Experiences matter: Educators’ attitudes toward disability in higher education

This study investigated 128 post-secondary educators’ attitudes toward disability at a college and a university in southwestern Ontario, Canada. The participants completed the Educators’ Attitudes toward Disability Scale (EADS) and a demographic questionnaire that included questions about their experiences with disability. There were three research questions at the heart of this study: (1) What are post-secondary educators’ overall attitudes toward disability? (2) Do demographic factors predict post-secondary educators’ attitudes toward disability? (3) Does exposure to people with disability predict post-secondary educators’ attitudes toward disability? The findings of this study suggest post-secondary educators hold overallpositive attitudes toward disability and there were very few differences observed between groups (e.g., based on age, gender, discipline, etc.). Educators’ experiences with people who have a disability, however, were positively associated with their attitudes. This factor included personal experiences (e.g., friends, family, etc.), but also professional experiences (e.g., students in their classes).

Clinical and Laboratory Features in Anti-NF155 Autoimmune Nodopathy

Background and ObjectivesTo study the clinical and laboratory features of antineurofascin-155 (NF155)–positive autoimmune nodopathy (AN).MethodsPatients with anti-NF155 antibodies detected on routine immunologic testing were included. Clinical characteristics, treatment response, and functional scales (modified Rankin Scale [mRS] and Inflammatory Rasch-built Overall Disability Scale [I-RODS]) were retrospectively collected at baseline and at the follow-up. Autoantibody and neurofilament light (NfL) chain levels were analyzed at baseline and at the follow-up.ResultsForty NF155+ patients with AN were included. Mean age at onset was 42.4 years. Patients presented with a progressive (75%), sensory motor (87.5%), and symmetric distal-predominant weakness in upper (97.2%) and lower extremities (94.5%), with tremor and ataxia (75%). Patients received a median of 3 (2–4) different treatments in 46 months of median follow-up. Response to IV immunoglobulin (86.8%) or steroids (72.2%) was poor in most patients, whereas 77.3% responded to rituximab. HLA-DRB1*15 was detected in 91.3% of patients. IgG4 anti-NF155 antibodies were predominant in all patients; anti-NF155 titers correlated with mRS within the same patient (r = 0.41, p = 0.004). Serum NfL (sNfL) levels were higher in anti-NF155+ AN than in healthy controls (36.47 vs 7.56 pg/mL, p < 0.001) and correlated with anti-NF155 titers (r = 0.43, p = 0.001), with I-RODS at baseline (r = −0.88, p < 0.001) and with maximum I-RODS achieved (r = −0.58, p = 0.01). Anti-NF155 titers and sNfL levels decreased in all rituximab-treated patients.DiscussionAnti-NF155 AN presents a distinct clinical profile and good response to rituximab. Autoantibody titers and sNfL are useful to monitor disease status in these patients. The use of untagged-NF155 plasmids minimizes the detection of false anti-NF155+ cases.Classification of EvidenceThis study provides Class IV evidence that anti-NF155 antibodies associate with a specific phenotype and response to rituximab.

550 - Caregiver Burden and Geriatric Patients Undergoing Electroconvulsive Therapy in the COVID-19 Era

IntroductionCaregivers are essential in providing valuable patient information to medical providers. With limited available research investigating caregiver burden among those caring for patients receiving ECT and the new life challenges presented by the COVID-19 pandemic, it is more important now than ever to take a closer look at the caregivers’ experiences.MethodsEmory’s Wesley Woods Geriatric Hospital is one of the busiest ECT services in the country with around 2000 treatments completed every year. In this chart review, researchers are looking at caregivers’ responses to the Zarit Caregiver Burden Interview. This assessment includes 22 questions assessing the caregivers’ current emotional state in order to examine the impact of the patient’s condition oncaregiver wellbeing. The score ranges from 0 (no burden) to 88 (severe burden). Other objective assessments completed with ECT patients are BDI (Beck Depression Inventory), BDI Suicide, Sheehan Disability Scale, ECCA (Electrocompulsive Cognitive Assessment), GAD-7 (Generalized Anxiety Disorder Scale), and CGI (Clinical Global Impression). The purpose of this chart review is to investigate whether the higher severity of depression in patients correlates with higher levels of caregiver burden and whether the pandemic contributed to caregiver burden.ResultsThe Zarit Caregiver Burden Interview has been administered on twelve caregivers (n=12; 6 male and 6 female), all providing care for patients currently undergoing ECT for depressive symptoms. Out of the twelve caregivers, 66.6% reported little caregiver burden, 16.6% reported mild to moderate burden, and 16.6% reported moderate to severe burden. Additional patients are being interviewed in the ECT suite and further data collected will be presented at the 2021 IPA Virtual International Congress.ConclusionAs the world adjusts to life in the COVID-19 era, caregivers face new challenges in providing care for vulnerable, at-risk populations. Caregivers of patients receiving ECT facilitate frequent COVID testing and limited visitation policies while continuing to provide care and emotional support to patients with advanced age and a mental illness. Administrating the Zarit Caregiver Burden Interview can help providers look at the degree of burden in caregivers of patients receiving ECT for depressive symptoms and provide better caregiving strategies during and post pandemic.

