of items in a focused group discussion, and a pilot study, the pre-final version was tested among 267 volunteers with cancer selected from three state-run cancer care institutions. Data were analysed for internal consistency and item-total correlations. Factor analysis was done using Varimax rotation with Kaiser normalization. A Scree plot was also made to determine the number of factors. RESULTS: The mean (SD) age of subjects was 63.2 (11.4) years. The total S-SNAP score ranged from 22 to 88 (maximum 88). The overall Cronbach's alpha was 0.94 while item-total correlations varied from 0.26 to 0.87. Total SNAP score showed inverse correlations with age, Charleson Comorbidity index and Barthel index while a positive correlation was seen with the Karnofsky performance status scale (p < 0.05). Kaiser-Meyer-Olkein value of 0.92 (P = < 0.001) for Bartlett's test indicated adequate sampling and non-linearity of factors. The scree plot showed a four-factor structure explaining 76% variation. Meaning of life and relationship with a supernatural being and religious rituals are loaded as 2 different factors. Worries, fears and forgiveness are grouped as the third factor while relaxation, coping and sharing feelings are loaded separately. CONCLUSIONS: The S-SNAP is a reliable and valid tool to assess spiritual suffering among patients with cancers conversant in the Sinhala language.

Internal Medicine Residents' Confidence and Preferences in Hospital Medicine Competencies: A Multi-Site Study.

BACKGROUND: Hospital medicine (HM) is an important career option for internal medicine (IM) residency graduates. Limited data exist regarding preferences and educational gaps in HM competencies among IM residents. OBJECTIVE: To assess resident confidence and desire for additional instruction in HM competencies across a broad spectrum of residents. DESIGN: A multi-center survey-based assessment of IM resident confidence and desire for additional instruction in published HM competencies. PARTICIPANTS: PGY-1 through PGY-4 residents from eight US IM residency programs, including academic medical center (AMC) and community-based programs (CBPs). MAIN MEASURES: Resident confidence and desire for more teaching in HM competency domains including procedures, point-of-care ultrasound (POCUS), system-level competencies, clinical skills, patient-level competencies, palliative care, and care transitions. KEY RESULTS: We received survey responses from 272 of 594 (46%) residents. More than half of respondents envisioned a future HM position. Results demonstrated lower than expected confidence for all HM competencies surveyed. Confidence was lowest (30-36% confident) for procedures, POCUS, and system-level competencies, and highest (65-78%) in care transitions, patient-level competencies, and palliative care. Desire for more instruction was highest in the same competency domains rated with the lowest confidence. Junior residents (PGY-1 and PGY-2) reported significantly lower confidence levels than senior residents (PGY-3 and PGY-4) across all domains except patient-level competencies. Junior residents expressed a significantly higher desire than senior residents for more teaching in all domains. There were no significant differences in confidence or desire for more instruction between trainees who envision a future HM position versus those who do not. Residents from AMCs expressed significantly higher confidence than those from CBPs in POCUS, clinical skill, patient-level, palliative care, and care transitions, while residents from CBPs reported significantly higher confidence in procedures. CONCLUSIONS: Our data can inform targeted inpatient competencies and educational curricula for IM residents in the USA.

Cross-cultural adaptation and validation of the 2021 Louisiana Needs Assessment Questionnaire for Arabic-speaking people living with HIV.

BACKGROUND: Despite the global decline in HIV infections and mortality worldwide, the HIV epidemic is still growing in the MENA region. In the region, People Living with HIV (PLWH) are facing many challenges related to cultural values, norms, and provided services which create significant obstacles to HIV prevention and control efforts. This study aimed to translate, culturally adapt, and validate the "2021 Louisiana Needs Assessment Questionnaire" for use among Egyptians and Arabic-speaking population. METHODS: Arabic translation and cultural adaptation of the questionnaire passed through five stages. The questionnaire was translated forward and backward then an expert committee reviewed the translated version. Another expert committee reviewed the developed version after modification to assess the content validity using the Content Validity Index (CVI). The last step included a cognitive interview of a convenient sample of 50 adult PLWH in five consecutive rounds to assess subjects' understanding of questions and response items and their meanings. RESULTS: Modifications were carried out all through the translation and adaptation process of the questionnaire including used words, nomenclature of services, adding or omitting response items, and ordering of questions and response items. The synthesized Arabic-adapted questionnaire has adequate content validity and all questions are clearly understood by the studied subjects. The calculated Content Validity Index of all questionnaire items ranged from 0.82 to 1. CONCLUSION: The developed culturally adapted questionnaire has adequate content validity/semantic appropriateness. It can be used to assess the needs of PLWH in the MENA region with minor adaptations to fit each country. It can also be used to follow the outcome and impact of implemented programs and services. Further research is recommended to assess its psychometric properties.

