Spanish for the Audiologist: Is There an App for That?

According to the U.S. Census Bureau, the number of people, 5 years of age and older speaking a language other than English at home has more than doubled within the last three decades. Spanish speakers are prominent in these numbers. Additionally, 41% report speaking English less than “very well.” We can surmise from this data that a significant number of patients/families seeking hearing health services from audiologists may have limited English proficiency or a language barrier. In contrast, according to ASHA demographics, the majority of audiologists in the United States are monolingual and speak primarily English.Audiology, a discipline with communication at its heart, is in a distinctive position to continue to provide high-quality, accessible, culturally sensitive services, regardless of language barriers. Ten audiologists in northern NJ volunteered to try a real time translation mobile app (Google Translate App) and document their experiences with the use of this tool with their Spanish-speaking patients/families. Results suggest that a mobile translation app may be a viable option to address language barriers in the audiology practice when professional and/or ad-hoc interpreters are not available. Technology driven solutions can then be applied to customize the translation apps to the specific needs of the audiology practice (e.g., vernacular used in adult vs. pediatric populations, or vestibular vs. rehabilitation terminology). Healthcare literacy is also addressed in the content of patient education and cultural competence.

Download Full-text

Interpreting services provided during consultations in the medical sector : identifying shortcomings

10.51415/10321/1438 ◽

2015 ◽

Author(s):

◽

Thabani Robert Khumalo

Keyword(s):

Limited English Proficiency ◽

Ad Hoc ◽

Language Barriers ◽

Medical Setting ◽

Medical Practitioners ◽

Medical Sector ◽

Medical Institutions ◽

Medical Interpreting ◽

English Speaking ◽

The Difference

The study focuses on the interpreting services provided during consultations in the medical setting. It looks broadly at the communication deficiencies created by the difference in the languages spoken by both medical practitioners and patients during consultations. Several times, the researcher’s personal experience has shown that isiZulu speaking patients are frequently consulted by English speaking doctors whenever they visit medical institutions. Consequently, as a result of this situation, these isiZulu speaking patients with limited English proficiency find it difficult to fully express all their medical conditions to the English speaking doctors and vice versa due to the existing language barriers. These language barriers are most likely to give rise to inferior medical assistance to isiZulu speaking patients. Furthermore, the nurses find themselves being ad hoc interpreters in this regard based on the assumption that they are bilingual. However, their linguistic and interpreting ability are not considered. The study therefore investigates the possible shortcomings and also looks at the implications most likely to occur as a result of reluctance to provide professional medical interpreting services. The data is collected from medical practitioners (doctors and nurses) and patients. From the results obtained, the researcher suggests possible recommendations in order to address the identified shortcomings. Lolu cwaningo lumayelana nokutolika ezikhungweni zezempilo. Lugxile ekubhekeni izinkinga zokuxhumna ngokolimi ngenxa yokwehluka kwezilimi ezikhulunywa abasebenzi bezempilo kanye neziguli uma zize ezikhungweni zezempilo. Umcwaningi usebone izikhawu eziningi ukuthi uma iziguli ezikhuluma ulimi lwesiZulu ziya ezikhungweni zezempilo zivame ukusizwa odokotela abakhuluma isiNgisi. Ngenxa yalesi simo , iziguli ezingasazi kahle isiNgisi ziyehluleka ukuchazela odokotela ngokuphelele izinkinga zazo zezempilo, kanjanlo nodokotela bayehluleka ukuxhumana kahle nazo. Lezi zinkinga zokuxhumana, zingaba nomthelela omubi wokuthi iziguli ezikhuluma isiZulu zingatholi usizo olugculisayo lwezempilo. Ngenxa yalesi simo, abahlengikazi bagcina bezithola sebengotolika ngenxa yokuthi kucatshangelwa ukuthi bayakwazi ukukhuluma izilimi zombili. Akube kusabhekwa ukuthi bazazi kangakanani izilimi lezo kanye nokuthi bayakwazi yini ukutolika. Ucwaningo lubheka izingqinamba ezikhona kanye nezingenzeka ngenxa yokungahlinzekwa ngokutolika okusezingeni elifanele ezikhungweni zezempilo futhi kungahlinzekwa abantu abaqeqeshiwe. Imininingwane yokwenza lolu cwaningo iqoqwe kubasebenzi bezempilo (odokotela kanye nabahlengikazi) kanye neziguli. Umcwaningi ube esenza izincomo ezingasiza ukuqeda izinkinga ezitholakele emuva kokuba esethole imiphumela.

