St. Louis Enhancing Engagement and Retention in HIV/AIDS Care (STEER): a participatory intersectional needs assessment for intervention and implementation planning.

Background Missouri is one of seven priority states identified by the Ending the HIV Epidemic Initiative, and St. Louis contains almost half of the people living with HIV (PLWH) in Missouri. As St. Louis has a marked history of structural racism and economic inequities, we utilized the Intersectionality Based Policy Analysis (IBPA) framework to guide a participatory needs assessment for planning and program development. Methods The planning team included researchers, the lead implementer from our community partner, and two community representatives, and had biweekly 60-90 minute meetings for 18 months. The planning team discussed and approved all research materials, reviewed and interpreted results, and made decisions about outreach, recruitment, conduct of the needs assessment and development of the planned intervention. The needs assessment integrated information from existing data, (1) interviews with (a) PLWH (n=12), (b) community leaders (n=5), (c) clinical leaders (n=4), and (d) community health workers (CHWs) (n=3) and (e) CHW supervisors (n=3) who participated in a Boston University-led demonstration project on CHWs in the context of HIV and (2) focus groups (2 FG, 12 participants) with front line health workers such as peer specialists, health coaches and outreach workers. A rapid qualitative analysis approach was used for all interviews and focus groups. Results The IBPA was used to guide team discussions of team values, definition and framing of the problem, questions and topics in the key informant interviews, and implementation strategies. Applying the IBPA framework contributed to a focus on intersectional drivers of inequities in HIV services. The effective management of HIV faces significant challenges from high provider turnover, insufficient integration of CHWs into care teams, and organizational limitations in tailoring treatment plans. Increasing use of CHWs for HIV treatment and prevention also faces challenges. People living with HIV (PLWH) encounter multiple barriers such as stigma, lack of social support, co-morbidities, medication side effects and difficulties in meeting basic needs. Conclusions Addressing intersectional drivers of health inequities may require multi-level, structural approaches. We see the IBPA as a valuable tool for participatory planning while integrating community engagement principles in program and implementation design for improving HIV outcomes.

Medicina familiar y comunitaria: la especialidad más elegida en el MIR / Family and community medicine: The most chosen specialty in the MIR

Medicina Familiar y Comunitaria es la especialidad más ofertada y elegida en el MIR, sin embargo, cada año se cuestiona su atractivo debido que no se ocupan todas las plazas ofertadas y un determinado número de médicos residentes desisten de continuar en dicha especialidad una vez iniciada. En este contexto algunas de las propuestas que se plantean para abordar el problema se centran en incrementar la oferta cuando los hechos muestran que el reto está en actuar sobre la demanda haciendo más atractiva la especialidad y su ámbito de ejercicio profesional. Se procede a analizar este problema y sus condicionantes abriendo el foco del análisis a 4 elementos que pueden estar influyendo en el mismo: los aspectos vocacionales de los graduados en medicina que acuden a la especialización, las características del programa de la especialidad y de las unidades docentes en las que se lleva a cabo la formación, la presencia de la medicina de familia en la universidad como elemento clave para el conocimiento y la afección a dicha especialidad desde el grado y finalmente la situación de la atención primaria, como espacio en el que se materializa la formación y lugar prioritario de desempeño profesional de los futuros especialistas. (AU)

Family and Community Medicine is the most offered and chosen specialty in the MIR (Spanish medical residency examination), however, every year its attractiveness is questioned due to not all offered positions being filled and a certain number of resident doctors deciding not to continue in this specialty once started. In this context, some of the proposals to address the problem focus on increasing the supply when the facts show that the challenge lies in addressing the demand by making the specialty and its professional scope more attractive. The problem and its determinants are analyzed in this context by focusing on four elements that may be influencing it: the vocational aspects of medical graduates who pursue specialization, the characteristics of the specialty program and the teaching units where training is carried out, the presence of family medicine in the university as a key element for knowledge and affinity to this specialty from undergraduate studies, and finally, the situation of primary care as the space where training is materialized and the priority setting for the professional practice of future specialists. (AU)

Development of A Suicide Prevention Training Module for Social Work Students in India.

Introduction: Social workers constitute a significant task force that serves diverse populations experiencing psychosocial challenges in their daily lives. Lack of suicide prevention content/training in the Master of Social Work program may affect the student's self-esteem/ability to intervene when they come across a person with suicidality in the field. Developing a suicide prevention training module for social work students would be a suitable measure for upbringing their skills in dealing with individuals with suicidality. Method: The purpose of the present study was to develop a suicide prevention training module for social work students at the postgraduate level. The researcher conducted two Focused Group Discussions (FGD) each with social work students (n = 13) and social work educators (n = 15) on an online platform. Notes were taken during the discussion, and the contents were videotaped. The videotaped content was transcribed, and content analysis was used to analyze the data. The content that emerged from the FGD with social work students and educators was discussed in later FGD with mental health experts (two psychiatrists, one psychologist, two psychiatric social workers, and two mental health nurses). The discussion with experts clarified what components to retain for the training program. Results: Five major themes and 22 sub-themes emerged from the two FGDs each with students and educators, and one FGD with mental health professionals are described. The five major themes were understanding of suicidality, understanding suicide education in the master of social work curriculum, experience with suicidality, training content suggestion, and suggestions for future implications. Conclusions: The present study identified the need for suicide prevention training in postgraduate-level social work students. Furthermore, a lack of suicide prevention training was observed indicating the incorporation of suicide education in the postgraduate curriculum.

