Development of a Micro-credential Curriculum: The Interprofessional Dementia Caregiving Telehealth Community Practicum Badge

Purpose: Informal dementia caregiving by family caregivers is a crucial component of the care provided to people living with dementia (PLwD). The numbers of these family caregivers are rapidly increasing at a time, when in the U.S., the availability of formal caregivers is decreasing. Currently, health professional training focuses on providing care to PLwD and not necessarily addressing the caregiver’s needs, and this training takes place within professional silos and not interprofessionally. This study sought to address this issue by: 1) examining the current state of interprofessional dementia caregiving trainings in the US; and 2) developing a micro-credential curriculum called interprofessional dementia caregiving telehealth community practicum badge suitable for health profession students in order to meet the needs of dementia caregivers in Wisconsin. Methods: A four-phase-embedded approach was used. In the first phase, a scoping review on the current state of interprofessional education regarding caregivers of PLwD was conducted. Next, a team comprised of 6 faculty and staff with expertise in dementia care and caregiving, 2 dementia care specialists (DCS), and 2 family caregivers provided their expertise and input into developing the components of a micro-credential badge. These components and details were then assessed/revised based on interviews with 11 additional family caregivers, DCSs, and community leaders. Finally, the micro-credential interprofessional dementia caregiving curriculum was developed. Results: The micro-credential curriculum was named the Interprofessional Dementia Caregiving Telehealth Community Practicum Badge. The badge requires that an interprofessional team of students to: 1) complete five self-directed modules; 2) conduct initial virtual caregiver home visit to assess needs; 3) hold a virtual meeting with an Aging Disability Resource Center (ADRC) specialist to acquire the resources; 4) develop a customized Caregiver Health and Wellness Resource Packet; 5) hold a second/final virtual home visit to present the packet to the caregiver; 6) conduct a debrief session with all involved parties; and 7) finalize/submit the Packet along with reflection as a Capstone Project. Conclusion The micro-credential badge curriculum was piloted in the spring of 2022 while incorporating findings from this study. The completion of the interprofessional dementia caregiving badge counts towards the UW IPE Path of Distinctio

Effectively training dementia care specialists and other dementia professionals on using the DICE ApproachTM with caregivers to improve the management of behavioral and psychological symptoms of dementia

Introduction: Most persons living with dementia will exhibit at least one behavioral or psychological symptom of dementia (BPSD) (Kales, et al., 2015). As brain pathology progresses, challenging behaviors can increase in frequency and severity, causing an increase in caregiver stress and burden. Furthermore, BPSD can result in unplanned hospitalizations and unnecessary use of psychotropic medications. Non‐pharmacological management of BPSD should be the first line of treatment. The DICE (Describe, Investigate, Create, Evaluate) ApproachTM was developed by experts from the University of Michigan and John Hopkins University, to help caregivers learn how to identify and manage BPSD. This project describes a statewide implementation of the DICE approach with community‐based dementia care providers.MethodsFrom September 2017 to April 2020, we held four DICE trainings (three in‐person trainings, one web‐based training) for Dementia Care Specialists (DCSs) and other dementia care professionals who work directly with family caregivers of people with dementia in Wisconsin. We assessed trainees’ knowledge and attitudes from the Dementia Attitudes Scale (DAS) and the Knowledge about Memory Loss and Care test (KAML‐C) at baseline of training, immediately after training, and six months after training. Consultations were provided to address challenging cases.ResultsParticipants (N=136) in both in‐person and online DICE trainings experienced significant changes in knowledge, self‐efficacy and attitudes from baseline to post‐training (immediately after training) assessments (p<.01) (see Table 2 for details). Narrative feedback from trainees was generally very positive. Trainees used DICE with 165 caregivers who were primarily non‐Hispanic white (92%) females (74.4%) from an urban location (68.1%), caring for their spouse (52.7%) (Table 1).Discussion: By using the DICE approach with caregivers of persons with dementia, Wisconsin’s DCSs and other dementia professionals are uniquely positioned to help reduce risks associated with BPSD, including the use of psychotropic medications. Training satisfaction was high, knowledge about BPSD increased, and attitudes improved. The DICE trainings prepared trainees to implement this intervention with 165 family caregivers. A follow‐up survey will explore the real‐world application of DICE, including barriers to its use and modifications made in communities across the state.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/171246/1/alz049782.pd

Visual Encounters in "Lost and Delirious" and "Blue is the Warmest Color"

The essay focuses on the surge of homosexual desire in adolescent girls as dealt with 'Lost and Delirious' (2001), a film of Léa Pool, and 'Blue is the Warmest Color' (2010), a graphic novel by young French artist Julie Maroh, adapted by French-Tunisian Director Adbellatif Kechiche as 'La Vie d'Adèle' (2013). The methodology of visual culture is to describe the tensions between visual and verbal representation

Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry

Objectives: To determine factors associated with COVID-19-related death in people with rheumatic diseases. Methods: Physician-reported registry of adults with rheumatic disease and confirmed or presumptive COVID-19 (from 24 March to 1 July 2020). The primary outcome was COVID-19-related death. Age, sex, smoking status, comorbidities, rheumatic disease diagnosis, disease activity and medications were included as covariates in multivariable logistic regression models. Analyses were further stratified according to rheumatic disease category. Results: Of 3729 patients (mean age 57 years, 68% female), 390 (10.5%) died. Independent factors associated with COVID-19-related death were age (66-75 years: OR 3.00, 95% CI 2.13 to 4.22; >75 years: 6.18, 4.47 to 8.53; both vs ≤65 years), male sex (1.46, 1.11 to 1.91), hypertension combined with cardiovascular disease (1.89, 1.31 to 2.73), chronic lung disease (1.68, 1.26 to 2.25) and prednisolone-equivalent dosage >10 mg/day (1.69, 1.18 to 2.41; vs no glucocorticoid intake). Moderate/high disease activity (vs remission/low disease activity) was associated with higher odds of death (1.87, 1.27 to 2.77). Rituximab (4.04, 2.32 to 7.03), sulfasalazine (3.60, 1.66 to 7.78), immunosuppressants (azathioprine, cyclophosphamide, ciclosporin, mycophenolate or tacrolimus: 2.22, 1.43 to 3.46) and not receiving any disease-modifying anti-rheumatic drug (DMARD) (2.11, 1.48 to 3.01) were associated with higher odds of death, compared with methotrexate monotherapy. Other synthetic/biological DMARDs were not associated with COVID-19-related death. Conclusion: Among people with rheumatic disease, COVID-19-related death was associated with known general factors (older age, male sex and specific comorbidities) and disease-specific factors (disease activity and specific medications). The association with moderate/high disease activity highlights the importance of adequate disease control with DMARDs, preferably without increasing glucocorticoid dosages. Caution may be required with rituximab, sulfasalazine and some immunosuppressants