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Patient perceptions of the readability and helpfulness of bilingual clinical forms: a survey study
No full textBackground Patients with limited English proficiency (LEP) are rarely provided with translated clinical materials. Typically, healthcare clinics cite high costs of translation and lack of professional translators as barriers to this service. The purpose of the current study was to investigate the perceptions of LEP dental patients regarding the readability, understanding, and helpfulness of translated clinical forms produced by dental student doctor translators. Methods We used a survey design and convenience sampling to recruit LEP patients from a dental school clinic. Participants completed a 9-question (8 Likert-type items and 1 open-ended item) paper survey about translated forms. The bilingual survey was a combination of English and 8 other languages (Arabic, Dari, Pashto, Russian, Spanish, Ukrainian, Urdu, or Vietnamese) and assessed the type of form received; self-reported literacy; design, readability, and helpfulness of the form; overall understanding of the form; understanding of medical and dental terms; helpfulness for patient-provider communication; and comfort level with dental care after receiving the form. Demographic characteristics of participants were collected from the clinic’s electronic health record. Survey responses were analyzed descriptively, and Spearman’s correlation was used to examine the relationship between outcomes. Results Ninety-seven LEP patients (61.9% [60] female, 78.4% [70] Spanish speakers) completed 140 surveys for various translated forms in Dari, Pashto, Spanish, Urdu, or Vietnamese. Participants positively rated translated clinical forms: range, 50.4% (70) for design of the form to 80.0% (112) for comfort level with dental care after receiving the form. For the open-ended item, participants indicated the translations were good, and no improvements were needed. They also thought providing the form was evidence of good customer service. When examining relationships between outcomes, positive correlations were found between self-reported literacy and readability (Spearman r=.57, P\u3c.001), overall understanding and understanding of medical and dental terms (Spearman r=.58, P\u3c.001), and type of form and helpfulness for patient-provider communication (Spearman r=.26, P=.005). Conclusions Study results suggested the translated clinical forms were perceived as helpful and beneficial by LEP dental patients. Similar approaches should be considered to reduce language barriers in healthcare
Assessment and Technology Use at a Graduate Health University
No full textEstablished in 1892 by Andrew Taylor Still, A.T. Still University (ATSU) is the founding institution of osteopathic healthcare. Osteopathic healthcare is a unique form of American medical care developed in 1874 by Dr. Still, in which osteopathic physicians take a “whole person” approach to caring for patients. Instead of treating specific symptoms or illnesses, they regard the body as an integrated whole consisting of mind, body, and spirit
Perception and Knowledge of Oral and Facial Piercings among Dental Students: Web-based Survey
No full textAim: The aim of this web-based questionnaire was to survey dental students to obtain their perception and knowledge of oral and facial piercings. Materials and methods: The participants comprised 240 students enrolled in the dental school who were asked to complete 20 close-ended, yes/no, yes/no/do not know, and multiple responses questions. The questionnaire covers general information concerning oral/facial piercing, triggers why youths and early adults get it, probable complications, their appreciation of the possibility of related health conditions, and their knowledge and perception. The survey was distributed to the students by email. The results were tabulated and statistically analyzed. Results: Dental first year (D1) and dental second year (D2) were substantially more likely to indicate that orofacial piercings as unacceptable and are less expected to have an orofacial piercing compared to D3 and D4 (p \u3c 0.01). About 16.8% of the students reported previous orofacial piercings. There was a definite correlation between previous orofacial piercings and thinking that is appropriate in society (p \u3c 0.05). Males were significantly more likely to have an orofacial piercing (p \u3c 0.01). The Internet was reported as the most common source of information. The most popular cause for piercings is to be unique and different. Conclusions: Orofacial piercings are relatively frequently used by students in dental school and few students intend on getting one in the future. Knowledge of the hazards of orofacial piercing correlated with the requirement for parental approval. The majority of students think piercings are appropriate in society and know their complications and risks. Clinical significance: Orofacial piercing has been gaining popularity but its risks/complications may not be known by practitioners. There is a need for research to assist dental/medical practitioners in advising, educating, and safeguarding patients by evaluating of the perception and knowledge of students about orofacial piercings
Pain Catastrophizing and Its Association with Military Medical Disability Among US Active Duty Service Members with Chronic Predominately Musculoskeletal Pain: A Retrospective Cohort Analysis
No full textAbstract
Context: Pain catastrophizing is characterized by negative emotional and cognitive responses to pain and is a predictor of work-related disability. Its association with military medical disability has not been studied.
