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Objective: To identify the impact of volunteering in a street medicine programme on perceptions of and attitudes towards individuals experiencing homelessness. Design: Prospective pre- and post-analysis using involvement in a street medicine programme as the intervention. Attitudes towards and perceptions of individuals experiencing homelessness were measured using the Health Professional Attitude Towards the Homeless Inventory (HPATHI). Setting: Participants provided outreach to individuals experiencing homelessness across metro Phoenix in parks and in homeless encampments along the streets. Method: Students and preceptors from numerous professions, including medicine, nursing, social work, physical therapy, occupational therapy, public health and undergraduate students, who volunteered for the street medicine programme were organised into small outreach teams. All volunteers were emailed the HPATHI to complete before and after semester-long, monthly outreach events. Results: Volunteering in our street medicine programme demonstrated statistically significant improvements in perceptions of and attitudes towards individuals experiencing homelessness for all volunteers, regardless of profession. Conclusion: Our findings suggest that integrating street medicine programmes into curricula for health and social care programmes can reduce the stigma towards individuals experiencing homelessness, inspire increased commitment to practising in underserved communities and meet the unmet health and social needs of the homeless population.

In post-Soviet Kazakhstan, the system of care for children with autism has been transforming over the past three decades. There is little known about the use of complementary and alternative medicine by families raising autistic children in the post-Soviet region. An exploratory qualitative focus group design was employed to study parents' experiences of using complementary and alternative medicine focusing on the perceived factors driving the utilization of complementary and alternative medicine by families of autistic children and the availability of complementary and alternative medicine. Six focus groups were conducted in five cities of diverse geographical locations in Kazakhstan. Data were analyzed using a framework analysis. Two overarching themes and subthemes are developed. The first "unmet needs" relates to predisposing factors that motivate parents to complementary and alternative medicine uptake and the second "chasing hope" relates to enabling factors that facilitate parents' uptake of complementary and alternative medicines. In summary, parents of autism spectrum disorder children in Kazakhstan face multiple challenges when seeking treatment for their children's condition and implement whatever complementary and alternative medicine interventions available. A decision to use, and the choice of intervention, mainly comes from perceptions of having no other choice rather than from rational decisions based on efficacy of complementary and alternative medicines. This study provides the first empirical conceptualization of parents' motives for choosing complementary and alternative medicine in Kazakhstan.

Background: Studies have reported unmet health needs in individuals with intellectual disability (ID). This study illustrated and analysed patterns of healthcare services utilization among people with intellectual disability and compared their use to that of the general population. Method: Participants (N = 791, aged 15-82) were mainly recruited through government-financed agencies specializing in services for people with intellectual disabilities in Québec, Canada. Comparisons were possible by using health administrative data. Results: Some services were more used by people with intellectual disability than the general population (general medicine, psychiatry, PSA blood tests), and others were accessed at significantly lower frequencies (optometry, physiotherapy, Pap tests). Similar rates were found for mammography, dentistry and psychology. Inequities were more salient for individuals who had more severe levels of intellectual disability. Conclusions: Our findings support that the population with intellectual disability would benefit from policies and practices aimed at enhancing the access to healthcare services.

Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from differing professions learn together. Our findings inform the design of future interprofessional education initiatives. Using activity theory, we conducted an ethnographic investigation of interprofessional education in primary care. During a 5 months period, we observed 14 clinic sessions involving mixed discipline student teams who interviewed people with chronic disease. Teams were comprised of senior medicine, nursing, occupational therapy, pharmacy and physiotherapy entry level students. Semi-structured interviews were also conducted with seven clinical educators. Data were analysed to ascertain the objectives, tools, rules and division of labour. Two integrated activity systems were identified: (1) student teams gathering information to determine patients' health care needs and (2) patients either as health consumers or student educators. Unwritten rules regarding "shared contribution", "patient as key information source" and "time constraints" were identified. Both the significance of software literacy on team leadership, and a pre-determined structure of enquiry, highlighted the importance of careful consideration of the tools used in interprofessional education, and the way they can influence practice. The systems of practice identified provide evidence of differing priorities and values, and multiple perspectives of how to manage health. The work reinforced the value of the patients' voice in clinical and education processes.

