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Interprofessional education (IPE) occurs when students are provided the opportunity to learn with and from others of related professions to improve the potential for future collaboration. The aim of this study was to explore the perceptions of students about working with professionals from different disciplines before and after their engagement in an interprofessional learning activity and determine any changes in their willingness to work in interprofessional teams. Doctor of Pharmacy students from the University of Manitoba and Master's speech-language pathology students from McMaster University participated in an online inter-university and inter-provincial education module. Students were invited to complete the Interprofessional Socialization and Valuing Scale (ISVS-9B) and three open-ended questions to capture attitudes toward interprofessional teams before and after the IPE event. A mixed-method approach was used to assess changes in attitudes, values, and comfort with collaborating. A total of 20 students completed the pre-survey and 19 completed the post-survey; significant changes in total ISVS-9B scores were observed. Four questions of the ISVS-9B also showed significant positive changes after the IPE event. Qualitative themes were identified from responses to the open-ended questions: collaboration optimizes patient care, collaboration is fostered by clear communication, learning from peers increases knowledge and appreciation of professional roles, and IPE fosters the potential for future collaborations. This study suggests that a virtual IPE event tailored to pharmacy and speech-language pathology trainees may be effective in fostering future interdisciplinary collaboration through increasing knowledge and appreciation of other professional roles with a primary goal of optimizing patient care.

Individuals with disabilities have been less involved in school activities than their peers of the same age and this includes career preparation in science and math (Agran et al., 2019; Eriksson et al., 2007; Jackson et al., 2022). Students with disabilities often lack access to facilities, programs, and equipment, and acceptance by educators, employers, and co-workers (Burgstahler, 1994). The effects of a virtual reality (VR) human anatomy application as the means of teaching science vocabulary definitions and locations acquisition for three different human anatomy systems (digestive, respiratory, and integumentary) to college-age students with intellectual disability (ID) are reviewed. This single subject, multiple baseline study included two transition age youth with ID. The intervention package included both a guided and exploratory portion. Data were collected on the participants' accuracy on the definitions and locations of ten vocabulary words for each of the three body systems on a paper assessment. Findings indicated that a functional relation existed between the implementation of the intervention package and an increase in the accuracy of scores in both definitions and locations for each of the three body systems for each participant.

This article is dedicated to the late Michael D. Fetters--a giant in the world of mixed methods research, an exceptional researcher and scholar, a professor of family medicine, a caring and beloved family physician, a lifelong learner, a colleague, a mentor, a steadfast advocate, a son, a sibling, a husband, a father, and, above all, a dear friend to everyone who knew him. Inspired by Professor Fetters's innovation, we offer an expanded definition of autoethnography through the formal introduction of the 10 dimensions of autoethnography, as well as the debut of mixed methods autoethnography and of integrated mixed methods autoethnography. An autoethnographic narrative writing style honors both the research genre and the mixed methods researchers' voices.

Emerging research suggests that episodic memory challenges are commonly encountered by autistic individuals; however, the specific nature of these memory challenges remains elusive. Here, we address critical gaps in the literature by examining pattern separation memory, the ability to store distinct memories of similar stimuli, and its links to the core autistic trait of repetitive, restricted interests and behaviors. Utilizing a large sample of over 120 autistic children and well-matched non-autistic peers, we found that autistic children showed significantly reduced performance on pattern separation memory. A clustering analysis identified three distinct pattern separation memory profiles in autism, each characterized by reduced or increased generalization abilities. Importantly, pattern separation memory was negatively correlated with the severity of repetitive, restricted interest and behavior symptoms in autism. These findings offer new evidence for challenges in pattern separation memory in autism and emphasize the need to consider these challenges when assessing and supporting autistic individuals in educational and clinical settings.

Improving the development of the social, emotional, and physical domains during early childhood impacts the overall trajectory of a child's well-being. However, researchers often address these independently, leaving a gap for a more integrated approach to promoting development. This study explores the effects of a dual-component intervention on changes in preschool-aged boys' and girls' gross motor and social-emotional skills. Preschoolers (N = 475; girls = 220 and boys = 255) ages 3-6 years completed the 9-month dual-component intervention and were randomized into control (n = 148) or intervention (n = 327) groups by classroom. Significant improvements were observed in social skills, locomotor, and total Test of Gross Motor Development-3. Additionally, boys and girls improved at the same rate in ball skills, locomotor, and total Test of Gross Motor Development-3. These results suggest that the dual-component intervention can improve preschoolers' social skills and motor skills with no differential effects.

Abstract Anaphylaxis is an acute, potentially fatal systemic hypersensitivity reaction with varied mechanisms and clinical presentations. Although prompt recognition and treatment of anaphylaxis are imperative, both patients and healthcare professionals often fail to recognize and diagnose its early signs. Clinical manifestations vary widely, however, the most common signs are cutaneous symptoms, including urticaria and angioedema. Immediate intramuscular administration of epinephrine into the anterolateral thigh is first-line therapy, and is always safe even if the diagnosis is uncertain. The mainstays of long-term management include specialist assessment, allergen avoidance measures, and the provision of an epinephrine auto-injector with an individualized anaphylaxis emergency plan. This article provides an overview of the causes, clinical features, diagnosis, and acute as well as long-term management of anaphylaxis.