Medical Students' Readiness for Prescription Communication Skills Training: A Needs Assessment Study.

Background and objectives The quality of doctor-patient communication plays a crucial role in determining positive medical outcomes. Medical educators may be able to develop effective programs to orient the students toward learning communication skills with the aid of assessment of the attitude of medical students toward such learning. Recently, the National Medical Commission's updated syllabus strongly emphasized on the value of training in prescription communication skills (PCS), in pharmacology. Our study utilizes the Communication Skills Attitude Scale (CSAS) to explore medical students' attitudes toward learning PCS in a private medical college, aiming to address the dearth of data in the Indian context. Methodology This cross-sectional study assessed the attitudes of 131 second-year medical students at Adichunchanagiri Institute of Medical Sciences toward PCS training. Validated, 26-item CSAS was used to measure their attitudes which include 13 items of Positive Attitude Scale (PAS) and 13 items of Negative Attitude Scale (NAS), and data analysis was conducted using independent t-tests to explore potential associations based on socio-demographic factors. Results The study scale showed an acceptable internal consistency of 0.71 (Cronbach's alpha) with 0.92 and 0.76 for PAS and NAS, respectively. The overall mean PAS score and NAS score were 54.2±6.9 and 34.7±6.3, respectively, indicating that the majority of students recognized the significance of communication skills for their future medical practice. Male students had significantly lower PAS scores (52.1±7.4) compared to female students (55±6.6) (p=0.02). Students with a rural background had significantly higher PAS scores (56.2±6.1) (p=0.01) compared to those with an urban background (53.2±9.8). No significant association was seen with demographic parameters like schooling background, presence of doctors in the family, and mother tongue they spoke. Conclusion The study revealed that second-year medical students had a strong inclination toward learning PCS. Therefore, greater emphasis should be placed on providing adequate training in PCS to the students to ensure effective doctor-patient interactions.

Needs assessment of military medicine education curriculum in medical students and upcoming challenges.

Introduction: The curriculum of military medicine for medical students of universities of military medical sciences is a priority and a practical goal. Paying attention to the educational needs of students creates vitality and motivation among students for better learning and improving the learning environment. Frequent monitoring and updating of the content of military courses and modern teaching improve the quality and quantity of the military medicine curriculum. Materials and Methods: This applied, inductive, and exploratory descriptive was conducted in a single cross-sectional and qualitative method. The data were collected using the brainstorming method and individual and collective Delphi techniques. The population included the medical students of Baqiyatallah University of Medical Sciences in Tehran, Iran, who completed the course in military medicine. The data were collected by purposive sampling and classified until the saturation limit was reached. EXCEL 2019 and MAXQDA2020 software were used for data analysis. Findings: This research was carried out in collaboration with the military medicine department of the university to identify the needs of students in the military medicine curriculum. First, the findings were collected in 22 axes. In the next step, the needs were prioritized in the four main components of the combat medicine curriculum (1 goal, 2 content, 3 teaching strategy, 4 evaluation), and the results were extracted. Conclusion: Identifying the needs of students; improving the current military medicine curriculum; paying attention to individual differences, interests, and talents of students; and enhancing the motivation and level of satisfaction of students are the study results.

GP Engagement: A Proposed Model to Guide Engagement Activities in Australian Primary Health Networks.