Comparison of Maslow's hierarchy of needs, decision-making, and attention control in individuals with sex addiction and normal people.

BACKGROUND AND PURPOSE: Sexual addiction as a neglected disorder requires investigation and exploration as it affects various aspects of individual's personal and social lives. Therefore, the current research purpose was to examine the afflicted individuals from the standpoints of Maslow's hierarchy of needs, decision-making styles, and the function of attention. MATERIALS AND METHODS: The research population of this study included all students of Isfahan University during the academic year January 2020 to February 2021, and after the screening, a total of 200 individuals were selected as a research sample and divided into two groups: the group with sexual addiction and the healthy group. Subsequently, both groups completed questionnaires related to Maslow's Hierarchy of Needs Questionnaire (MHNQ), General Decision-Making Style Questionnaire, and Attention Control Scale (ACS). FINDINGS: The results of multivariate analysis of variance showed significant differences between two groups, normal and abnormal, in the needs for safety and the need for respect from Maslow's hierarchy of needs, decision-making styles (intuitive, dependent, and spontaneous), and the focus maintenance of attention in attentional functioning (P < 0/001). The variables of physiological needs, belongingness, and self-actualization in Maslow groups, normal and abnormal, decision-making styles, and the subscale of attention switching in attentional functioning did not show any significant difference in the two groups. CONCLUSION: Overall, it appears that fixing (stabilization) in one category and returning (regression) in the stages of Maslow's hierarchy of needs, attention deficits including excessive or hyper-focused attention, malfunctioning in the decision-making process, and an impulsive, desire-driven approach, may significantly account for the difference observed between the two groups in these variables.

Interprofessional Educational Needs for Shared Governance of Integrated Care.

Introduction: This study investigated the educational needs of integrated care among professionals in the public sector of healthcare and social care services in South Korea. Methods: A cross-sectional secondary data analysis was performed. Original data were obtained from 10 metropolitan communities with a convenience sample of 210 integrated care professionals. The Borich Needs Assessment Model and the Locus for Focus Model were used to examine the priority educational needs of each integrated care professional. Results: This study analyzed the key details of educational needs in integrated care by focusing on the competencies of integrated care approaches for person-centered care, interprofessional collaboration, and community involvement. The core educational needs of community care administrators, care coordinators, healthcare and social care providers, and community health champions, which are common to all professionals, and the specific educational needs for each type of professional were demonstrated, which contained specific content to implement integrated care. Conclusion: This study provides an opportunity to comprehensively understand the educational needs of integrated care professionals based on their competencies. They want better interprofessional cooperation through networking and collaborative strategies. The results of this study may be utilized as fundamental data by future instructors to provide evidence-based education programs.

[Advancing standards for the development of evidence-based health information for consumers: Needs and priorities among members of the Network for Evidence-based Medicine]. / Inhaltliche Weiterentwicklung von Standards zur Erstellung evidenzbasierter Gesundheitsinformationen: Eine Bedarfserhebung und Priorisierung im EbM-Netzwerk.

BACKGROUND: The Good Practice Guidelines for health information, Good Health Information Austria and Guideline Evidence-based Health Information are established resources for developing evidence-based health information in the German-speaking regions. The aim of this project was to capture challenges in applying these standards in practice, identify gaps and development needs and gain insights for their further development. METHODS: In December 2020, members of the working group for patient information and involvement of the Network for Evidence-based Medicine were invited to share their experiences and needs in applying German standards for evidence-based health information through an online survey focussing on open questions (part 1: needs assessment). The feedback was analysed using qualitative content analysis and presented in a workshop at the EbM Congress 2021 with the goal of specifying the feedback from the needs assessment and discussing ideas for the further development of the standards (part 2: specification). In the final step, a second survey was conducted in February 2023 to prioritize the identified topics by the working group members (part 3: prioritization). The results were analysed descriptively. RESULTS: Among the 41 participants, only 23% considered the standards to be sufficient, and only 55% found their application in the development of information to be easy or rather easy. The needs assessment and workshop (n=46) helped to identify various areas of action. With regard to the application of the standards, the following challenges were identified: lack of user orientation, content gaps, methods and risk communication. Gaps in the standards were identified regarding formats, content, and the connection to healthcare provision. For the advancement of the standards ideas for additional content, stakeholder involvement, and improvement of the usability of the standards were identified. In the prioritization survey, the topic areas, "presenting benefits and harms" and "content beyond treatments (in particular, diagnostics and prognosis)" were considered to be the most important (n=36). DISCUSSION: Among members of the working group for patient information and involvement of the German Network for Evidence-based Medicine, a high demand has been identified for the further development of standards for creating evidence-based health information. In addition to content development, the integration of existing documents and tools should also be considered, including products issued by other institutions. The success of advancing the standards also depends on improving their applicability - for example through an attractive online platform. The results are limited by the sample which only included members of the EbM Network's patient information and participation working group and a limited response rate. CONCLUSIONS: The needs assessment showed that the currently established standards and recommendations for the development of evidence-based health information in the German-speaking regions represent important cornerstones but need to be expanded to answer more practice-oriented questions. The challenges and proposed solutions stated by the participants can help further develop the standards. The prioritization can be used to set priorities for the development of the standards, guide the order of possible work packages and allocate resources.