This article reviews the personal and professional processes of developing an interdisciplinary approach to understanding the complex issues of environmental health in their community, political-economic, social science, and scientific contexts. This interdisciplinary approach includes a synthesis of research, policy work, and advocacy. To examine multiple forms of interdisciplinarity, I examine pathways of integrating medical and environmental sociology via three challenges to the boundaries of traditional research: (1) crossing the boundaries of medical and environmental sociology, (2) linking social science and environmental health science, and (3) crossing the boundary of research and advocacy. These boundary crossings are discussed in light of conceptual and theoretical developments of popular epidemiology, contested illnesses, and health social movements. This interdisciplinary work offers a more comprehensive sociological lens for understanding complex problems and a practical ability to join with scientists, activists, and officials to meet public health needs for amelioration and prevention of environmental health threats. (Contains 1 figure.)

This article offers a reflective view of five articles published in this Special Issue of the "International Journal of Disability, Development and Education." The 5 articles address various aspects of indigenous healing practices in different cultures. In distilling a number of pertinent themes, the author presents the view that indigenous healing practices can no longer be ignored by conventional medicine. These practices are potentially an invaluable resource available in addressing the ongoing global health crisis. However, in order to ethically address the role of indigenous healing practices within a westernised worldview, certain policy, methodological, and conceptual changes will be necessary.

Examines the semantic relationships in consumers' health-related questions, physician-provided answers, and between questions and answers with the purpose of supporting the design of health consumer question-answering systems. The information present in the text was expressed using a "pilot" ontology that was based on the semantic relationships from the Unified Medical Language System Semantic Network. (Author/AEF)

Based on recognized health care needs, a curriculum revision was undertaken at the College of Pharmacy at Saudi Arabia's University of Riyadh. The revised curriculum included a unified basic health sciences core program for Medicine, Dentistry, Pharmacy, and Allied Medical Sciences. (Author/MLW)

This essay discusses the correlation between health and medical care, progress in medical science, and education. The growth in medical care, non-medical factors contributing to this growth, and different views concerning the effectiveness of medical care are examined. (EB)

The debate about cost as it pertains to medical technology misses the mark by not pressing on the central problem of increased prevalence of chronic illness. Far from cost containment, what are needed are additional services which may in the end reduce total costs. (Author/MJL)

Abstract Background Interprofessional assessment and management of health needs for older adults living at home can help prioritize community service resources and enhance health, yet there is a shortage of professionals with the necessary competencies. Therefore, support and training for healthcare professionals in community settings to assess older adults’ health with the aim of for health promotion are needed. Aim To identify and provide an overview of published papers describing approaches for training healthcare professionals in assessing physical, mental, and social health needs in older adults living at home. Method A systematic literature search of the Cinahl, Medline, Academic Search Ultimate, Scopus, Embase, and British Nursing Index databases was performed. We considered studies focusing on the training of healthcare professionals in assessing a single or multiple health needs of older adults aged 65 and above living at home. We considered studies published between 1990 – and March 2024. The review evaluated qualitative, quantitative, and mixed methods studies published in English-language peer-reviewed academic journals. A quality appraisal was conducted via the Mixed Methods Appraisal Tool (MMAT). Results Twenty-three studies focused on training healthcare professionals to assess health needs and plan care for older adults living at home were included. The majority of the included studies combined teacher-driven pedagogical approaches consisting of educational sessions, written materials or e-learning, and more participant-engaging pedagogical approaches such as knowledge exchange or various forms of interactive learning. Healthcare professionals were trained to detect and manage single and multiple health needs, and some studies additionally incorporated interprofessional collaboration. Healthcare professionals were satisfied with the training content and it increased their confidence and competencies in health needs assessment and care planning for older adults. Moreover, some studies have reported that training interventions foster the implementation of new and effective ways of working and lead to positive outcomes for older adults. Conclusion Healthcare professionals were satisfied with a combination of participant-engaging and teacher-driven pedagogical approaches used to train them in assessing health needs and planning care for older adults living at home. Such training can lead to enhanced assessment skills and facilitate improvements in practice and health promotion for older adults. Future research is recommended on interprofessional simulation training for conducting structured and comprehensive health needs assessments of older adults living at home, as well as on the implementation of such assessments and health-promoting interventions.

