Attitudes towards people with disabilities across different healthcare undergraduate students: A cluster analysis approach.

BACKGROUND AND PURPOSE: Negative attitudes towards disability amongst healthcare professionals endanger social inclusion of people with disabilities (PwD). This study aimed to investigate the attitude of undergraduate healthcare students of various disciplines towards PwD, including specific aspects of their attitude. METHODS: We assessed the attitudes of university students, including physiotherapy, speech therapy, nursing, social work and medical students, through the Greek Interaction with Disabled Person Scale (IDPS) in a survey. Data were analysed using a two-step clustering technique. RESULTS: Four hundred-eighty undergraduate healthcare students (21.4 ± 5.3 years-old; 135 males, 345 females) were recruited. Two-step cluster analysis identified three homogenous subgroups labelled Least positive attitude (42.3%), Moderately positive attitude (26.9%), and Most positive attitude (30.8%) groups. Τhe main differences in healthcare students' attitudes between the three distinct groups appeared to be in feelings of sympathy, fear and susceptibility towards disability, suggesting that these aspects of attitude needed to be primarily addressed. Results also revealed that females, being in higher semester/year of studies, having completed a clinical module with PwD and having frequent contact with PwD were related to more positive attitudes. CONCLUSION: Taking into account that the majority of the healthcare students' sample yielded least and moderately positive attitudes, towards PwD, further actions should be taken for promoting more positive attitudes towards disability. A social model in teaching to increase student's awareness of PwD and skills to work with these people, having PwD themselves teaching such modules, focussing on positive experiences and reminding the students of the benefits of having positive attitudes towards PwD, as well as promoting ways to increase the contact of healthcare students with PwD (such as teaching in co-operation with organisations of PwD or finding alternative clinical placements with PwD), can be beneficial in promoting more positive attitudes towards disability.

Toxoplasmosis and Schizophrenia: A Systematic Review and Meta-Analysis of Prevalence and Associations and Future Directions.

Background: A potential link between toxoplasmosis with schizophrenia (SCZ) has been extensively studied over the past 2 decades. Our study was aimed to determine whether, beyond an association, the field is primed for randomized clinical trials of anti-Toxoplasma prophylaxis in Toxoplasma seropositive patients with SCZ. Methods: We performed a methodological appraisal of toxoplasmosis-SCZ association studies, a meta-analysis, and a compilation of claims and pathophysiologic hypotheses. Results: We analyzed 66 studies with 11,540 patients with SCZ and 69,491 controls. For patients with SCZ, 54 studies targeted Toxoplasma-IgG seropositivity, 18 targeted Toxoplasma-IgG serointensity, and 17 targeted Toxoplasma-IgM seropositivity. For SCZ-phenotypes, 26 targeted Toxoplasma-IgG seropositivity, six targeted Toxoplasma-IgG serointensity, and three targeted Toxoplasma-IgM seropositivity. Two-thirds of these studies reported a positive association. Statistically significant associations with SCZ were reported in 31/54 studies, 11/18 studies, and 3/17 studies. Significant associations with SCZ-phenotypes were reported in 20/26 studies, 2/6 studies, and 0/3 studies, respectively. Toxoplasma-IgG seropositivity increased the odds of SCZ (OR = 1.91; 95% CI: 1.61-2.27). Heterogeneity across studies was large (I 2 = 80.03%). Adjusted analyses for at least age and socioeconomic status/place of residence were done in 17 studies; temporality was addressed only in 4. Conclusion: A large number of observational studies revealed a modest to large association between toxoplasmosis and SCZ. Although important methodological biases were identified, further association studies are unlikely to change this association and are not justified. It is time to test this association in randomized double-blind placebo-controlled clinical trials of first line anti-Toxoplasma prophylaxis in Toxoplasma seropositive patients with SCZ.

Transient Cytopenias as a Rare Presentation of Classic Galactosemia.

Although galactosemia can be detected through neonatal screening, some cases are characterized by rapid and severe presentation before screening results become available. We report the case of a neonate with classic galactosemia presenting with acute liver failure and cytopenias (thrombocytopenia, anemia, and neutropenia). Neonatal screening results showed increased galactose and phenylalanine levels. The diagnosis of galactosemia was confirmed by the measurement of galactose-1-phosphate uridyltransferase (GALT) activity in erythrocytes. Two mutations of the GALT gene (c.563 A>G [p. Q188R] and c.957C>A [p.H319Q]) were revealed. High clinical suspicion of galactosemia is crucial to identify, as early as possible, cases with classical or even unusual presentation, and to initiate early treatment that could change the disease course and improve outcomes. Cytopenias should be included in the broad phenotypic spectrum of galactosemia.

