The Mini-Med School and Its Impact on Future Health Care Professionals' Attitudes toward Indigenous People.

Mini-Med Schools (MiMS) are an opportunity for health sciences and social work undergraduates to discuss health-related topics with Innu and Atikamekw youth in Canada. More than 500 undergraduates and 1,000 students have taken part in the project since its beginning in 2011. This study aims to assess the impact of both 1) MiMS's predeparture training and 2) the MiMS themselves on undergraduates' prejudices toward Indigenous peoples. Satisfaction of the undergraduates taking part in the activity was also assessed. Seventy-eight undergraduates were recruited and completed the Old-fashioned and Modern Prejudiced Attitudes Toward Aboriginals Scales (O-PATAS and M-PATAS) at baseline, after the pre-departure training, and after the MiMS. They also completed satisfaction surveys. This study shows a reduction of prejudices after participating to a MiMS, but no effect of a pre-departure training. The activities were overall appreciated by undergraduates and most of them would like to take part again in the MiMS.

Screening for Cognitive Dysfunction Using the Rowland Universal Dementia Assessment Scale in Adults With Sickle Cell Disease.

Importance: Adults with sickle cell disease (SCD) disproportionally experience early cognitive decline; however, guidance on the optimal screening strategy for cognitive dysfunction is lacking, and several available tools are biased by language, educational level, socioeconomic status, and race/ethnicity. The Rowland Universal Dementia Assessment Scale (RUDAS) was specifically designed for cognitive screening in multicultural populations. Objective: To ascertain the prevalence of suspected dementia in adults with SCD using the RUDAS, and to identify whether age, sex, educational level, several biological variables, and SCD complications were associated with RUDAS scores. Design, Setting, and Participants: This multicenter, bilingual, cross-sectional study was conducted in 2 SCD comprehensive care centers in Canada (Centre Hospitalier de l'Université Montréal in Montréal and University Health Network in Toronto). Participants were adults aged 18 years or older and were enrolled in the study between July 1, 2018, and July 30, 2019. All outpatients were eligible and offered study participation, unless they had an acute medical condition that required inpatient care or they were unable to follow study instructions. Interventions: The RUDAS was administered by trained personnel in either French or English, according to the patient's language preference. A questionnaire on social determinants of health was also administered, and participants underwent screening for anxiety and depression. Main Outcomes and Measures: Proportion of participants with RUDAS scores that were suggestive of dementia and the RUDAS score. Any score lower than 23 points was suggestive of dementia, a score between 23 and 27 points indicated a possible association with mild neurocognitive disorder, and a score higher than 27 points was normal. Results: A total of 252 adult patients with SCD were included (136 women [54.0%]; mean [range] age, 34.8 [18-75] years). Overall, 29 patients (11.5%) had RUDAS scores that were suggestive of dementia, and this proportion increased with age (15 [8.7%] in the 18-39 years age group, 10 [14.5%] in the 40-59 years age group, and 4 [36.4%] in the ≥60 years age group). The RUDAS scores were not associated with sex, language, SCD genotype, and SCD complications. The highest level of education was significantly associated with the RUDAS score; however, the association was small (η2 = 0.02; 95% CI, 0.00-0.07; P = .02). In a multivariable analysis, lower glomerular filtration rate (r = 0.40; 95% CI, 0.29-0.50; P < .001) and increasing age (r = -0.37; 95% CI, -0.47 to -0.26; P < .001), but not SCD genotype or disease severity, were associated with lower RUDAS scores. Conclusions and Relevance: This study found that using the RUDAS revealed a high prevalence of suspected dementia in adult patients with SCD that was associated with worsening kidney function and age. Cognition should be screened in all adult patients with SCD, regardless of age, disease severity, and SCD genotype; further validation of the RUDAS is ongoing.

Cognitive diagnostic assessment via Bayesian evaluation of informative diagnostic hypotheses.

There exist diverse approaches that can be used for cognitive diagnostic assessment, such as mastery testing, constrained latent class analysis, rule space methodology, diagnostic cognitive modeling, and person-fit analysis. Each of these approaches can be used within 1 of the 4 psychometric perspectives on diagnostic testing discussed by Borsboom (2008), that is, the dimensional, diagnostic, constructivist, and causal system perspectives. Bayesian evaluation of informative diagnostic hypotheses is an alternative for each of the other approaches that is more flexible in the diagnostic hypotheses that can be evaluated, and it can be used in each of the 4 psychometric perspectives on diagnostic testing. After being formulated, informative diagnostic hypotheses are evaluated by means of the Bayes factor using only the data from the person to be diagnosed. Already, relatively small diagnostic tests render Bayes factors that provide convincing evidence in favor of 1 of the diagnostic hypotheses under consideration.