Abstract Background Mobile health (mHealth) applications have been utilized in chronic diseases to improve medication adherence, though factors driving engagement remain understudied. We previously demonstrated the benefits of mHealth app utilization in increasing adherence to hydroxyurea. In the “Integration of mHealth into Sickle Cell Disease (SCD) Care to Increase Hydroxyurea Utilization” (meSH) study, greater engagement with the InCharge Health app increased the percentage of days covered (PDC) for hydroxyurea. However, factors influencing app engagement were not investigated. This study aimed to identify patient-level factors associated with mHealth engagement during and post-study among adolescents and adults with SCD. Methods All meSH participants were included. The InCharge Health app use was measured for 24 weeks (study period) and 12 weeks (post-study period). Baseline demographics and validated measures of self-efficacy, financial hardship, and pain severity, impact, and frequency were evaluated as predictors of app engagement during the study period and post-study using linear models. Results Complete app use data were obtained from 284 of 293 participants, including 150 (52.8%) females and 240 (84.8%) who were HbSS/HbSβ0-thalassemia with a median age of 27 years. During the study period, 232 (81.7%) used InCharge Health at least once (median use excluding zeros: 26 days; IQR: 7–72 days). During the post-study period, 132 (46.5%) participants used the app at least once (median use excluding zeros: 16 days; IQR: 3–44 days). During the study period, the HbSS genotype, age > 25 years, higher education, higher self-efficacy score, and lower pain severity were associated with greater app engagement. Only age (p = 0.0032) and financial hardship (p = 0.0125) were significant in a multivariable model after backward elimination. During the post-study period, older age (p = 0.035), lower pain severity (p = 0.021) and lower frequency of pain (p = 0.033) predicted mHealth engagement. All three remained significant in a multivariable model after backward elimination. Conclusions Older age, lower financial hardship, lower pain severity, and greater self-efficacy were associated with increased engagement with a mHealth intervention for improving medication adherence among people living with SCD. This research can shift future app development from focusing on factors that drive patient interaction with mHealth targeting modifiable factors influencing app engagement. Trial registration The trial was registered with ClinicalTrials.gov. Registration Identifier: NCT04080167. Registration date: November 11, 2019.

Abstract This position statement addresses the critical concerns and recommended practices surrounding the use of panel food testing for diagnosing food allergies. Food allergies are a significant public health concern, and the misdiagnosis of food allergies remains a prevalent concern, made worse by the ongoing use of panel food testing. The practice of screening patients for multiple food allergens, regardless of clinical relevance, is commonly referred to as “panel food testing.” Fundamentally, a panel food test is not simply a single test; a panel food test is a series of several distinct tests for multiple foods, each with its own variable predictive value. These tests have not been adequately validated as screening tests and carry a considerable false positive rate. The resulting false diagnoses lead to unnecessary dietary restrictions, increased healthcare costs, and significant psychosocial distress for patients and their families.

Abstract Background Timothy syndrome (OMIM #601005) is a rare disease caused by variants in the gene CACNA1C. Initially, Timothy syndrome was characterized by a cardiac presentation of long QT syndrome and syndactyly of the fingers and/or toes, all associated with the CACNA1C variant, Gly406Arg. However, subsequent identification of diverse variants in CACNA1C has expanded the clinical spectrum, revealing various cardiac and extra-cardiac manifestations. It remains underexplored whether individuals with the canonical Gly406Arg variants in mutually exclusive exon 8A (Timothy syndrome 1) or exon 8 (Timothy syndrome 2) exhibit overlapping symptoms. Moreover, case reports have indicated that some CACNA1C variants may produce a cardiac-selective form of Timothy syndrome often referred to as non-syndromic long QT type 8 or cardiac-only Timothy syndrome, however few reports follow up on these patients to confirm the cardiac selectivity of the phenotype over time. Methods A survey was administered to the parents of patients with Timothy syndrome, querying a broad range of symptoms and clinical features. Study participants were organized into 5 separate categories based on genotype and initial diagnosis, enabling comparison between groups of patients which have been described differentially in the literature. Results Our findings reveal that Timothy syndrome patients commonly exhibit both cardiac and extra-cardiac features, with long QT syndrome, neurodevelopmental impairments, hypoglycemia, and respiratory issues being frequently reported. Notably, the incidence of these features was similar across all patient categories, including those diagnosed with non-syndromic long QT type 8, suggesting that the ‘non-syndromic’ classification may be incomplete. Conclusions This study represents the first Natural History Study of Timothy syndrome, offering a comprehensive overview of the disease’s clinical manifestations. We demonstrate that both cardiac and extra-cardiac features are prevalent across all patient groups, underscoring the syndromic nature of CACNA1C variants. While the critical role of long QT syndrome and cardiac arrhythmias in Timothy syndrome has been well recognized, our findings indicate that hypoglycemia and respiratory dysfunction also pose significant life-threatening risks, emphasizing the need for comprehensive therapeutic management of affected individuals.