Voices unheard, insights into the lives of people with disabilities: A needs assessment study.

BACKGROUND: The phenomenon of disability in society is as ancient as human history itself. Approximately one billion people worldwide experience some form of disability, with a fifth of these individuals facing significant disabilities. Disability affects various life dimensions, including access to health services. This study aimed to identify the needs and challenges encountered by people with disabilities and to propose solutions for these issues. MATERIALS AND METHODS: This qualitative content analysis research was conducted at Isfahan University of Medical Sciences in 2019. Participants included faculty members from the rehabilitation school, senior students, therapists, disabled individuals, and their families (23 interviews in total). These participants were chosen for their extensive knowledge of the challenges faced by people with disabilities. Semi-structured interviews were conducted, with informed consent obtained before each interview. The interviews were analyzed using the Graneheim and Lundman content analysis method and MAXQDA software. To ensure data accuracy, the criteria of conformability, credibility, dependability, and transferability were applied. RESULTS: The analysis of the interviews yielded two main categories and 10 subcategories. In the category of disability-related problems, family problems, therapeutic problems, psychological problems, academic problems, and social problems were identified as the most significant. As for solutions, educational solutions, therapeutic solutions, social solutions, research solutions, and solutions for reintegrating patients into normal life were proposed to address the problems faced by disabled individuals. CONCLUSION: People with disabilities are an integral part of any country's society. To adequately address their therapeutic needs, it is essential to equip our health workers with the knowledge and skills tailored to the specific needs and challenges of disabled individuals.

Towards a taxonomy for assessing and classifying the needs of curly hair: A mixed method, ethnographic and quantitative data study.

Hair defined as curly has an elliptical cross sectional area and unique 3D form. While the chemical, morphological and mechanical characteristics of such hair are being explored using a range of analytical techniques, hair assembly (head of hair) characteristics and individual behaviour are difficult to determine via tress-based instrumental and sensory testing. Since the demand for more efficacious and personalized products is expected to gain pace, this project sets the groundwork for developing a taxonomy for exploring and classifying curly hair needs from an individual's perspective. A mixed-method exploratory sequential design was used to gather information from people with curly hair starting with a novel in the field of cosmetics qualitative research method, Subjective Evidence-Based Ethnography (SEBE) (n = 14) and followed by an online survey (n = 212). The SEBE data analysis identified four common hair goals (aesthetic, haptic, practical and emotive) and a group of perceptions related to hair management routines. The survey explored the relationship of these hair goals with hair perceptions, hair esteem, hair characteristics and demographic variables. The findings suggest that hair goals and perceptions are stronger predictors of hair esteem than other characteristics such as hair length or curl type. Hence, a taxonomy for classifying curly hair should facilitate the development of more appropriate products, and product testing methods should incorporate such personal information in addition to objective fibre and hair assembly data. The focus of this study is on curly hair due to the lack of established methods for its objective evaluation and the personal challenges faced by people with curly and textured hair; however, the approach could be adopted to include straighter hair types.

