A Novel Disability Advocacy and Awareness Program for Training Future Healthcare Professionals on Care for Patients with Disabilities.

In a poll of 714 US physicians, it was revealed that only 40.7% felt very confident in their ability to provide the same quality of care, overall, to patients with disabilities (PWDs) compared with patients without disabilities. It was also found that only 56.5% strongly agreed that they welcomed PWDs into their practice as healthcare providers. This suggests a systemic issue of inequity in medicine, which affects both physicians and patients. If this problem is not corrected, our healthcare system will continue to lack in providing adequate care to PWDs. A key component of this issue is that the lack of confident care for PWDs appears to be a result of insufficient exposure to PWDs during the formative years in medical schools. Although medical students are taught extensive clinical skills and bedside manners, there appears to be little mention of how to make adaptations to basic patient encounters to accommodate PWDs. Further, the lack of representation of PWDs in the medical community results in minimal experience among trainees and the perpetuation of unjust biases in the healthcare system. Changes to the medical field must start with shaping future physicians and filling the void in medical education. As a solution, we at Florida State University (FSU) College of Medicine (COM) propose a program called the Disability Advocacy and Awareness Program (DAAP). Two interactive sessions were designed, and students were offered an immersive experience in which they were not only provided with information through well-crafted presentations but also encouraged to engage in direct interactions with PWDs and a myriad of assistive devices. We believe a great deal of the program's success stemmed from the two-phase interactive model that allowed students to undergo a truly immersive experience that a textbook cannot endow. Although we cannot expect every provider to be an expert on all disabilities, all physicians should have an understanding of how a disability may impact a patient's life and medical care. Improved knowledge and awareness surrounding disability and the barriers faced by the PWD population will provide insights that will allow for the most equitable, patient-centered care for the disabled community.

Correction: A Novel Disability Advocacy and Awareness Program for Training Future Healthcare Professionals on Care for Patients with Disabilities.

[This corrects the article DOI: 10.7759/cureus.33881.].

Personality traits at age 16 and risk of metabolic syndrome at age 46.

OBJECTIVE: To examine whether five-factor model personality traits at age 16 are associated with risk of metabolic syndrome 30 years later at age 46 and whether adolescent personality mediates the association between childhood social class and midlife metabolic health. METHODS: Participants were from the British Cohort Study 1970, a birth cohort study of participants all born in the same week in 1970. Personality was assessed by participants' mothers (n = 3819) and participants' themselves (n = 2697) at age 16. The five components of the metabolic syndrome were measured at the age 46 assessment: elevated blood pressure, glucose, triglycerides, waist circumference and lower HDL cholesterol. RESULTS: Mother-rated neuroticism and mother-rated conscientiousness at age 16 were associated with risk of metabolic syndrome at age 46 (OR = 1.19, 95% CI = 1.04, 1.36 and OR = 0.70, 95% CI = 0.62, 0.78, respectively). Self-reported neuroticism was also associated with metabolic syndrome risk (OR = 1.43, 95% CI = 1.08, 1.91). Mother-rated conscientiousness at age 16 accounted for 10% of the association between childhood social class and metabolic health at age 46. None of the other traits were significant mediators. CONCLUSION: Consistent with lifespan models of personality and health, age 16 personality traits were associated with metabolic health measured 30 years later. Personality traits may also function as a mechanism through which early-life socioeconomic status contributes to midlife health.

Differential consequences of habitual responding in a mouse model of repetitive behavior.

Restricted, repetitive behavior (RRB) is diagnostic for autism spectrum disorder (ASD) and characteristic of a number of neurodevelopmental, psychiatric, and neurological disorders. RRB seen in ASD includes repetitive motor behavior and behaviors reflecting resistance to change and insistence on sameness. C58 mice provide a robust model of repetitive motor behavior and have shown resistance to change in a reversal learning task. We further characterized resistance to change in this model by inducing habitual responding and testing for differences in the ability to suppress habitual behavior and shift to goal-directed responding. We found no differences between C58 and control (C57BL/6) mice in the acquisition of operant tasks, habit formation, and expression of habitual responding. Habitual responding, however, induced significant reversal learning and contingency reversal performance deficits in C58 mice compared with C57BL/6 mice. Decreased dendritic spine density of the dorsomedial striatum in C58 mice was related to higher repetitive motor behavior, whereas dendritic spine density in the subthalamic nucleus was significantly positively correlated with improved contingency reversal performance in both C58 and C57BL/6 mice. Our results demonstrate that induction of habitual responding markedly impaired the ability of C58 mice to shift to goal-directed behavior. Such impairment may have resulted from the effects of the induction of habitual responding on already compromised basal ganglia circuitry mediating repetitive motor behavior. These findings provide additional evidence for the translational value of the C58 model in modeling RRB in neurodevelopmental disorders. (PsycINFO Database Record (c) 2020 APA, all rights reserved).