Background With the continuous development of society and technological innovations, the average life expectancy of human beings has gradually increased, leading to the gradual increase in the number of perimenopausal women. This trend poses a serious challenge to the management of perimenopausal health in the community. Objective To understand the health characteristics and health needs of perimenopausal women in the community, explore the relationship between the two, and provide evidence to support the development and improvement of perimenopausal health management in community health service organisations. Methods Perimenopausal women (n=260) who attended or were accompanied to the Huamu Community Health Service Centre and its subordinate stations in Pudong New Area, Shanghai, from February to March 2023 were selected as study subjects. Questionnaires were used to collect information on the health characteristics of the study subjects (related to physiological stage, social characteristics, disease status, lifestyle, and quality of life), their knowledge of menopause and attitudes toward treatment, as well as their needs for knowledge related to menopause and preventive health care for menopausal diseases. Results Fifty percent (130/260) of perimenopausal women had a current history of chronic disease, 51.9% (135/260) of perimenopausal women had a past history of chronic disease, 73.8% (192/260) of perimenopausal women had fair/poor quality of sleep, 33.5% (87/260) of perimenopausal women did little exercise. 58.5% (152/260) of perimenopausal women were completely unaware or had only heard of menopause, 41.9% (109/260) of perimenopausal women had a negative attitude towards menopause treatment, 45.0% (117/126) of perimenopausal women needed menopause-related knowledge, and 66.6% (173/260) of perimenopausal women needed preventive health care for menopausal diseases. The results of ordered multicategorical Logistic regression analyses showed that literacy, the number of menopausal symptoms in the last 3 monthss, and attitudes toward menopause treatment were the factors influencing perimenopausal women's need for menopause-related knowledge (P

ObjectiveTo understand the health information needs of chronic disease inpatients and the current utilization of community health resources， and to analyze the influencing factors， so as to provide basis for personalized and high-quality health education for chronic disease inpatients and to guide them to make full use of community health resources.MethodsFrom November 2020 to February 2021， we conducted a face-to-face multi-center clinical epidemiological survey with paper questionnaire in three general hospitals of Shanghai. The study included 404 inpatients with diabetes， hypertension， coronary heart disease， chronic respiratory diseases， cancer and other chronic diseases.Results94.01% of the 404 respondents had different needs for disease or health related information， and there was no significant difference between patients of different ages， genders and educational backgrounds in their needs for health knowledge. Among these patients， only 39.11% of them participated in the establishment of a card for chronic disease management in the community or signed for a family doctor. The participation rate of male patients was lower than that of female patients （P

Introduction: The global population is undergoing a significant demographic shift, with a rapidly increasing number of elderly population. As people age, their health and quality of life become increasingly important considerations. The elderly population has unique health needs that must be addressed to ensure their well-being and maximize their quality of life. In Bhutan, elderly health needs are lacking despite information on health policy and planning. This study was proposed to assess quality of life and health needs among elderly aged between 60 – 79 years old under Naja, Dogar, Shaba, and Lyungni gewogs (blocks) under Paro district, Bhutan. Methods: An explanatory sequential mixed method design with a quantitative and descriptive qualitative was conducted in the four blocks. For quantitative component, a survey was conducted and for qualitative, focus group discussion was used. This study was carried out in four selected rural areas known as gewogs (blocks) in local language under Paro district. A representative sample of 403 respondents was selected by simple random sampling in quantitative work and 12 elderly people in focus group discussion. The demographic data were analyzed by ANOVA and data from focus group discussion were done in content analysis. Results: The quantitative data for the overall QoL score among elderly showed a mean score of 39.01, which was considered a low level of QoL. Among the eight components of QoL, role of pain and general health showed same result level as the overall QoL. While others (physical function, body pain, vitality, social function, role of emotion, and mental health) were at average level (score 46.19-58.68). Conclusions: Overall QoL of elderly people in Paro district is lower than the average at 47.84 (CI 45.87 – 49.81). Mental health was in average level compared to physical health, which is at a lower level.

Background: This mixed method research aimed to investigate health needs of older people and the attributes of the Elderly Care Managers (ECMs), and to evaluate the outcomes of two ECMs coordination. Methods: Three phases were: 1) a field survey of the health needs of 94 older persons; 2) group discussions between ten relevant persons involved in ECMs characteristics; 3) two ECMs coordinating with health-related agencies and measuring the outcomes of older people who needed assistance. Results: 63.1% of the participants had difficulties with their health, 12.8% of them had no caregiver, 26.6% of them had >1 health condition. Group talks dealt with the characteristics, role and attributes of ECMs. The two-month of ECMs coordination with health-related agencies according to older adults' needs, and made home visits encouraged the aged to acquire knowledge on their diseases. Conclusion: ECMs’s coordination with health-related agencies could support the needs of those of advanced age.