BACKGROUND: Engagement with general practice is a requirement of Australia's Primary Health Networks (PHNs). We propose a model for engagement that draws on principles of stakeholder and clinician engagement, tailored to meet the needs of PHNs and general practitioners (GPs). METHODS: A comprehensive literature review was undertaken to identify components, challenges, and approaches to optimizing clinician engagement. Interviews with GPs (n = 18), other practice staff (n = 12), PHN staff, and other stakeholders (n = 15) across 3 PHN regions in Victoria, Australia, were used to identify perceived needs of GPs and opportunities for engagement with PHNs. Interview transcripts, notes, and contact summaries were collated and organized using QSR NVivo to support the process of coding and identification of common themes and perspectives. Information from the literature and interviews was synthesized to inform development of a model for GP engagement that could guide GP strategy and engagement activities undertaken by PHNs. FINDINGS: PHNs engaged with GPs for accreditation, quality improvement, data sharing, continuing professional development, commissioning, and population health initiatives, among others. GPs were motivated to engage with PHNs, however, the roles of PHNs and benefits of engagement were not always clear. A model to support PHN engagement with general practice was developed comprising: (1) Organizational values for engagement; (2) Needs of GPs; (3) Areas of engagement; (4) Stages of engagement; (5) Communication planning; and (6) Monitoring and Evaluation. CONCLUSION: The proposed model represents contemporary understanding in clinician engagement, drawing upon concepts from community and stakeholder engagement, and extending established models for engagement into the setting of general practice.

Health Needs and Priorities of an Underserved Karenni Refugee Community: A Community Needs Assessment.

Background: Southeast Asian refugee communities are frequently underserved by social and medical systems and experience profound health and health care inequities. The purpose of this study was to detail the health needs, priorities, and health care utilization of the Karenni, a Southeast Asian refugee community, in Forsyth County, North Carolina. Methods: A mixed-mode survey (i.e., online and in-person) was distributed in Kayah, Burmese, and English to Karenni adults in Forsyth County. Quantitative and qualitative questions focused on community health needs, health and public health service utilization, and social determinants of health. Results: 101 Karenni adults completed the survey, with a total of 91 participants completing the quantitative portion (N = 91). Utilization of health care and public health services was low and impacted by individual- and contextual-level barriers, such as limited English profi-ciency and social determinants of health (e.g., lower levels of education and employment compared to state and national averages). Mental health, chronic pain, and health care access were highlighted as prominent community concerns while theh plaw theh jie (togetherness) and community organizations were described as community strengths. Limitations: Data were collected using convenience sampling, and limited knowledge from the Karenni community regarding research served as a barrier to recruitment. Some sensitive questions (e.g., income) also experienced higher levels of missingness. Conclusion: This assessment highlights the need to increase engagement with and lower barriers to care for the Karenni community in Forsyth County, North Carolina. To produce culturally congruent and acceptable care, public health and health care systems should partner with the community to identify and address community needs and priorities, harness assets, and mitigate health and health care inequities.

Determining the Need for Palliative Care Patients with Multiple Sclerosis-A Cross-Sectional Study.

BACKGROUND/OBJECTIVES: Multiple sclerosis is characterised by the manifestation of heterogeneous symptoms that affect daily functioning. Patients face physical impairment, psychological problems and socioeconomic changes. Depending on the form of the disease, they may have different needs, which are often unsatisfied and could be overcome by including palliative care in the treatment. Despite the above, not enough is known about this population's needs for palliative care. This cross-sectional study aimed to identify the need for palliative care and assess the functional dependence level in daily living activities in patients with multiple sclerosis. METHODS: The sample consisted of 120 patients from the Neurology Clinic of the University Clinical Center of Vojvodina, Serbia. The following research instruments were used: a General questionnaire, Sheffield Profile for Assessment and Referral for Care, Multiple Sclerosis Impact Scale and Barthel Index. RESULTS: The need for palliative care was expressed by 36.7% of patients, who expressed the most concern for the physical symptoms, independence and activity domains. Also, it was determined that the disease prevents patients from doing demanding physical tasks and that they are worried about multiple sclerosis. Almost a quarter of patients have had complete/severe dependence on other persons in performing daily activities. CONCLUSIONS: The most frequently reported physical symptoms by patients with MS were weakness, bladder problems, fatigue and different levels of dependence, while concerns related to sexual health, low mood and anxiety emerged as key challenges in the psychological domain. These findings underscore the importance of conducting needs assessments to guide the development of an appropriate palliative care model for MS patients.