Download Full-text

The Future of Radiation Oncology in the United States From 2010 to 2020: Will Supply Keep Pace With Demand?

Journal of Clinical Oncology ◽

10.1200/jco.2010.31.2520 ◽

2010 ◽

Vol 28 (35) ◽

pp. 5160-5165 ◽

Cited By ~ 92

Author(s):

Benjamin D. Smith ◽

Bruce G. Haffty ◽

Lynn D. Wilson ◽

Grace L. Smith ◽

Akshar N. Patel ◽

...

Keyword(s):

Radiation Therapy ◽

Radiation Oncology ◽

The United States ◽

Census Bureau ◽

Population Projections ◽

Full Time ◽

Full Time Equivalent ◽

Radiation Oncologists ◽

Number Of Patients ◽

Using Data

Purpose Prior studies forecasted an incipient shortage of medical oncologists as a result of the aging US population, but the radiation oncology workforce has not been studied. Accordingly, we projected demand for radiation therapy and supply of radiation oncologists in 2010 and 2020 to determine whether a similar shortage may exist for this specialty. Methods Demand for radiation therapy in 2010 and 2020 was estimated by multiplying current radiation utilization rates (as calculated with Surveillance, Epidemiology, and End Results data) by population projections from the Census Bureau. Supply of radiation oncologists was projected using data from the American Board of Radiology inclusive of current radiation oncologists and active residents, accounting for variation in full-time equivalent status and expected survival by age and sex. Results Between 2010 and 2020, the total number of patients receiving radiation therapy during their initial treatment course is expected to increase by 22%, from 470,000 per year to 575,000 per year. In contrast, assuming that the current graduation rate of 140 residents per year remains constant, the number of full-time equivalent radiation oncologists is expected to increase by only 2%, from 3,943 to 4,022. The size of residency training classes for the years 2014 to 2019 would have to double to 280 residents per year in order for growth in supply of radiation oncologists to equal expected growth in demand. Conclusion Demand for radiation therapy is expected to grow 10 times faster than supply between 2010 and 2020. Research is needed to explore strategies to enhance capacity to deliver quality radiation therapy despite increased patient loads.

Download Full-text

Language Discordance in Mental Health Services: An Exploratory Survey of Mental Health Providers and Interpreters

Societies ◽

10.3390/soc10030066 ◽

2020 ◽

Vol 10 (3) ◽

pp. 66

Author(s):

Mansha Mirza ◽

Elizabeth Harrison ◽

Jacob Bentley ◽

Hui-Ching Chang ◽

Dina Birman

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Best Practices ◽

Limited English Proficiency ◽

Language Barriers ◽

The United States ◽

Mental Health Providers ◽

Health Providers ◽

Snowball Sampling

Global migration has contributed to greater language diversity in many parts of the world. Many migrants experience language barriers in their adopted countries. Language barriers hinder access to healthcare, including mental health. There exists little research on the extent of communication difficulties during language discordant mental health services. A cross-sectional observational study design was used to examine prevalence of communication challenges, use of communication best practices, and training needs among mental health providers and interpreters working with immigrants with Limited English Proficiency (LEP) in the United States. Using snowball sampling methods, 38 providers and 34 interpreters were recruited to complete online surveys. Challenges reported by interpreters pertained to technicalities of communication, while those reported by providers pertained to content of communication. Communication best practices such as pre-session briefings and post-session debriefings were used infrequently by providers in the sample. Providers with higher education levels were more likely to endorse some best practices. Fifty-four percent of the providers and 84% of the interpreters were interested in additional training in working with patients with LEP. Findings suggest the need for customized trainings for providers and interpreters to improve the quality of mental healthcare for patients with LEP.

Download Full-text

Electronic cigarettes: How confident and effective are allergists, pulmonologists, and primary care physicians in their practice behavior?

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.200009 ◽

2020 ◽

Vol 41 (3) ◽

pp. 192-197

Author(s):