Objective: To (1) identify the pain catastrophizing scale (PCS) score cut point most strongly associated with military medical disability, (2) measure the difference in rate of disability between service members with baseline PCS scores above versus below the cut point, and (3) determine if improvement in PCS score during pain specialty care is associated with decreased likelihood of disability.
Methods: This was a retrospective cohort analysis comparing PCS scores collected from US Army active duty service members at time of initial visit to an interdisciplinary pain management center and periodically during pain treatment. Outcome was determination during the following year of a military service-disqualifying disability.
Results: Receiver operating characteristic (ROC) curves determined that a PCS score of 20 was the single cut point most closely associated with subsequent disability. Kaplan-Meier curves showed significantly higher disability rate during the following year among those with baseline PCS scores ≥20 (52%) compared to those with lower scores (26%). Scheffe-adjusted contrasts showed that service members with PCS scores ≥20 whose scores improved to \u3c20 at follow-up were significantly less likely to have a medical disability (42.6%; 95% CI, 0.07-0.58) than those whose PCS score remained ≥20 (76.3%; 95% CI, 68.0%-84.7%).
Conclusion: A PCS score cut point of 20 distinguishes between high versus low likelihood of disability among service members. Those with high baseline PCS score had twice the likelihood of disability than those with low scores. Service members who decreased their PCS score from high to low during pain specialty care had lower likelihood of disability. Prospective research is needed to determine if treatments that lower pain catastrophizing yield reduced likelihood of subsequent disability
The influence of spinal venous blood pressure on cerebrospinal fluid pressure
No full textIn Alligator mississippiensis the spinal dura is surrounded by a venous sinus; pressure waves can propagate in the spinal venous blood, and these spinal venous pressures can be transmitted to the spinal cerebrospinal fluid (CSF). This study was designed to explore pressure transfer between the spinal venous blood and the spinal CSF. At rest the cardiac-related CSF pulsations are attenuated and delayed, while the ventilatory-related pulsations are amplified as they move from the spinal venous blood to the spinal CSF. Orthostatic gradients resulted in significant alterations of both cardiac- and ventilatory-related CSF pulsations. Manual lateral oscillations of the alligator’s tail created pressure waves in the spinal CSF that propagated, with slight attenuation but no delay, to the cranial CSF. Oscillatory pressure pulsations in the spinal CSF and venous blood had little influence on the underlying ventilatory pulsations, though the same oscillatory pulsations reduced the ventilatory- and increased the cardiac-related pulsations in the cranial CSF. In Alligator the spinal venous anatomy creates a more complex pressure relationship between the venous and CSF systems than has been described in humans
Pre- and post-microsurgical rehabilitation interventions and outcomes on breast cancer-related lymphedema: a systematic review.