Using a Patient-Reported Outcome Measure to Assess Physical, Psychosocial, and Existential Issues in COPD.

Background: Chronic obstructive pulmonary disease (COPD) is marked by severe physical symptoms, impaired quality of life, and high psychological distress. Despite its impact, the identification of not only physical but also psychosocial and existential issues in the clinic lags behind that of other patient groups. Methods: This study aimed to assess physical, psychosocial, and existential issues among patients with COPD using a patient-reported outcome measure for general palliative care (the 'PRO-Pall') in a Danish outpatient clinic. We included 115 adults with COPD who completed the PRO-Pall either electronically or in the clinic. Sociodemographic and illness-related data were retrieved from their electronic health records. Results: We found that shortness of breath, tiredness, and difficulty walking were predominant physical issues. Worry about change in social roles was the most frequently reported psychosocial issue, while existential issues were reported by approximately one in ten patients. Most patients (44.5%) felt able to share their feelings with family or friends, and a majority (62.2%) felt their illness-related issues were addressed satisfactorily. Females expressed a greater need for rest and males more frequently reported intimacy issues. Higher COPD-impact on life measured by the COPD Assessment Test was associated with lower ratings on the quality-of-life item of the PRO-Pall independent of age, gender, lung function, and smoking status. Conclusions: Patients reported issues in physical, psychosocial, and existential dimensions of the PRO-Pall. The PRO-Pall shows potential as a broader alternative to measures that focus mainly on physical issues.

Addressing Hispanic Veterans that Live in Rural Area's Needs to Improve Suicide Prevention Efforts.

Despite the alarming recent increase in suicide rates among Hispanic Veterans, suicide among this population remains relatively understudied and little is known about their needs and how to prevent suicide in this population. A mixed methods approach was utilized to conduct a needs assessment of community suicide prevention services and resources available to Hispanic Veterans living in rural areas in the Veterans Health Administration's Veterans Integrated Services Network (VISN) 8. Five themes related to the suicide prevention's needs and gaps in services were identified: (1) lack of adequate information; (2) disruptions in social support network; (3) limited or lack of access to services; (4) risky behaviors; and (5) natural disasters. Understanding the unique needs of Hispanic Veterans in rural communities and the gaps in services in these areas can help in the development of tailored suicide prevention efforts and potentially mitigate suicide disparities.

Nurse-related behavioural determinants associated with healthy eating support provided by Dutch community nurses: a cross-sectional study.

BACKGROUND: Community nurses (CNs) play an important role in supporting healthy lifestyles, including healthy eating behaviour of patients. However, many CNs do not incorporate healthy eating support in their daily routines to the fullest extent possible. This study aimed to explore (1) the associations between nurse-related behavioural determinants and self-reported healthy eating support practices of Dutch CNs and (2) CNs' need for additional knowledge. METHODS: In this cross-sectional survey design, 244 Dutch CNs completed an online, self-administered questionnaire in October-November 2021. The 60 questionnaire items were related to CNs' characteristics, nurse-related determinants, healthy eating support practices (observing problems, having a conversation about patients' dietary behaviour, motivating patients to eat and drink healthier and supporting patients in goal setting) and the need for additional knowledge. The items on determinants and practices used a 5-point Likert scale. Adjusted prevalence ratios (PRadjusted) with 95% confidence intervals (95%CIs) were obtained for the associations between determinants and practices, using adjusted Poisson regression with robust variance estimations. RESULTS: More CNs practiced observing problems (75%) and having a conversation (70%) than did motivating patients (45%) and supporting goal setting (28%) at least often. A more positive attitude (PRadjusted 1.8; 95%CI 1.5-2.2), greater self-efficacy (PRadjusted 1.3; 95%CI 1.1-1.5), greater motivation (PRadjusted 1.5; 95%CI 1.3-1.7) and better abilities (PRadjusted 1.4; 95%CI 1.2-1.6) were associated with a greater prevalence of supporting healthy eating at least often (vs. never to sometimes). Barriers were not associated with healthy eating support (PRadjusted 1.1; 95%CI 1.0-1.2). CNs especially desired more knowledge on diet in relation to cancer, gastrointestinal diseases, severe psychiatric diseases and dementia; methods for motivating patients to start and for supporting patients to sustain healthy eating; and dealing with patient autonomy. CONCLUSIONS: This study suggests that nurse-related behavioural determinants such as attitude, self-efficacy, motivation and ability should be addressed to improve CNs' competences in healthy eating support. In addition, based on self-reported need for additional knowledge, it is recommended to pay attention to evidence-based behaviour change techniques, dealing with patient autonomy, and diet in relation to cancer, gastrointestinal diseases, severe psychiatric diseases and dementia. REPORTING METHOD: The STROBE Statement was followed for reporting.