Sherry S. Zhou ◽

Alan P. Baptist

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Electronic Cigarettes ◽

The United States ◽

Fisher Exact Test ◽

Exact Test ◽

Knowledge And Beliefs ◽

Tobacco Cigarette ◽

Number Of Patients ◽

Personal Use

Background: There has been a striking increase in electronic cigarette (EC) use in the United States. The beliefs and practices toward ECs among physicians are unknown. Objective: The purpose of this study was to investigate EC practice patterns among allergists, pulmonologists, and primary care physicians. Methods: An anonymous survey was sent to physicians. The survey contained 32 questions and addressed issues related to demographics, cessation counseling behaviors, personal use, and knowledge and beliefs about ECs. Statistical analysis was performed by using analysis of variance, the Pearson χ2 test, Fisher exact test, and logistic regression. Results: A total of 291 physicians completed the survey (222 primary care physicians, 33 pulmonologists, and 36 allergists) for a response rate of 46%. The allergists asked about tobacco cigarette use as frequently as did the pulmonologists and more than the primary care physicians (p < 0.001), but they rarely asked about EC use. The pulmonologists scored highest on self-reported knowledge on ECs, although all the groups answered <40% of the questions correctly. The allergists did not feel as comfortable about providing EC cessation counseling as did the pulmonologists and primary care physicians (p < 0.001). All three groups were equally unlikely to recommend ECs as a cessation tool for tobacco cigarette users. Conclusion: Allergists lacked knowledge and confidence in providing education and cessation counseling for EC users. As the number of patients who use these products continues to increase, there is an urgent need for all physicians to be comfortable and knowledgeable with counseling about ECs.

Download Full-text

Mosquito and Tick-borne Illnesses in the United States. Guidelines for the Recognition and Empiric Treatment of Zoonotic Diseases in the Wilderness.

Infectious Disorders - Drug Targets ◽

10.2174/1871526518666180626123340 ◽

2019 ◽

Vol 19 (3) ◽

pp. 238-257

Author(s):

Suresh Antony

Keyword(s):

United States ◽

Lyme Disease ◽

Spotted Fever ◽

Disease Process ◽

Rocky Mountain ◽

The United States ◽

Health Care Facilities ◽

Diagnostic Tools ◽

Rocky Mountain Spotted Fever ◽

Number Of Patients

Background:In the United States, tick-borne illnesses account for a significant number of patients that have been seen and treated by health care facilities. This in turn, has resulted in a significant morbidity and mortality and economic costs to the country.Methods:The distribution of these illnesses is geographically variable and is related to the climate as well. Many of these illnesses can be diagnosed and treated successfully, if recognized and started on appropriate antimicrobial therapy early in the disease process. Patient with illnesses such as Lyme disease, Wet Nile illness can result in chronic debilitating diseases if not recognized early and treated.Conclusion:This paper covers illnesses such as Lyme disease, West Nile illness, Rocky Mountain Spotted fever, Ehrlichia, Tularemia, typhus, mosquito borne illnesses such as enteroviruses, arboviruses as well as arthropod and rodent borne virus infections as well. It covers the epidemiology, clinical features and diagnostic tools needed to make the diagnosis and treat these patients as well.

Download Full-text

"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

10.2196/preprints.25150 ◽

2020 ◽

Author(s):

Swati Anand ◽

Amardeep Kalsi ◽

Jonathan Figueroa ◽

Parag Mehta

Keyword(s):

Blood Glucose ◽

Diabetes Management ◽

Positive Impact ◽

The United States ◽

Phone Call ◽

Diabetic Patients ◽

Dietary Compliance ◽

Glucose Levels ◽

Uncontrolled Diabetes ◽

Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

Download Full-text

Tax Progressivity of Personal Wages and Income Inequality

Journal of Risk and Financial Management ◽

10.3390/jrfm14020060 ◽

2021 ◽

Vol 14 (2) ◽

pp. 60

Author(s):

Nikolaos Papanikolaou

Keyword(s):

Income Inequality ◽

The United States ◽

Census Bureau ◽

Tax System ◽

Race And Gender ◽

Tax Progressivity ◽

Income Data ◽

Kakwani Index ◽

And Gender ◽

Wage Income

The paper examines tax progressivity and income inequality using Census Bureau Current Population Survey (CPS) personal income data. The Kakwani index is used to derive tax progressivity for All, Male, Female, White and African American personal wage income of CPS respondents, respectively. The tax progressivity results show a tax system that is partly progressive and mostly regressive. Due to its regressive nature, the tax system did not display tax progressivity for the entire period under analysis for personal wage income respondents as well as when broken-down by race and gender in the United States for years 1996 to 2011.