Background: Family medicine is the medical specialty that continuously provides comprehensive type of health care for individuals and families. Although the family physician role is essential, this specialty faces underestimation by other physicians of other specialties, thus resulting in a considerable gap in their cooperation and coordination, as some studies around the world had shown. The present study aimed to estimate the perception of other physicians toward the practice of family medicine physicians to improve the relationship between family physicians and other physicians, which in turn may lead to enhance healthcare system by high quality of work and higher efficiency. Objective of the Study: To estimate the perception among the physicians of Prince Sultan Military Medical City, Riyadh City by measuring the satisfaction toward the family medicine medical practices. Subjects and Methods: Through a cross-sectional design, the study had recruited 289 physicians who were actively practicing and working at Prince Sultan Military Medical City and fulfill the inclusion and exclusion criteria during the period from October 2018 until June 2019. Data collection carried out by questionnaire designed and revised by an expert panel of health professionals. An appropriate statistical test, such as the Chi-square test, was used to record the statistical significance between participants' answers and their demographic characteristics. Results: According to the study design, 289 patients were included in the study; the mean age was 42 years that ranged between 25 and 74 years. Two-Third of them (66%) were male and had Saudi nationality. Half of the participants are medical consultant, and a third of all participants worked under the department of internal medicine. The majority expressed their good perception with the family physician practice (91%). Most of the medical departments satisfied with statistically significant (P value < 0.05) with the need for family medicine services. There was less satisfaction from physicians in different departments with effective communication between family medicine services and other departments but didn't reach up to significant statistical level. Higher qualified physicians with high-rank job categories were less satisfied with the performance of family medicine services. Conclusion: Among other physicians in different departments, family medicine physicians have a good perception, and most of the physicians agreed that family medicine physicians should work more in their referral letters to improve their communication between them and other departments.

Background: The Efficacy and Mechanism Evaluation (EME) programme – a Medical Research Council (MRC) and National Institute for Health Research (NIHR) partnership – funds trials that evaluate the efficacy of interventions with the potential to promote health and studies that improve our understanding of the mechanisms of underlying diseases and their treatments. Objective: To conduct an independent review of the EME programme’s impact and identify opportunities for future improvement. Design: A mixed-methods approach, including desk research, an analysis of secondary data, stakeholder consultation and the development of impact case studies. Participants: Chief investigators of EME awards, unfunded applicants to the EME programme and key opinion leaders relevant to the programme and research ecosystem. Interventions: No interventions were tested, as this was a retrospective programme evaluation. Main outcome measures: The evaluation was guided by a set of 15 evaluation questions. Results: The EME programme bridges the gap between proof-of-concept and effectiveness studies that are located among other MRC and NIHR schemes and grants from charities in the funding landscape. Mechanistic studies alongside EME trials add value by lending confidence to trial findings and providing insights into the underlying biology. Between 2009 and September 2018, £175.7M in funding was approved for 145 EME projects. EME programme-funded research has started to deliver value to the NHS and patients by improving treatments and providing more efficient use of resources. Of the 43 completed trials, 14% (n = 6) showed that the intervention had a positive effect, whereas 74% (n = 32) of trials did not. The remaining five (12%) trials were unable to recruit participants or did not proceed to the full-trial stage. Seven projects (i.e. 16% of completed trials) have informed clinical guidelines or regulatory approval decisions and another eight projects have the potential to do so in the future, given the nature of their findings. Projects in the EME programme portfolio address a range of UK health needs and government priority areas, but they do not fully align with the level of health needs present. Commissioned calls for applications steer applicants. However, many commissioned calls do not lead to funded awards, and a better understanding of the underlying reasons for this would enable targeted supported to address key health needs. The majority of EME projects investigate existing interventions of limited commercial interest, focusing on repurposing (67/136, 49%) and informing current practice (23/136, 17%). Although there is little evidence of wider economic impact from commercial benefits, the EME programme is important in funding research in which industry is unlikely to invest. Stronger co-ordination with other funders, such as charities, could lead to synergies, enhancing the potential for health impact and influence on other funders’ agendas. The main challenges identified for EME projects were ‘complex and slow contracting processes’ (35/46, 76%), ‘setting up of study sites’ (30/46, 65%) and patient recruitment (28/46, 61%). Enablers of research included a clinical research fellow position on the project and support from Clinical Research Networks and Biomedical Research Centres. Nearly all of the chief investigators consulted had engaged in patient and public involvement at some project stage, and a lack of patient and public involvement did not emerge as a barrier to research or impact. Research ideas stemming from patients were, however, over-represented among unfunded applications, but the reason for this is unclear. Limitations: Only about one-third of all studies had been completed or had published their main findings, necessitating a purposive, rather than representative, sampling of the portfolio. The COVID-19 outbreak cut short the programme of interviews, limiting the depth to which some evaluation questions could be explored. Several data sources were based on self-reporting by chief investigators; whereas key self-reported aspects were verified through desk research, this was not possible for all findings. Conclusions: The EME programme plays an important role in the UK research funding landscape and has started to deliver value to the NHS and patients. Based on the evidence gathered, seven recommendations were developed to enhance the EME programme’s health and economic impact and address challenges encountered by chief investigators in implementing research projects. Funding: This project was funded by the EME programme, a MRC and NIHR partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 8, No. 20. See the NIHR Journals Library website for further project information.