Changes in hospital-supported substance use services across US nonprofit hospitals, 2015-2021.

Substance use remains a timely and important community need to understand and address. Nonprofit hospitals are in a unique position to identify needs and develop programs in response to substance use challenges in their communities. To better understand how nonprofit hospitals do this, we collected data from community health needs assessments and their corresponding implementation strategy (IS) to address these needs for a 20% random sample of hospitals in each state of the United States over 2 periods (2015-2018 and 2019-2021). The sample of nonprofit hospitals came from the American Hospital Association's (AHA) Annual Survey Database. Community health needs assessment and IS documents were coded for the inclusion of substance use programs using a systematic protocol and analyzed quantitatively. We found that the percentage of nonprofit hospitals in our sample with at least 1 substance use program increased from 66.5% in 2015-2018 to 73.6% in 2019-2021. Of the types of programs analyzed, harm reduction approaches saw the greatest increase in implementation in the time period studied, while primary care approaches decreased. This indicates that hospitals are continuing or even increasing their responses to community needs regarding substance use, but there is evidence that their approaches in doing so are shifting over time.

Support needs of gout patients and suitability of eHealth to address these needs.

Objectives: To investigate the support needs of patients with gout regarding information, communication, treatment and disease monitoring, and patients' views on and preferences for eHealth applications to address these needs. Methods: A focus group study using purposive sampling was conducted. Three focus group sessions with a duration of 2 h per group were held with in total of 23 patients using urate-lowering therapy, recruited from primary and secondary care. Audio recordings were transcribed, and data were analysed using thematic analysis. Results: Eight themes were identified. Five themes addressed support needs of gout patients and suitability of eHealth in addressing those needs: (1) Timely access to healthcare, especially during flares; (2) (personalized) information regarding diagnosis, medication, and diet; (3) insight into uric acid levels and medication side effects through blood monitoring; (4) better coordination across primary and secondary care; and (5) self-management and shared responsibility over care for maintaining health. Three themes addressed eHealth in general: (1) receptive towards eHealth in gout care; (2) the preference for eHealth to have a complementary role (i.e. not replacing face-to-face) contact with healthcare providers; and (3) preferences on eHealth use and functionalities. Conclusion: Patients expressed various needs regarding their disease management and projected a supporting role for eHealth in (self)management of gout. Addressing the needs and preferences of patients could enhance their understanding of the disease and treatment, self-management, and possibly health outcomes.

Understanding Nonpharmacologic Palliative Care for People With Serious COPD: The Individual and Organizational Perspective.

TOPIC IMPORTANCE: This narrative review emphasizes the growing interest in palliative care for people with serious lung diseases such as COPD. It reflects on recent publications from the American Thoracic Society, the World Health Organization, and European Respiratory Society, with a focus on nonpharmacologic palliative care for people with COPD from both the health care professional and organizational perspective. REVIEW FINDINGS: The concept of palliative care has changed over time and is now seen as applicable throughout the entire disease trajectory according to need, in conjunction with any disease-modifying therapies. Palliative care should pay attention to the needs of the person with COPD as well as the informal caregiver. Timely integration of palliative care with disease-modifying treatment requires assessment of needs at the individual level as well as organizational changes. High-quality communication, including advance care planning, is a cornerstone of palliative care. SUMMARY: Therefore, services should be based on the understanding that palliative care is not only specific standardized actions and treatments, but rather a holistic approach that includes compassionate communication, treatment, and care addressing the patient and informal and formal caregivers. Living with and dying of COPD is much more than objective measurements. It is the sum of relationships with others and the experience of living in the best possible harmony with one's own values and hopes, despite having a serious illness.