Les cheveux décrits comme bouclés ont une surface transversale elliptique et une forme tridimensionnelle unique. Si les caractéristiques chimiques, morphologiques et mécaniques de ces cheveux sont étudiées à l'aide de diverses techniques d'analyse, il reste difficile de déterminer les caractéristiques de l'assemblage capillaire (tête du cheveu) et le comportement individuel d'une chevelure via des analyses instrumentales de la tresse et des tests sensoriels. La demande de produits plus efficaces et personnalisés allant sans doute augmenter à l'avenir, ce projet pose les bases d'une taxonomie visant à étudier et à classer les besoins liés aux cheveux bouclés du point de vue de la personne qui les porte. Une approche séquentielle à méthodes mixtes a été utilisée pour recueillir des informations qualitatives auprès de personnes ayant des cheveux bouclés à l'aide d'une ethnographie factuelle subjective (Subjective Evidence­Based Ethnography, SEBE) (n = 14), suivie d'une enquête en ligne (n = 228). L'analyse des données SEBE a permis d'identifier quatre objectifs capillaires fréquents et un ensemble de perceptions liées aux routines de gestion des cheveux. L'enquête a étudié la relation entre ces objectifs capillaires et la perception des cheveux, l'estime de soi liée aux cheveux, les caractéristiques des cheveux et les variables démographiques. Les résultats suggèrent que les objectifs et les perceptions des cheveux constituent des facteurs prédictifs plus puissants de l'estime de soi liée aux cheveux que d'autres caractéristiques comme la longueur des cheveux ou le type de boucle. Par conséquent, une taxonomie pour classer les cheveux bouclés doit faciliter le développement de produits plus appropriés, et les méthodes de test des produits devraient incorporer ces informations personnelles en plus des données objectives sur les fibres et les assemblages capillaires. Cette étude se concentre sur les cheveux bouclés en raison du manque de méthodes établies pour évaluer objectivement ce type de cheveux et des défis personnels auxquels les personnes ayant des cheveux bouclés et à texture sont confrontées. Toutefois, l'approche adoptée ici pourrait aussi permettre d'étudier les cheveux plus raides.

Necesidades de cuidado en la persona consumidora de alcohol en un contexto hospitalario / Necessidades de cuidado na pessoa que consome álcool em contexto hospitalar / Care needs in the person consuming alcohol in a hospital context

Introducción: El consumo de alcohol es considerado unode los transcendentales factores de riesgo de discapacidad ymuerte prematura. Develar el sentido de la experiencia de lapersona consumidora de alcohol en cuanto a las necesidades decuidado en el contexto hospitalario e incentiva que enfermeríabrinde un cuidado humano.Objetivo: Comprender las necesidades de cuidado de unapersona consumidora de alcohol durante la estancia hospitalaria.Método: Investigación cualitativa fenomenológica. Muestreopor conveniencia, participaron 07 hombres y 02 mujeres queconsumen alcohol e ingresaron al hospital. Para recolectarlos datos se utilizó una entrevista fenomenológica, previoconsentimiento informado. El análisis se realizó medianteel círculo hermenéutico de Martin Heidegger.Resultados: Fueron develadas cinco categorías: 1) Necesidadesfísicas ante deterioro corporal, 2) Necesidades emocionales yde apoyo con traspaso de energía para vivir, 3) Necesidades deconfort humano dentro de la hospitalización, 4) Agradecimientoverbalizado y escrito ante acompañamiento y preocupación,5) Anhelos de ser cuidado como persona.Conclusiones: Enfermería se encuentra con un ser vulnerableque muestra necesidades físicas debilitadas, necesidadesemocionales que requieren apoyo y confort humano, unser que anhela y agradece al ser enfermera.(AU)

Introduction: Alcohol consumption is consideredone of the transcendental risk factors for disabilityand premature death. Reveal the meaning of theexperience of the person who consumes alcoholin terms of care needs in the hospital context andencourages nursing to provide humane care.Objective: Understand the care needs of a personwho consumes alcohol during the hospital stay.Method: Phenomenological qualitative research.Sampling for convenience, 07 men and 02 womenwho consume alcohol and admitted to the hospitalparticipated. To collect the data, a phenomenologicalinterview was used, with prior informed consent. Theanalysis was carried out through the hermeneuticalcircle of Martin Heidegger.Results: Five categories were revealed: 1) Physicalneeds in the face of bodily deterioration, 2) Emotionaland support needs with the transfer of energy to live,3) Human comfort needs within hospitalization, 4) Verbalized and written gratitude for accompanimentand concern, 5) Desire to be cared for as a person.Conclusions: Nursing meets a vulnerable being thatshows weakened physical needs, emotional needsthat require support and human comfort, a beingthat longs for and appreciates being a nurse.(AU)

Introdução: O consumo de álcool é considerado umdos fatores de risco transcendentais para incapacidade emorte prematura. Revelar o significado da experiência dapessoa que consome álcool em relação às necessidades decuidado no contexto hospitalar e estimular a enfermagema prestar assistência humanizada.Objetivo: Compreender as necessidades de cuidado deuma pessoa que consome álcool durante a internação.Método: Pesquisa qualitativa fenomenológica. Amostragempor conveniência, participaram 07 homens e 02 mulheresque consomem álcool e internados no hospital. Para a coletados dados, foi utilizada uma entrevista fenomenológica,com consentimento prévio informado. A análise foirealizada por meio do círculo hermenêutico de MartinHeidegger.Resultados: Foram reveladas cinco categorias: 1)Necessidades físicas diante da deterioração corporal, 2)Necessidades emocionais e de apoio com transferênciade energia para viver, 3) Necessidades de confortohumano na hospitalização, 4) Gratidão verbalizada eescrita por acompanhamento e preocupação, 5) Desejode ser cuidado como pessoa.Conclusões: A enfermagem atende a um ser vulnerável queapresenta necessidades físicas fragilizadas, necessidadesemocionais que requerem apoio e conforto humano,um ser que anseia e valoriza ser enfermeiro.(AU)

Evaluation of Met and Unmet Needs in Patients with Severe Psychiatric Disorders and its Relation to the Quality of Life: A Cross-Sectional Study.

