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The objective was to evaluate (1) students' knowledge in a variety of geriatrics competencies, (2) students' attitudes toward the value of interprofessional practice, and (3) pharmacy students' experiences after an advanced pharmacy practice experience (APPE) in a practice-based interprofessional education (IPE) model. Nursing, pharmacy, social work, and health sciences programs who participated in the Richmond Health and Wellness Program (RHWP) interprofessional experience received pre- and post-surveys to assess changes in geriatrics knowledge. An adapted Attitude Toward Health Care Teams Scale (ATHCTS) was used to assess changes in students' attitudes toward the value of interprofessional teamwork. Finally, representative quotes were taken from APPE evaluations to illustrate the pharmacy student experience. Seventy-two out of 82 (87.8%) interprofessional students who participated in the practice-based IPE model at RHWP in the fall 2018 participated in this study. Geriatrics knowledge scores significantly increased by 4.03 (P <.001) with a significant change in some knowledge domains: frailty (P =.005) and medication knowledge (P =.017). Attitudes toward the value of interprofessional practice increased with a statistically significant difference in the ATHCTS quality of care subscale (P <.001). Pharmacy students found the interprofessional collaboration to be valuable. A practice-based IPE experience can provide many benefits to health professional students. By working as a team, students learn from each other, leading to increased knowledge on several geriatrics competencies. Students understand the importance of IPE experiences, but their attitudes become more positive through application. [ABSTRACT FROM AUTHOR]

CAREGIVER attitudes, SERVICES for caregivers, RESEARCH, MOTHERS, CAREGIVERS, COUNSELING, DOWN syndrome, MEDICAL care, PATIENTS, BURDEN of care, QUALITATIVE research, SOCIOECONOMIC factors, PATIENT education, PSYCHOLOGICAL adaptation, and PSYCHOLOGICAL factors

Aim and Objective: This study aimed to explore how caregivers of persons with Down syndrome (DS) believe caring had an impact on their own lives. A secondary objective was to understand their experience of seeking educational, social, and health care services for the persons with DS. Methods: This qualitative exploratory study was conducted with 21 caregivers of persons with DS in Kuwait. Results: Caregivers struggled to accept the diagnosis initially that led them to search for answers to many of their concerns about raising a person with DS. For the caregivers, who mostly comprised of mothers, dealing with health conditions that persons with DS suffered from was initially difficult. Caring for these individuals led to heavy impact upon their caregivers' own lives who took extraordinary efforts to cope with the burden. Seeking quality education for the persons with DS and participation in social activities was also challenging, and the caregivers believed that better services, facilities, and benefits for the families of persons with DS may help them better cope with the socioeconomic and psychological burden. Conclusions: Improving the availability of specialized services, the delivery of guidance and counselling, and social integration may help overcome challenges of raising a person with Down Syndrome. [ABSTRACT FROM AUTHOR]

CREATIVE ability, GATEKEEPING, and IMAGINATION

This article is an ontological investigation of the term creativity, to suggest a model that infuses key philosophical and critical perspectives. This article proposes that creativity has three modes of existence or ways of being in the world: the Visceral (embodiments), the Ideational (mind and conceptual), and the Observational (appreciation, critical, and evaluative). We view creativity synergistically as representing both the individual creative experience and output, in conceptual and embodied ways—and also what externally shapes, enhances, and constrains creative experience. Technologies, as tools to think or create with, often mediate the operation of these three modes. We discuss each mode, instantiating it in an educational exemplar, and also engage with issues of power, discourse, and gatekeeping over what is deemed to be creative in education. Our discussion examines the rhetoric around the term, as well as issues of access to technologies that afford creativity. This tri‐modal model of creativity offers an interdisciplinary framework to complement existing models for understanding creativity. [ABSTRACT FROM AUTHOR]

Despite advances in the diagnosis and management of breast cancer (BC), it is still associated with high mortality rates. New biomarkers are being developed for the diagnosis, treatment, and prediction of responses of BC. Ceramide (CER), a bioactive sphingolipid, has emerged recently as a useful diagnostic tool in several types of tumors. In this study, we evaluated CER expression in invasive BC and assessed its relation to the molecular subtypes of BC. The clinical data and histopathological slides of 50 patients with invasive ductal carcinoma were retrieved and reviewed. The cases were then stained with a mouse monoclonal anti-ceramide antibody. Pearson correlation was used to assess the correlation between CER percentage and intensity and other clinical and pathological variables. CER expression showed a direct relationship with estrogen and progesterone receptors Allred scores. However, it showed an inverse relation with tumor grade, HER2/neu status and Ki-67 index. CER expression is likely to be associated with luminal BC molecular subtypes. However, more research is needed to confirm these results and to explore its relation to the different clinical outcomes, including response to treatment and prognosis. [ABSTRACT FROM AUTHOR]