Abstract Background COVID-19 vaccine effectiveness declines months after vaccination. Therefore, it is likely that during the next few years, people may be repeatedly offered a booster vaccine to enhance humoral immunity levels. A growing number of people are questioning whether the benefits of a booster vaccine outweigh the side-effects. Objective This study aims (1) to identify the most frequently reported side-effects after different doses of COVID-19 mRNA vaccines, (2) and the longest lasting symptoms; and (3) to predict the likelihood of having moderate-to-severe side-effects after a booster COVID-19 mRNA vaccine given individual- and vaccine-specific characteristics. Design, setting, and participants Secondary analysis of a prospective cohort study in primary health care providers (PHCPs) in Belgium conducted between December 2020 and December 2021, and in February-March 2023. Methods In nine subsequent surveys over a period of 2 years vaccine dose-number and side-effects after COVID-19 vaccines were collected. A Generalized Estimation Equations approach on the data of the first and second booster dose was used to investigate the probability of having moderate-to-severe side-effects after mRNA booster vaccination. Predictive performance of a binary classifier was assessed by looking at discrimination (i.e., quantified in terms of the area under the receiver operating characteristic curve). The final prediction model was validated using data with regard to the third booster by assessing misclassification rate, sensitivity and specificity. Results In total, 11% of the PHCPs had moderate-to-severe side-effects after their booster COVID-19 mRNA vaccine. The most common side-effects of COVID-19 mRNA doses included fatigue, local pain at the injection site, general pains, and headache. These side-effects typically lasted for a median of 1 to 2 days. The final model included five predictors: sex, alcohol consumption, history of moderate-to-severe side-effects after any previous dose, recent COVID-19 infection, and the booster dose-number (first, second). Having experienced moderate-to-severe side-effects after any previous dose was the strongest predictor of moderate-to-severe side-effects following an mRNA vaccine booster, with an odds ratio (OR) of 3.64 (95% CI: 2.80–4.75). The OR for female sex was 1.49 (95% CI: 1.21–1.84) implying that females have a higher odds of moderate-to-severe side-effects following booster vaccination. The differences in effect for booster dose-number, alcohol consumption and recent COVID-19 infection was not significant. Conclusion and relevance COVID-19 mRNA booster vaccination implies a low prevalence of moderate-to-severe side-effects among PHCPs, with a short median duration of symptoms if any. The strongest predictors are a history of moderate-to-severe side-effects after any previous dose and being female. These reassuring findings can help addressing concerns about booster vaccination and encourage their uptake. Trial Registration NCT04779424 (registration date: 2021-02-22).

The purpose of this study was to examine the use of virtual reality, an emerging technology, to teach college-age students with intellectual disability and autism to acquire science vocabulary words relating to human anatomy. One student with autism and two students with an intellectual disability participated in a multiple baseline across skills (i.e., acquisition of science vocabulary words) design. Data were collected on the three students' abilities to define and label three sets of human anatomy vocabulary words (i.e., bones, muscles, and organs) while using Organon 3D. Students used this application while using the Oculus Rift S, a virtual reality head-mounted display. Results indicated that all students acquired definitions and labeling knowledge for the new science vocabulary terms in the area of human anatomy.

This study aimed to better understand how autism spectrum disorder (ASD) and developmental coordination disorder (DCD) differ in types of praxis errors made on the Florida Apraxia Battery Modified (FAB-M) and the potential relationships between praxis errors and social deficits in ASD. The ASD group made significantly more timing sequencing errors in imitation of meaningful gestures, as well as more body-part-for-tool errors during gesture-to-command compared to the other two groups. In the ASD group, increased temporal errors in meaningful imitation were significantly correlated with poorer affect recognition and less repetitive behaviors. Thus, in ASD, aspects of imitation ability are related to socioemotional skills and repetitive behaviors.

Garden-based learning, a key component of Farm to School (FTS), continues to grow in popularity as a tool for engaging students in hands-on learning. Recent literature calls for professional development to help educators overcome barriers - including a lack of horticulture skills, curricular connections, and time - that often hinder program success and sustainability. This study sought to understand the role of professional development and its ability to support resilient FTS programs in the classroom. Following participation in a multiday FTS professional development program, seven educators participated in an 11-month photo elicitation study to capture their experience implementing FTS in their classrooms. We find that educators drew on FTS professional development to expand their self-efficacy by successfully implementing what they learned, observing effective models, being affirmed by colleagues and others, and growing their overall confidence to engage in the work. Results also identified persistent barriers that professional development alone cannot reduce.