Empowering Continuing Medical Education (CME) in India: leveraging Kern's instructional design model.

INTRODUCTION: Continuing Medical Education (CME) is vital for healthcare professionals to remain current with advancements and maintain their competence. In India, CME remains in its early stages, lacking a systematic approach. There is a pressing need for a comprehensive framework that addresses needs assessment, program development, accreditation, and credit allocation. Specifically, there is a gap in delivering targeted CME that meets the needs of different medical professionals at appropriate times. The aim of this study is to employ Kern's six steps of curriculum design to plan and evaluate a faculty development program focused on Entrustable Professional Activities (EPAs) for MD (Doctor of Medicine) Biochemistry professionals. METHODS: This study utilized Kern's six-step approach to design a training program on Entrustable Professional Activities (EPAs) tailored for MD Biochemistry professionals. Approval was obtained from the Institutional Human Ethics Committee. Following problem identification, a targeted needs assessment was conducted through expert consultations. The goal of the program was established, focusing on the development and delivery of an interactive online CME program. The program was developed, implemented and evaluated using surveys and feedback questionnaires. RESULTS: A comprehensive literature review revealed a notable gap in EPA-related works for MD Biochemistry program. Expert consultations highlighted significant training needs and barriers, such as limited resources and professional commitments. Consequently, the program's primary objective was to raise awareness and sensitize participants to EPA development. A 4-h online CME was designed, featuring expert-led sessions and collaborative group activities. The program attracted 152 participants and utilized interactive elements, such as polls and chats, to foster engagement. Group activities allowed participants to apply concepts in EPA validation. Pre- and post-program surveys demonstrated significant improvements in participants' knowledge and confidence. Feedback highlighted the practical relevance of the content and the interactive, hands-on nature of the sessions. CONCLUSION: Kern's six-step approach provided a structured and effective framework for developing the CME program, addressing identified needs and barriers, and enhancing faculty development in MD Biochemistry. This study underscores the importance of a systematic approach in CME to improve program effectiveness. TRIAL REGISTRATION: Not applicable.

Training Needs Analysis for Medical Students in Assessing Cognitive Functioning: An Observational Study.

Backgrounds: Research shows that medical students' knowledge and skills concerning the assessment of cognition in various neuropsychiatric conditions (e.g., Alzheimer's disease and schizophrenia) are unsatisfactory. This research aims to conduct a training needs analysis (TNA) for medical students to identify and refer patients with neuropsychiatric conditions. Methods: The study comprised two phases. First, developing a TNA toolkit to assess training needs in clinical tasks related to cognitive function assessment (by adopting the Hennessy-Hicks TNA toolkit); and second, through a self-reported survey, their training needs in cognitive function assessment were assessed. Data analysis involved calculating training gaps, importance scores, performance scores, training scores, and organization scores for various clinical tasks-stratified participants' study year; for training needs and trends, factor analysis and post-hoc analyses were conducted. Results: A total of 153 medical students from a tertiary care center participated in the survey. The participants rated their performance lower than the perceived importance of tasks, indicating a need for improvement in all competencies (P < .01). Pre-final-year students had the highest training needs, particularly in accessing literature, planning, and organizing care for patients with cognitive impairment, performing mental status examination, screening patients for cognitive deficits, and counseling them/caregivers about interventions (P < .01). Factor analysis identified a single dominant factor, suggesting a correlation among these skills. Conclusion: Pre-final-year students require targeted training, whereas students beyond this stage can benefit from special training modules and awareness of available resources for cognitive assessment. The findings also suggest the importance of a hybrid approach involving training and organizational modifications.

Testing and refining an approach to identifying health and social care needs in probation.

We piloted an approach to identifying the health and social care needs of people on probation using a survey consisting of validated screening tools and key additional questions. We share findings from our analysis of the sample data, showing that there is a high complexity of needs in this population, with 65.4% of participants reporting at least one unmet need. We also explore the acceptability of this approach to identifying needs being used in routine probation practice and make recommendations about how identification and recording of needs could be approached and further researched in the future.