Background: Paying attention to the needs of patients with psychiatric disorders has recently come into focus. Failure to meet the needs of patients can affect their quality of life. This study aimed to determine the main areas of the needs of patients with severe psychiatric disorders and evaluate their relationship with the quality of life. Methods: In this cross-sectional study, 174 patients with severe mental illness who were referred to Iran Psychiatric Hospital for hospitalization or outpatient treatment were enrolled in this study (68 with schizophrenia and schizoaffective disorder, 106 with bipolar disorder type 1). A qualified psychiatry resident conducted interviews with each patient to determine their needs using the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and the severity of their illness using the Hamilton Depression Rating Scale (HAM-D), Positive and Negative Syndrome Scale (PANSS), and Young Mania Rating Scale. A checklist for demographic data and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire was completed by patients. Data were analyzed using descriptive statistics. Since the number of needs distribution was not normal, we used the Mann-Whitney, Kruskal-Wallis, and chi-square tests for qualitative variables. Results: The total number of patient needs was 9 (mean = 9.1, SD = 3.7). The most unmet needs were intimate relationships (69.5%), sexual expression (65.5%), and information on condition and treatment (51.1%). Unmet needs showed a negative correlation with the quality of life (P < 0.001) and a positive correlation with the severity of depression (P = 0.045), negative symptoms (P = 0.001), and general psychopathology (P < 0.001). Conclusion: A higher number of unmet needs of severe psychiatric patients is associated with lower quality of life and more severe disorders.

Technological acceptance and features needed in mobile health apps development for people living with dementia and their caregivers in Indonesia.

In Indonesia, the number of People Living with Dementia (PLWD) is predicted to be rising continuously. PLWD need help operating cell phones for their daily needs. Numerous mobile health applications have been innovated to deliver better dementia care. The objective of this study is to identify the technological acceptance and features needed by PLWD and caregivers in Indonesia. This study started with questionnaire development through focused-group discussion with experts, caregivers and PLWD. It was followed by item development involving experts in geriatrics (psychiatry, internal medicine, medical rehabilitation and neurology) to prepare an online questionnaire. We considered using jargon and words that are familiar to users. The data collected was analyzed for the technological acceptance model (TAM) using Structural Equation Model (SEM). This study showed that perceived usefulness and ease of use of the technology have positively correlated to the actual use. This study reflects the need for social connectedness and information for PLWD. For caregivers, the main feature needed is information related to dementia symptoms and treatment. The understanding gained from this study can be used to improve strategies related to developing mobile health technology for PLWD and caregivers.

Co-production processes for translation and validation of psychosocial assessments for older adults in aged care.

OBJECTIVE: Given the diverse ethnic backgrounds of aged care clients, there is a critical requirement to translate psychosocial assessment tools into various languages to effectively evaluate social engagement and quality of life in older adults receiving aged care services. This study aimed to translate psychosocial tools into Turkish, Korean and Mandarin, the primary languages spoken by clients of an Australian community aged care provider. METHODS: A co-development approach encompassing forward and backward translations of the Australian Community Participation Questionnaire and ICEpop CAPability measure for Older people tools, along with focus group discussions involving bilingual staff (n = 7) and clients (n = 16), was employed to ensure precision and cultural relevance. Multiple iterations were undertaken until linguistic, conceptual and scaling equivalence was achieved, with recorded sessions transcribed and analysed thematically. RESULTS: Cultural appropriateness significantly impacted the delivery of questions within the tools, emphasising translation challenges tied to specific queries. These difficulties included the lack of terms for unique places of worship, the use of outdated language (e.g., references to reading newspapers), and varying priorities in social and well-being matters between Western and Eastern/Asian cultures. Staff feedback identified that formal translated tool versions eased administration for culturally and linguistically diverse (CALD) clients, enabling them to independently interpret questions, resulting in improved questionnaire completion rates. CONCLUSIONS: Insights indicate the need for continued efforts in tailoring assessment tools to diverse cultural contexts to ensure accurate and meaningful data collection.

Perceptions on Specialist Palliative Care Involvement During and After Cardiopulmonary Resuscitation: A Qualitative Study.