Download Full-text

Learning to Detain Asylum Seekers and the Growth of Mass Immigration Detention in the United States

Law & Social Inquiry ◽

10.1017/lsi.2021.11 ◽

2021 ◽

pp. 1-29

Author(s):

Smita Ghosh ◽

Mary Hoopes

Keyword(s):

United States ◽

Infectious Diseases ◽

Cognitive Dissonance ◽

Media Coverage ◽

Asylum Seekers ◽

Ad Hoc ◽

The United States ◽

Critical Component ◽

Immigration Detention ◽

Important Shift

Drawing upon an analysis of congressional records and media coverage from 1981 to 1996, this article examines the growth of mass immigration detention. It traces an important shift during this period: while detention began as an ad hoc executive initiative that was received with skepticism by the legislature, Congress was ultimately responsible for entrenching the system over objections from the agency. As we reveal, a critical component of this evolution was a transformation in Congress’s perception of asylum seekers. While lawmakers initially decried their detention, they later branded them as dangerous. Lawmakers began describing asylum seekers as criminals or agents of infectious diseases in order to justify their detention, which then cleared the way for the mass detention of arriving migrants more broadly. Our analysis suggests that they may have emphasized the dangerousness of asylum seekers to resolve the dissonance between their theoretical commitments to asylum and their hesitance to welcome newcomers. In addition to this distinctive form of cognitive dissonance, we discuss a number of other implications of our research, including the ways in which the new penology framework figured into the changing discourse about detaining asylum seekers.

Download Full-text

Lessons Learned from Development of a Mobile App for Cardiovascular Health Awareness

Sustainability ◽

10.3390/su13115985 ◽

2021 ◽

Vol 13 (11) ◽

pp. 5985

Author(s):

Bryan Weichelt ◽

Jeffrey VanWormer ◽

Yin Xu ◽

Chris Kadolph ◽

Simon Lin

Keyword(s):

Cardiovascular Disease ◽

Health Information ◽

Healthcare System ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

The United States ◽

Mobile App ◽

Lessons Learned ◽

Health Concern ◽

Development Processes

Cardiovascular disease (CVD) is a major public health concern in the United States. In response to the federally sponsored Million Hearts Risk Check Challenge, a team of programmers, software developers, health-information technologists, and clinicians in an integrated healthcare system in Wisconsin collaborated to develop Heart Health MobileTM (HHM), designed to improve awareness of cardiovascular disease risk and promote risk factor control among users. This paper outlines the development processes and highlights key lessons learned for mobile health applications. An agile project management methodology was used to dedicate adequate resources and employ adaptive planning and iterative development processes with a self-organized, cross-functional team. The initial HHM iOS app was developed and tested, and after additional modifications, gamified and HTML 5 versions of the app were released. The development of an iOS app is low in cost and sustainable by a healthcare system. Future app modifications to enhance data security and link self-reported cardiovascular risk assessment data to patient medical records may improve performance, patient relevance, and clinician acceptance of HHM in the primary-care setting. Legal and institutional barriers regarding the capture and analyses of protected health information must be mitigated to fully capture, analyze, and report patient health outcomes for future studies.

Download Full-text

Photosensitizing Medications and Skin Cancer: A Comprehensive Review

Cancers ◽

10.3390/cancers13102344 ◽

2021 ◽

Vol 13 (10) ◽

pp. 2344

Author(s):

Elisabeth A. George ◽

Navya Baranwal ◽

Jae H. Kang ◽

Abrar A. Qureshi ◽

Aaron M. Drucker ◽

...

Keyword(s):

Skin Cancer ◽

Cancer Risk ◽

Cell Carcinoma ◽

The United States ◽

In Vivo Studies ◽

Cancer Risk Factors ◽

Skin Cancer Risk ◽

Number Of Patients

(1) The incidence of skin cancer is increasing in the United States (US) despite scientific advances in our understanding of skin cancer risk factors and treatments. In vitro and in vivo studies have provided evidence that suggests that certain photosensitizing medications (PSMs) increase skin cancer risk. This review summarizes current epidemiological evidence on the association between common PSMs and skin cancer. (2) A comprehensive literature search was conducted to identify meta-analyses, observational studies and clinical trials that report on skin cancer events in PSM users. The associated risks of keratinocyte carcinoma (squamous cell carcinoma and basal cell carcinoma) and melanoma are summarized, for each PSM. (3) There are extensive reports on antihypertensives and statins relative to other PSMs, with positive and null findings, respectively. Fewer studies have explored amiodarone, metformin, antimicrobials and vemurafenib. No studies report on the individual skin cancer risks in glyburide, naproxen, piroxicam, chlorpromazine, thioridazine and nalidixic acid users. (4) The research gaps in understanding the relationship between PSMs and skin cancer outlined in this review should be prioritized because the US population is aging. Thus the number of patients prescribed PSMs is likely to continue to rise.

Download Full-text