The Interaction with Disabled Persons Scale: evidencing construct validity with factor analysis and measurement invariance in Greek-speaking healthcare students.

PURPOSE: To explore the construct validity and reliability of the Greek version of the Interaction with Disabled Persons Scale (IDPS) amongst healthcare students. METHODS: Greek IDPS factors were extracted and confirmed by Analysis of Moment Structures. Measurement invariance for the group of students completing a clinical module with people with disabilities was also evaluated. The scale was distributed twice, 3 weeks apart (test-retest reliability) to sample. Greek IDPS scores amongst students with frequent contact with people with disabilities were compared with those with infrequent contact (discriminant validity). RESULTS: 327 healthcare students (21.25 ± 4.3 years, 118 males) participated. Exploratory factor analysis extracted 6 factors explaining 55.66% of total variance. Confirmatory factor analysis showed a good fit of the model (AGFI = 0.95 > 0.90, RMSEA = 0.07 < 0.08, CFI = 0.95 ≥ 0.90, SRMR = 0.00 < 0.08). An adequate fit for the students completing a clinical practice module was observed. The scale's test-retest reliability and internal consistency were excellent; ICC(2,1)=0.86 (CIs:0.82-0.89) and Cronbach's α = 0.87, respectively. Statistically significant differences between the two student groups were yielded; students with frequent contact with people with disabilities had lower scores (mean difference: -4.5; CI: -6.6 to -2.4), suggesting that they were significantly more comfortable with people with disabilities than the students with infrequent contact. CONCLUSION: The Greek IDPS provided sufficient validity and reliability evidence for evaluating healthcare students' perceptions and attitudes towards people with disabilities.IMPLICATIONS FOR REHABILITATIONThe Greek IDPS demonstrated sufficient validity and reliability evidence to assess the Greek-speaking healthcare students' perceptions and attitudes towards people with disabilitiesCompleting a clinical module working with people with disabilities is not enough to produce adequately positive attitudes in Greek-speaking undergraduate healthcare students. Therefore, faculties need to organize further actions, such as lectures by people with disabilities, students' role play, and discussions or events in co-operation with people with disabilities.

Measles epidemic in pediatric population in Greece during 2017-2018: Epidemiological, clinical characteristics and outcomes.

BACKGROUND AND AIM: A measles outbreak occurred in Greece during 2017-2018 affecting mainly pediatric population. The aim of the study was to describe the epidemiological and clinical characteristics of the cases diagnosed in the major pediatric tertiary hospital of Athens, where 26.5% of national pediatric measles cases were diagnosed and treated. METHODS: This is a retrospective study of children 0-16 years old, who presented at the emergency department and/or were hospitalized with clinical presentation compatible with measles and diagnosis was confirmed with molecular detection of the measles RNA in pharyngeal swabs. Epidemiological, clinical and laboratory characteristics were retrieved from medical records and analyzed. RESULTS: A total of 578 children with measles were identified during the study period. 322 (55.7%) were male with median age 36 months (range:1-193), while the largest number of documented cases (251; 43.4%) were children aged 1-5 years. Most children (429/578; 74.2%) belonged to the Roma minority and only 64 (11.1%) had Greek origin. 497 (91.5%) children were unvaccinated and 37 (6.8%) were partially vaccinated with measles vaccine. Hospitalization was required for 342 (59.2%) children, whereas one or more complications were reported in 230 (67.2%) of them. Most frequent complications were elevated transaminases (139; 40.6%), acute otitis media (72; 21%), dehydration (67; 19.6%) and pneumonia (58; 16.9%). 11 children (3.2%) required intensive care admission for altered mental status/status epilepticus (3), sepsis (2) and ARDS (6). 119/342 (34.8%) children were treated with antibiotics because of possible or confirmed bacterial coinfection. One death was reported, concerning an 11-month-old unvaccinated infant, with underlying dystrophy, who died of sepsis. CONCLUSION: Measles is not an innocent viral infection, as it is still characterized by high morbidity and complications rates. Unvaccinated or partially vaccinated populations could trigger new outbreaks, resulting in significant cost in public health. To avoid future measles outbreaks, high vaccination coverage should be achieved, as well as closing immunity gaps in the population and ensuring high-quality measles surveillance.