• The program enhanced wellness and healthcare access among medically complex, lower income, older adults living in subsidized apartment buildings. • Health care utilization among participating residents showed a reduction in emergency department visits and hospital admissions. • Positive changes in student perception of interprofessional practice occurred in two areas: teamwork and collaboration and person-centeredness Background/Purpose: An innovative care coordination program was developed to enhance wellness among low-income older adults living in subsidized apartment buildings and to provide rich interprofessional education experiences for health professions students. Program effectiveness for the residents was measured through an evaluation of participation, services used, and healthcare utilization. Educational effectiveness was measured through a change in health concepts and perceptions of interprofessional practice. Health care utilization among participating residents showed an 8.6% reduction in emergency department visits and 9.8% reduction in hospital admissions. Students demonstrated improved knowledge in motivational interviewing (p =.02); diabetes (p =.02); hypertension (p ≤.01); and frailty (p ≤.01). Changes in students perception of interprofessional practice were significant in two areas; Teamwork and Collaboration (p ≥.00); and Person Centeredness (p =.00). This care coordination model may be an effective approach to reduce care resource utilization among medically complex lower income older adults and provides a rich interprofessional learning experience for students. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. This cross-sectional study among female schoolteachers assessed the prevalence of i) unawareness of HPV infection's causal role in cervical cancer; ii) unawareness of HPV vaccine availability and iii) examined the sociodemographic variables associated both the outcome variables. This cross-sectional study was conducted among female schoolteachers employed in public and private sectors schools in Kuwait using a structured questionnaire for data collection. Prevalence of each of the outcome variables was computed. Multivariable logistic regression analyses were used to evaluate independent predictors of two dependent variables. A total 1341 female schoolteachers were enrolled. Of the participants, 60% were unaware of HPV causal role in cervical cancer and 88% were unaware of HPV vaccine availability. Among those who were aware of HPV vaccine availability, 83.8% were unvaccinated. Multivariable logistic regression (MLR) model showed that 20–29 years old participants or those with low family income (< 500 KD/month) were significantly (p < 0.05) more likely to be unaware of HPV causal role in cervical cancer. Moreover, participants with family/ personal history of cervical cancer were significantly (p < 0.05) less likely to be unaware of HPV role in causation of cervical cancer. A separate MLR model revealed that the participants were significantly more likely to be unaware of HPV vaccine availability if they were Kuwaiti nationals or non-Kuwaiti Arabs (p < 0.05), employed in public schools (p = 0.003) or less likely to be unaware if they had personal or family history of cervical cancer (p < 0.001). High prevalences of unawareness of causal role of HPV in cervical cancer and unawareness of HPV vaccine availability were recorded. Targeted education among identified sociodemographic groups with high levels of unawareness is warranted. If undertaken, future studies may evaluate the impact of recommended efforts. [ABSTRACT FROM AUTHOR]

Characteristics of critical Severe Acute Respiratory Syndrome-related Coronavirus 2 (SARS-CoV-2) infection in children is not well understood. This study described the clinical characteristics of children admitted to intensive care units (ICU) and explored factors associated with the need for invasive ventilation or mortality. A multicenter, retrospective, cohort study was conducted over eight medical centers, including all patients younger than 18 years of age and admitted to the ICU due to a direct consequence of coronavirus disease 2019 (COVID-19). Patients who were admitted to the ICU for any alternate reason and tested positive for SARS-CoV-2 by screening test, and patients who were admitted due to multi-inflammatory syndrome in children, were excluded. Demographic, laboratory, imaging, and clinical data were collected. Descriptive statistics were used to compare survivors and non-survivors. Fine and Gray's hazard model was used to estimate the association between clinical variables and ICU death. During the study period, 25 pediatric COVID-19 patients received care in the ICUs. The median age was 2.78 years (IQR 0.21–8.51), and 60% were male. Only three patients were reported to be previously healthy at admission. Nine (36%) patients required invasive mechanical ventilation, including two were on extracorporeal membrane oxygenation. Four (16%) patients died during ICU care. In univariate analysis, the presence of comorbidity (HR 0.0001; 95%CI 0.00001–0.00016), platelets count (HR 0.99; 95% CI 0.98–0.99), elevated procalcitonin (HR 1.05; 95%CI 1.016–1.09), and circulatory compromise (HR 16.34; 95%CI 1.99–134.35), all at the time of ICU admission, were associated with in-ICU mortality. Our findings suggest that children admitted to the ICU with SARS-CoV-2 infection, generally, have a favorable outcome. Low platelets count, elevated procalcitonin, presence of comorbidity, and shock at the time of ICU admission were associated with death. This study may shed more light on the disease dynamics of critical pediatric COVID-19. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is the most common endocrinal disorder, and the greatest cause of infertility in women. Despite availability of individual data on impact of multiple endocrinal, reproductive and even metabolic factors in PCOS individuals, the data on the co-existence of BED and depression in PCOS patients with its relationship on the quality of life in Saudi Arabian females is not found. Hence this study is aimed to elucidate the implication of PCOS on eating behaviour, induction of depression and general health quality in Saudi Arabian population of Riyadh. This is a cross-sectional study carried out in multiple health facilities of Riyadh from January to March 2019. The study samples (494) were recruited by convenience sampling and administered validated questionnaire by trained research participants. The data obtained was analysed by binary logistic regression using SPSS-IBM 25. Of the total 494 women participated in the study, 23.48% (116) were PCOS individuals. The odds of developing abnormal health related quality of (HRQ) in patients with PCOS was significantly (P = 0.000, OR = 3.472) high when compared to non-PCOS participants. The odds of showing high binge eating disorder (BED, P = 0.007, OR = 2.856) and depression (P = 0.000, OR = 2.497) scores in PCOS participants were significantly more than patients who were not having PCOS. Out of the three parameters studied, abnormal health related quality of life possessed a higher influence of PCOS compared to depression and abnormal eating behavior. In conclusion, the present study shows that women with PCOS are at a significant risk for depressive disorders, disorganized eating behavior and impaired quality of life. Therefore, necessary care and screening is required to minimize the impact of PCOS on already burdened individuals. [ABSTRACT FROM AUTHOR]