Pandemic Grief Scale in detection of grief reaction among physicians in COVID-19 era

Background Physicians are considered one of the most vulnerable groups who might develop pandemic grief during this critical time of COVID-19 infection, and this grief reaction might have deleterious effects on their life. This cross-sectional observational online study aimed to investigate the pandemic grief reaction among physicians and its burden on their aspects of life. Results Socio-demographic characteristics of 900 physicians were collected. The Pandemic Grief Scale (PGS) was used to detect the grief reaction among them and also Patient Health Depression Questionnaire-9 (PHQ-9) was used to evaluate the depressive manifestations. Sheehan Disability Scale was considered to investigate the burden of this grief on different aspects of life. The study revealed high mean score of Pandemic Grief Scale: 11.12 ± 2.34; the mean score of Sheehan Disability Scale was 17.63 ± 5.17, and the mean score of Patient Health Depression Questionnaire-9 was 19.89 ± 4.27. Conclusion Pandemic grief is commonly experienced by the physicians during this COVID-19 era due to sudden loss of loved one or the cases themselves. This pandemic grief has drastic effect on domains of physicians’ life.

Perbedaan Nilai The Clinic GBS Severity Evaluation Scale (CGSES) dan Skala Disabilitas Sindroma Guillain-Barre (SDSGB) pada Pasien Sindroma Guillian Barre dengan dan tanpa Imunoterapi

Background and objective: The Clinical GBS Severity Evaluation Scale (CGSES) was developed to determine immunotherapy of GBS patients more objectively. GBS Disability Scale (SDSGB) describes severity of GBS and assesses effectiveness of immunotherapy. Purpose of this study was to measure difference of CGSES and GBSDS in GBS patients with and without immunotherapy and to compare the suitability of subjective decisions with CGSES. Subject and Methods: This is a comparative cross-sectional analytic observational study retrospectively in GBS patients from January 2015-March 2020 hospitalized at Dr Hasan Sadikin Hospital, Bandung. Results: There were 92 subjects (35 with and 57 without immunotherapy). Mean age was 41.5 years, and male:female ratio was 57.6%:42.4%. There were no differences in demographics and physical examination between two groups, except for cranial nerve paresis (62.9% vs. 33.3%; p=0.006). There was a difference in mean length of stay with and without immunotherapy (29.5 ± 34.4 vs. 11.4 ± 4.1 days, p=0.0001). Results of the CGSES assessment with and without immunotherapy had a significant difference (p=0.035). There were significant differences in GBSDS at admission and discharge with (p=0.007) and without immunotherapy (p=0.025). There was a discrepancy between subjective decisions and CGSES value (Kappa value 0.117; 95% CI 0.021-0.213). Conclusion: There were differences in CGSES and GBSDS in group of GBS patients with and without immunotherapy. There was a discrepancy between subjective assessment of decision to give immunotherapy with CGSES scoring.

Functional outcomes following inpatient rehabilitation of guillain-barré syndrome patients: Intravenous immunoglobulins versus plasma exchange

BACKGROUND: Treatment with either Intravenous immunoglobulin (IVIg) or plasma exchange (PE) in patients with Guillain-Barré Syndrome (GBS) showed equivalent efficacy as attested by a commonly used disability scale. However, it has been suggested that this scale may not be sensitive enough to detect subtle functional changes between the two treatments since it mainly focuses on walking capability and respiratory function. OBJECTIVE: To evaluate functional outcomes following treatment with IVIg or PE using comprehensive scales that incorporate parameters of basic activities of daily living. METHODS: A retrospective cohort study was conducted between 2007 and 2013 in an inpatient neurologic rehabilitation department. The study group included 70 individuals with GBS: 39 were treated with PE and 31 with IVIg. A comparison of functional outcomes was performed using Functional Independence Measure (FIM), rehabilitation efficiency (REy), rehabilitation effectiveness (REs), and the GBS disability scale (GDS). RESULTS: Both treatments had a comparable effect on the various functional outcomes. Patients showed a significant increase in total FIM scores (30 points on average) during rehabilitation mainly as a result of an increase in motor sub-scores. A mean improvement of 1.23 (SD 0.9) in GDS was also observed. On average, individuals with GBS spent 20 days combined in the acute departments and 61 days in the rehabilitation department, with length of stay being similar for both treatments. CONCLUSIONS: IVIg and PE treatments have similar basic activities of daily living (ADL) functional outcomes. Nevertheless, due to the different mechanism of actions of these treatments and the multitude of GBS variants, it is possible that further comprehensive assessment tools may demonstrate differences in activity and participation of individuals with GBS.

Perception and Acceptance of People with Disabilities by Employers and Co-Workers

The perception of people with disabilities is crucial for their full inclusion and in order that they might stay economically active. The measurement tools used should be resistant to the demographic or professional characteristics of the research participants. The article attempts to test this resistance for one of the most popular tools measuring the perception of people with disabilities in everyday life—the Attitudes to Disability Scale (ADS) test developed by the WHOQOL Group. Another issue raised in the article is the acceptance of people with various types of disabilities in terms of their possible employment. We checked the differentiation of acceptance among employers from different countries. This article uses representative samples of respondents from two studies—the CATI research (2019) on samples of Polish employers and co-workers, and the CAWI research (2021) on samples of employers from Poland and Finland. The analysis methods used included confirmatory factor analysis, nested models and nonparametric analysis of variance. The research confirmed the resistance of the ADS scale to respondents’ characteristics, and found no differences for nested models constructed for groups based on categorical variables characterizing the respondents. As for acceptance of various types of disability in the workplace, significant differences were found in the statements of employers from Poland and Finland.