IMPORTANCE: Cardiopulmonary resuscitation (CPR) is an exceptional physical situation and may lead to significant psychological, spiritual, and social distress in patients and their next of kin. Furthermore, clinicians might experience distress related to a CPR event. Specialist palliative care (sPC) integration could address these aspects but is not part of routine care. OBJECTIVES: This study aimed to explore perspectives on sPC integration during and after CPR. A needs assessment for sPC, possible triggers indicating need, and implementation strategies were addressed. DESIGN SETTING AND PARTICIPANTS: A multiprofessional qualitative semistructured focus group study was conducted in a German urban academic teaching hospital. Participants were clinicians (nursing staff, residents, and consultants) working in the emergency department and ICUs (internal medicine and surgical). ANALYSIS: The focus groups were recorded and subsequently transcribed. Data material was analyzed using the content-structuring content analysis according to Kuckartz. RESULTS: Seven focus groups with 18 participants in total were conducted online from July to November 2022. Six main categories (two to five subcategories) were identified: understanding (of palliative care and death), general CPR conditions (e.g., team, debriefing, and strains), prognosis (e.g., preexisting situation, use of extracorporeal support), next of kin (e.g., communication, presence during CPR), treatment plan (patient will and decision-making), and implementation of sPC (e.g., timing, trigger factors). CONCLUSIONS: Perceptions about the need for sPC to support during and after CPR depend on roles, areas of practice, and individual understanding of sPC. Although some participants perceive CPR itself as a trigger for sPC, others define, for example, pre-CPR-existing multimorbidity or complex family dynamics as possible triggers. Suggestions for implementation are multifaceted, especially communication by sPC is emphasized. Specific challenges of extracorporeal CPR need to be explored further. Overall, the focus groups show that the topic is considered relevant, and studies on outcomes are warranted.

Veterans Administration Readjustment Counseling Service Counselors' Training Needs: Results of a National Needs Assessment.

The Department of Veteran Affairs established Readjustment Counseling Service (RCS) to meet the mental health needs of active-duty service members, veterans, and their families. A diverse therapeutic skill set is needed to serve this complex population. To assess training needs, a national mixed-methods needs assessment consisting of a survey for RCS counselors and focus groups among counselors, RCS educational trainers, and national leadership was conducted. Survey results (n = 681) showed that RCS counselors were most interested in trainings on moral injury, acceptance and commitment therapy, and military sexual trauma (MST). Desired trainings aligned with populations served. Themes from focus groups revealed the need for foundational trainings so that all RCS counselors are adept in treating MST, moral injury, and posttraumatic disorder and proficient in caring for couples. Additionally, counselors desired advanced trainings tailored to individual counselors' needs. RCS counselors identified multiple trainings to help them treat those they serve.

Residents-as-teachers: A Needs Assessment of Residents' Teaching Skills in the Clinical Setting Using Direct Observation of Teaching.

BACKGROUND AND OBJECTIVES: Residents play a significant role in teaching undergraduate medical students though most residents have not received formal training in teaching and may be adopting ineffective teaching strategies. Many institutions have established a residents-as-teachers (RaT) programme to improve residents' teaching skills. However, many RaT programmes were established without a context-specific needs assessment. This study describes a need assessment survey of residents' teaching skills. The specific objectives of the study were to determine the residents' selfperceived and true learning needs for facilitating clinical teaching, the preferred important topics and methods of instruction for a RaT programme. METHODS: This cross-sectional, prospective, observational, quantitative study involved self-assessment of residents' teaching skills and assessments of those residents by medical students and an observer during actual clinical bedside teachings using the Maastricht Clinical Teaching Questionnaire. RESULTS: Thirty-nine (78%) out of 50 residents participated in the study, of which 20 agreed to direct observation of teaching. Sixty-two (85%) of the 73 medical students completed 82 evaluations of residents' teaching. The residents' self-perceived and true learning needs were in the domains of exploration, scaffolding, modelling, coaching and reflection. The leading preferred topics were communication skills, leadership, the teaching of procedural skills, and bedside teaching. The preferred methods of instruction were interactive sessions with teachers and working in small groups with a facilitator. CONCLUSIONS: Residents performed well in creating a safe learning environment but were poor in exploration, scaffolding, modelling, coaching and reflection domains of teaching. These findings will inform the design of a tailor-made RaT programme.