No full textPurpose of Review Breast cancer–related lymphedema (BCRL) is a debilitating progressive disease resulting in various impairments and dysfunctions. Complete decongestive therapy embodies conservative rehabilitation treatments for BCRL. Surgical procedures performed by plastic and reconstructive microsurgeons are available when conservative treatment fails. The purpose of this systematic review was to investigate which rehabilitation interventions contribute to the highest level of pre- and post-microsurgical outcomes. Recent Findings Studies published between 2002 and 2022 were grouped for analysis. This review was registered with PROSPERO (CRD42022341650) and followed the PRISMA guidelines. Levels of evidence were based upon study design and quality. The initial literature search yielded 296 results, of which, 13 studies met all inclusion criteria. Lymphovenous bypass anastomoses (LVB/A) and vascularized lymph node transplant (VLNT) emerged as dominant surgical procedures. Peri-operative outcome measures varied greatly and were used inconsistently. There is a dearth of high quality literature leading to a gap in knowledge as to how BCRL microsurgical and conservative interventions complement each other. Summary Peri-operative guidelines are needed to bridge the knowledge and care gap between lymphedema surgeons and therapists. A core set of outcome measures for BCRL is vital to unify terminological diferences in the multidisciplinary care of BCRL. Condensed Abstract Complete decongestive therapy embodies conservative rehabilitation treatments for breast cancer-related lymphedema (BCRL). Surgical procedures performed by microsurgeons are available when conservative treatment fails. This systematic review investigated which rehabilitation interventions contribute to the highest level of pre- and post-microsurgical outcomes. Thirteen studies met all inclusion criteria and revealed that there is a dearth of high quality literature leading to a gap in knowledge as to how BCRL microsurgical and conservative interventions complement each other. Furthermore, peri-operative outcome measures were inconsistent. Peri-operative guidelines are needed to bridge the knowledge and care gap between lymphedema surgeons and therapists
Secondary vasculitis attributable to post-COVID syndrome
No full textWhile the acute phase of the COVID-19 pandemic has largely come to pass, the chronic physiologic effects of the coronavirus continue to unfold. Specifically, the number of COVID-19-associated vasculitis cases has steadily increased since the onset of the pandemic. Data have shown that vasculitis may develop less than two weeks after COVID-19 or during a later onset of the disease. At this time, research has demonstrated that the novel coronavirus invades more than just the lungs; it can also attack the nervous system, cardiovascular system, and kidneys. In addition, there is a greater understanding of the pathogenesis regarding COVID-19-induced vasculitis via humoral immunity and immune complex disease. Recent case reports have shown an association between COVID-19 and secondary vasculitis. This review paper discusses case reports and data that suggest that COVID-19 may lead to specific vasculitis diseases such as giant cell arteritis, ophthalmic arteritis, aortitis, and Kawasaki-like disease. More research needs to be performed on this association to aid in diagnosis and treatment
The use of mazes over time in Spanish heritage speakers in the US
No full textIntroduction: Mazes are linguistic disfluencies such as filled pauses, repetitions, or revisions of grammatical, phonological, or lexical aspects of words that do not contribute to the meaning of a sentence. Bilingual children are believed to increase the numbers of mazes in their native or heritage language, the minority language, as they become more proficient in the second language, the societal language. Mazes may increase over time in bilingual Spanish-speaking children as they become more proficient in English, the societal language in the United States. However, current studies have not been conducted longitudinally. Higher rates of mazes in the heritage language over time may be due to changes in language proficiency and differences in processing demands in the children as they use more complex language. Moreover, children with developmental language disorder (DLD) can also present higher rates of mazes than children with typical language. Heritage speakers, therefore, are at risk of being misdiagnosed with DLD due to high rates of mazes. Currently, we do not understand what the typical rates of mazes are as heritage speakers get older and become more proficient in the societal language. The current study examined the type and frequency of Spanish mazes longitudinally in a group of 22 Spanish heritage speakers with and without DLD and determined the changes over time. Methods: A total of 11 children with typical language development (TLD) and 11 with DLD participated in this 5-year longitudinal study. Using a wordless picture book, children completed a retelling task in Spanish during the spring of each academic year (PK to 3rd grade) as part of a 5-h testing battery. Narratives were transcribed and coded for types of mazes (filled pauses, repetitions, grammatical revisions, phonological revisions, and lexical revisions). Results and conclusion: The results of the study indicate that TLD children increased their overall percentage of mazed words and utterances. The opposite pattern was observed in the DLD group, which decreased their percentage of mazed words and utterances. In contrast, both groups demonstrated a decrease in repetitions in first grade and an increase in third grade. Additionally, the TLD and DLD children decreased in the percentage of fillers in first grade and then increased in the third grade. Results suggest that maze use is quite variable in heritage speakers and does not necessarily differentiate groups. Clinicians should not rely solely on mazes to determine ability status. In fact, high use of mazes can reflect typical language development