Assessment of the Need for Designing an Interactive Educational Tool on Exophytic Lesions of the Oral Mucosa.

Introduction This study sought to evaluate the necessity of creating an interactive educational resource for instructing dental students on oral exophytic lesions. It also aimed to determine the validity and reliability of a questionnaire designed to assess the quality of educational software tailored to these lesions. Materials and methods This descriptive cross-sectional study involved 102 dental students from Mashhad University of Medical Sciences, Iran, who had completed the theoretical course on oral exophytic lesions. A paper questionnaire, including 23 items, assessed their clinical knowledge, the efficacy and limitations of existing educational resources, and the need for interactive electronic courseware (e-courseware). The questionnaire's validity and reliability were evaluated through expert feedback and statistical measures (intraclass correlation coefficient (ICC) and Cronbach's alpha). Results Students' answers to the seven items about evaluating their clinical diagnosis knowledge of oral exophytic lesions were between four and five items correct on average. This finding indicated that students' overall skill in diagnosing exophytic lesions was poor to moderate. The study highlighted a moderate level of self-assessed clinical ability in diagnosing oral exophytic lesions among students (62.7%), with a preference for textbooks and color atlases as primary information sources. The disadvantages of existing electronic resources were noted, alongside a strong student consensus (88.23%) on the need for interactive e-courseware featuring comprehensive, visually engaging content for differential diagnosis education. The reliability and validity analyses of the questionnaire underscored its appropriateness for assessing educational needs. In this regard, ICC for the usability of scientific context, training ability, and interaction was 0.92, 0.73, and 0.82, respectively. Also, Cronbach's alpha score was at 0.90. Conclusion The research underscores a significant gap in dental students' knowledge and diagnostic skills regarding oral exophytic lesions. It emphasizes the critical need for an innovative, interactive educational tool that aligns with contemporary students' digital learning preferences. The envisioned e-courseware would facilitate self-learning and address current resources' limitations, potentially transforming dental education by enhancing clinical diagnostic skills through accessible, effective, and engaging digital content.

Development of an evaluation list for older adult community-based rehabilitation needs through a Delphi method.

Older adults' functional and intrinsic abilities may decline with increasing age. The positive effects of comprehensive community-based rehabilitation services to maintain physical, mental, and social function are essential. Nevertheless, few tools are available to assess the community-based rehabilitation needs of older adults. Therefore, we aimed to construct a list for the comprehensive evaluation of community-based rehabilitation needs of older adults. The International Classification of Functioning, Disability, and Health (ICF) was used to construct a first draft of the assessment list. From September to November 2023, 18 experts from five provinces and nine tertiary hospitals and institutions of higher education in China participated in this Delphi study. The older adult community-based rehabilitation needs evaluation list included six dimensions and 29 items. The weights of the six dimensions, from high to low, included mental function rehabilitation need (0.30), body function rehabilitation need (0.24), social participation need (0.18), individual activity rehabilitation need (0.14), environmental rehabilitation need (0.09) and rehabilitation information need (0.05). Using the Delphi method, an assessment list of older adult community-based rehabilitation needs based on ICF was developed. Future work should evaluate the list's reliability and validity and its application in managing community-based rehabilitation for older adults.

[Project Alifara: a participatory health needs assessment in a rural area in the Valencian County]. / Proyecto Alifara: experiencia de un análisis de salud participativo en comunidades rurales de la Comunidad Valenciana.

A description of the Alifara Project is provided a participatory process to promote community health. In 2020, a core working group was created in the rural region of Els Ports, in the north of the Valencian Community, Spain, with the participation of 39 people, including professionals and community members. The core group itself designed the first health needs assessment survey, based on the health determinants they considered relevant in their context, and 1180 responses were collected. The results were presented in each town through focus groups or world café to gather suggestions for health promoting activities to implement locally. Finally, the process set the basis for the creation of a local health council, to implement the new Community Health Care Plan of the Valencian Community. Community engagement and partnerships were the key to the success of the process, while the limited resources and lack of training in data analysis were the main challenges.