CONTEXTE ET OBJECTIFS: Les résidents jouent un rôle important dans l'enseignement des étudiants en médecine de premier cycle, bien que la plupart des résidents n'aient pas reçu de formation formelle en enseignement et puissent adopter des stratégies d'enseignement inefficaces. De nombreuses institutions ont mis en place un programme de résidents en tant qu'enseignants (RaT) pour améliorer les compétences pédagogiques des résidents. Cependant, de nombreux programmes RaT ont été établis sans évaluation préalable des besoins spécifiques au contexte. Cette étude décrit une enquête sur les besoins en compétences pédagogiques des résidents. Les objectifs spécifiques de l'étude étaient de déterminer les besoins d'apprentissage auto-perçus et réels des résidents pour faciliter l'enseignement clinique, les sujets importants préférés et les méthodes d'instruction pour un programme RaT. MÉTHODES: Cette étude quantitative prospective observationnelle transversale impliquait une auto-évaluation des compétences pédagogiques des résidents et des évaluations de ces résidents par des étudiants en médecine et un observateur lors d'enseignements cliniques en direct au lit du patient à l'aide du Questionnaire d'Enseignement Clinique de Maastricht. RÉSULTATS: Trente-neuf (78 %) des 50 résidents ont participé à l'étude, dont 20 ont accepté l'observation directe de l'enseignement. Soixantedeux (85 %) des 73 étudiants en médecine ont complété 82 évaluations de l'enseignement des résidents. Les besoins d'apprentissage auto-perçus et réels des résidents étaient dans les domaines de l'exploration, de l'échafaudage, de la modélisation, du coaching et de la réflexion. Les sujets préférés étaient les compétences en communication, le leadership, l'enseignement des compétences procédurales et l'enseignement au lit du patient. Les méthodes d'instruction préférées étaient les séances interactives avec les enseignants et le travail en petits groupes avec un facilitateur. CONCLUSIONS: Les résidents se sont bien comportés dans la création d'un environnement d'apprentissage sûr mais étaient faibles dans les domaines de l'exploration, de l'échafaudage, de la modélisation, du coaching et de la réflexion de l'enseignement. Ces résultats orienteront la conception d'un programme RaT sur mesure. MOTS-CLÉS: Résidents en tant qu'enseignants, évaluation des besoins, enseignement clinique au lit du patient, évaluation, compétencespédagogiques.

Spiritual Needs and Influencing Factors of Postoperative Breast Cancer Women Undergoing Chemotherapy: A Cross-Sectional Study.

Purpose: The purpose of the study was to determine the status of spiritual needs and influencing factors of postoperative breast cancer (BC) women undergoing chemotherapy. Participants and Methods: This study is a cross-sectional study. A total of 173 participants completed a general information questionnaire and a Chinese version of the Spiritual Needs Scale at the Guangxi Medical University Cancer Hospital. Data were collected by purposive sampling from December 2022 to April 2023. Data were analyzed by descriptive statistics, independent t-test, ANOVA, non-parametric test, and logistic regression analysis. Results: The spiritual needs of postoperative BC women undergoing chemotherapy were at a high level (84.20 ± 12.86). The need for "hope and peace" was considered paramount and the need for a "relationship with transcendence" was considered the least important. Significant differences were found in the following: spiritual needs total score (P=0.040) and "hope and peace" (P=0.021) in education level; "love and connection" in disease stage (P=0.021); "meaning and purpose" in education level (P=0.013), household income (P=0.012), and payment method (P=0.015); "relationship with transcendence" in religion (P<0.001); and "acceptance of dying" in marital status (P=0.023). The level of education was the influencing factor of spiritual needs (OR=1.50, P=0.005), especially for "hope and peace" (OR=1.50, P=0.012). Conclusion: The spiritual need of postoperative BC Chinese women undergoing chemotherapy is at a high level and should receive more attention. In clinical work, nurses should fully assess the spiritual needs of patients and meet their specific needs. Results may help nurses to develop targeted and comprehensive spiritual intervention strategies according to the characteristics of patients.

Transitioning to home and beyond following stroke: a prospective cohort study of outcomes and needs.

INTRODUCTION: Understanding of the needs of people with stroke at hospital discharge and in the first six-months is limited. This study aim was to profile and document the needs of people with stroke at hospital discharge to home and thereafter. METHODS: A prospective cohort study recruiting individuals with stroke, from three hospitals, who transitioned home, either directly, through rehabilitation, or with early supported discharge teams. Their outcomes (global-health, cognition, function, quality of life, needs) were described using validated questionnaires and a needs survey, at 7-10 days, and at 3-, and 6-months, post-discharge. RESULTS: 72 patients were available at hospital discharge; mean age 70 (SD 13); 61% female; median NIHSS score of 4 (IQR 0-20). 62 (86%), 54 (75%), and 45 (63%) individuals were available respectively at each data collection time-point. Perceived disability was considerable at hospital discharge (51% with mRS ≥ 3), and while it improved at 3-months, it increased thereafter (35% with mRS ≥ 3 at 6-months). Mean physical health and social functioning were "fair" at hospital discharge and ongoing; while HR-QOL, although improved over time, remained impaired at 6-months (0.69+/-0.28). At 6-months cognitive impairment was present in 40%. Unmet needs included involvement in transition planning and care decisions, with ongoing rehabilitation, information, and support needs. The median number of unmet needs at discharge to home was four (range:1-9), and three (range:1-7) at 6-months. CONCLUSION: Stroke community reintegration is challenging for people with stroke and their families, with high levels of unmet need. Profiling outcomes and unmet needs for people with stroke at hospital-to-home transition and onwards are crucial for shaping the development of effective support interventions to be delivered at this juncture. ISRCTN REGISTRATION: 02/08/2022; ISRCTN44633579.