Context: Adolescents constitute nearly 21% of the population in India. They are more likely to be constrained than adults from access to and timely use of appropriate care. Adolescence in girls is a turbulent period. The changes that take place during this period need to be made stress free. These are mostly physiological, for which simple family remedies can be found out. Objectives: 1. Assessing the health needs of adolescent girls living in an urban slum. 2. Identifying the barriers in accomplishing the health needs. Methodology: This was a community-based cross-sectional study with mixed method approach. A focus group discussion was held with 13 adolescent girls. FGD results were used to prepare a questionnaire to interview 80 adolescent girls. Results: The FGD revealed adolescent girls needed more information on menstrual hygiene, reproductive health, and its associated illness. Totally, 45% of the adolescent girls belonged to the age group 17–19 years. About 90% had inadequate knowledge on reproductive health. They preferred group sessions over one-to-one session on these topics and their mother as the source of information. Conclusion: The reproductive and sexual healthcare education that is currently being imparted to the girls need to be devised in such a way that it empowers them. A family member—the mother needs to be trained so that she can make this age transition smooth and stress free. The correct scientific knowledge will help in ensuring sustainable development.

Introduction Many factors exert an effect on the state of health, which are difficult to determine unequivocally, because many of them act together, and only a few occur independently. They also differ with respect to number and the degree of intensity. The diversification of these factors from the territorial aspect, both in Poland and worldwide, requires many actions coordinated by the agencies of international organizations, mainly the World Health Organization. In order to identify and shape the strength of individual and interdependent factors modelling of the state of health it is necessary to undertake further efforts to unify the definitions of health, disease, and disability. In the whole scheme of medical care, the modelling of health status of an individual and the entire population is most important, in the area of actions for health promotion and prophylaxis, mainly on behalf of high quality programmes and the effectiveness of conducting these programmes. Objective The objective of the study was presentation of the significance of the selected health and social factors which may be of primary importance in maintaining and improvement of the state of health, both of an individual and the population. The detailed goals were: the discussion about these factors in the sphere of health promotion and anti-health behaviours, the level of health knowledge among the adult population and availability of health education, types of screening tests and determination of the trends in conducting studies in order to improve the health status and quality of life of an individual and the population. Description of the state of knowledge The literature reports available show that several strategic problem groups, which form sub-groups, contribute to the factors shaping the level of human health, including life style and quality of life, hazards in the physical environment, many natural and geographic factors, opportunities for health education, and the quality of care provided by health services. Qualitative and organizational actions of health care teams functioning in local environments are of special importance in the improvement of the quality of health status of an individual, family, and population. The major areas of actions which are a basis for the maintenance and enhancement of the state of health are health promotion and prophylaxis, as well as rehabilitation understood as a process of stages of actions. Reports are increasingly more often published concerning the modelling of the processes for diagnosing and evaluation of a patient’s state of health. This is, among other things, the modelling of processes related with morbidity in cardiology, the concept of modelling of gossamer space structures in medical diagnosing and diagnosing of the health state of a patient, or the model of normalized life space with consideration of the selected health parameters. Summary Actions aimed at obtaining an improvement in the quality of modelling of the health status of an individual and the population should be based on systematic achievements in prevention studies, which provide possibilities for increasing control of own health of each person. A high quality of actions in the area of prophylaxis and health promotion may contribute to the selection of health promoting behaviours by increasingly larger population groups. An aware selection of such behaviours results in avoidance of risky behaviours, better skills in coping with stress, or selection of a pro-health life style. Efforts undertaken to increase pro-health knowledge lead to a systematic reduction in the incidence of so-called civilization diseases, which are currently a great public health problem.