An investigation of depression and fatigue post West Nile virus infection.

INTRODUCTION: The purpose of this study was to examine depression and fatigue in individuals with a seropositive confirmed history of West Nile virus (WNV) infection. METHODS: The South Dakota State Epidemiologist sent 218 letters inviting residents with a diagnosis of WNV to participate in the study. Forty-five subjects were tested. An occupational therapist and a physical therapist met with each participant to assess performance parameters, including depression and fatigue levels. Subjects (n=42) completed the Revised Center for Epidemiologic Studies Depression Scale (CES-D) during the assessment. The Modified Fatigue Impact Scale (MFIS) was sent to participants as a follow-up questionnaire, and 29 were returned. Subjects were placed within one of three diagnosis groups: West Nile Fever (WNF), West Nile Neuroinvasive Disease (WNND) and WNV without fever or neuroinvasive disease (clinical/unspecified). RESULTS: Frequency of those reporting low risk of depression was similar between diagnosis groups (each approximating 75 percent). Depression severity differences were noted, with subjects diagnosed with WNND more likely to report severe risk for depression. Low correlations between depression and overall fatigue, depression and cognitive fatigue, and depression and psychosocial fatigue indicators were found. There was little if any correlation between depression and physical fatigue indicators. Mean CES-D scores for subjects between 13 to 18 months post infection fell within the mild-moderate risk for depression category. CONCLUSIONS: Identifying depression risk is useful for patient referral purposes and may help minimize symptoms of depression correlated with fatigue, especially following hospitalization for WNV infection

Using International, Interprofessional Service Learning to Promote Transcultural Self-Efficacy and Interprofessional Attitudes in Health Science Students

Interprofessional teams of occupational therapy, physical therapy, physician assistant, and dental hygiene students from the University of South Dakota participated in a service-learning experience in Guatemala. Student perceptions were measured using the Interprofessional Attitudes Scale and the Transcultural Self-Efficacy Tool. Qualitative data were obtained through written reflections and discussions during the immersion component of the service-learning experience. Students reported statistically significant improvements in transcultural self-efficacy as defined by their confidence in interviewing individuals from different cultures; their values, attitudes, and beliefs regarding cultural awareness, acceptance, appreciation, recognition, and advocacy; and their knowledge on how cultural factors influence care. Slightly different findings emerged concerning students’ attitudes about interprofessional practice. Qualitative analysis of personal reflections showed that many students felt purposeful when working as part of an interprofessional team and appreciated the dialogue with other professionals when discussing patient care