Advancing One Health through veterinary education: a mixed methods needs assessment for implementing a WOAH-harmonized national veterinary medicine curriculum in Ethiopia.

Introduction: International organizations now actively promote and implement One Health collaborative approaches to prevent, detect, and control diseases in humans and animals, recognizing the critical importance of the veterinary and agricultural sectors. Moreover, Veterinary Services are chronically under-resourced, especially in low- and middle-income countries. Given the importance of National Veterinary Services to food security, nutrition, poverty alleviation, and global health security, strengthening veterinary capacity is a priority for the international community. The World Organisation for Animal Health (WOAH) outlines a set of minimum competencies veterinarians need to support National Veterinary Services effectively. To improve the quality of veterinary education, Ethiopia has developed a new 2020 national curriculum that is harmonized with the WOAH competencies. Methods: A mixed methods needs assessment was conducted to identify barriers and challenges that Ethiopian veterinary medicine programs have faced in implementing the new WOAH-harmonized national curriculum. Representatives from active veterinary programs granting a Doctor of Veterinary Medicine (DVM) degree were invited to share their experiences via an online survey and follow-up focus group discussion. Results: Fourteen veterinary programs, representing 93% of eligible programs nationwide, participated in the needs assessment. Quantitative analysis indicated that the most difficult topics associated with the new curriculum included Organization of Veterinary Services (Competency 3.1), Inspection and Certification Procedures (3.2), and practical applications of the regulatory framework for disease prevention and control (multiple competencies). Challenges associated with specific instructional methodologies, particularly the facilitation of off-site (private and public sector) student training, were also perceived as barriers to implementation. Focus group discussions elucidated reasons for these challenges and included limitations in faculty expertise, resource constraints (e.g., supplies, infrastructure), and access to off-site facilities for hands-on teaching. Conclusion: The results of this needs assessment will be used to identify and prioritize solutions to implementation challenges, helping Ethiopian veterinary medicine programs move the new WOAH-harmonized curriculum from theory to practice. As veterinarians are integral partners in advancing One Health, strengthening the capacity of Veterinary Services can ultimately safeguard animal and human health, grow economies, and improve lives.

Screening tools to address social determinants of health in the United States: A systematic review.

The Centers for Medicare & Medicaid Services have mandated that hospitals implement measures to screen social determinants of health (SDoH). We sought to report on available SDoH screening tools. PubMed, Scopus, Web of Science, as well as the grey literature were searched (1980 to November 2023). The included studies were US-based, written in English, and examined a screening tool to assess SDoH. Thirty studies were included in the analytic cohort. The number of questions in any given SDoH assessment tool varied considerably and ranged from 5 to 50 (mean: 16.6). A total of 19 SDoH domains were examined. Housing (n = 23, 92%) and safety/violence (n = 21, 84%) were the domains assessed most frequently. Food/nutrition (n = 17, 68%), income/financial (n = 16, 64%), transportation (n = 15, 60%), family/social support (n = 14, 56%), utilities (n = 13, 52%), and education/literacy (n = 13, 52%) were also commonly included domains in most screening tools. Eighteen studies proposed specific interventions to address SDoH. SDoH screening tools are critical to identify various social needs and vulnerabilities to help develop interventions to address patient needs. Moreover, there is marked heterogeneity of SDoH screening tools, as well as the significant variability in the SDoH domains assessed by currently available screening tools.

Educational needs of community visiting nurses for infection prevention and control: Application of the Borich needs assessment and the Locus for Focus models.

OBJECTIVES: This study aimed to assess the educational needs and analyze the priorities of infection prevention and control (IPC) for community-visiting nurses. DESIGN: This is a cross-sectional descriptive study. SAMPLE: This study was conducted with 144 visiting nurses working in public health centers and long-term care facilities in South Korea. METHOD: A total of 23 questions in five subcategories were used to measure the current knowledge and perceived importance of IPC in community-visiting nursing. Data were collected from June 23 to October 30, 2021, during the COVID-19 pandemic. Data were analyzed paired t-test, the Borich needs assessment, and the Locus for Focus models. RESULTS: Top-priority content was defined as content belonging to two models, the first 10 contents of Borich needs assessment and the contents located in the Quadrant I of the Locus for Focus models. "Reporting in case of infection-related accidents," "Mandatory vaccination for visiting nurses," "Standard precaution," "Airborne precaution," "Contact precautions," "Respiratory infection control," and "Post-visit management." CONCLUSIONS: This study suggests that it is necessary to provide visiting nurses with more opportunities for IPC education and to develop standardized IPC programs that consider educational priorities.