need for alternative solutions when caring for patients with language barriers

Barriers to quality communication increase the risk for misunderstanding, negatively impact the thoroughness of health investigations, and can lead to delayed diagnoses and increased readmissions. In addition, language barriers disproportionately affect the most vulnerable populations; thus, a lack of appropriate interpretation services promotes health disparities and increases the vulnerability of the underserved minority populations. According to the Act Respecting Health Services and Social Services of Quebec, health organizations need to take into account the distinctive linguistic and sociocultural characteristics of each region and, “foster […] access to health services and social services through adapted means of communication for persons with functional limitations”. A language barrier is a form of functional limitation that patients face when accessing healthcare services. Despite a clear policy, the current use of professional interpretation services is limited in our healthcare facilities, thus increasing obstacles in accessing healthcare services for patients with language barriers. It is thought that by identifying how language barriers present in our healthcare system and by highlighting the tools available to mitigate their consequences, healthcare workers, including medical students, may be better placed to serve the non-French and non-English speaking community. A group of medical students from the Universities of Montreal and McGill who are part of MedComm researched the problematic, most specifically in Montreal, in the hopes of emphasizing the need for alternative solutions to the current state of affairs in regard to offering optimal care to patients with language barriers.

Working Conditions and Health Among Italian Ageing Workers

In many European countries requirements for retirement have been tightened, causing an increase in work participation of older workers, in spite their potentially poorer health may limit their work ability. This study aimed at assessing the diffusion of health problems and exposure to unfavorable working conditions among ageing workers in two Italian surveys, as well as comparing them with those observed in the same surveys conducted before the 2011 Italian pension reform tightening the normal retirement age. The 2013 National Health Survey (NHS) and Labour Force Survey (LFS) were employed to assess the prevalence of poor perceived health, health conditions and functional limitations, and of exposure to physical, psychosocial and organization factors at work, among 60–64 years workers. Poisson regression models were used to estimate Prevalence Ratios of health outcomes and unfavorable working conditions in the two surveys, compared to data from the 2005 (NHS) and 2007 (LFS) corresponding surveys, respectively. Among both men and women, approximately one quarter had at least one physical disorder or functional limitations and 15% poor mental health. Exposure to different ergonomic factors (15–30%) and working during unsocial hours (19%) were particularly diffused. A significant increase in the prevalence of functional limitations and of working at night or during unsocial hours was found in 2013, compared to corresponding data from 2005 and 2007, respectively. Our results indicate that exposure to ergonomic and organizational hazards should be reduced among ageing workers, to avoid decreased work ability, health damage or early exit from the labour market.

Evaluation of Shoulder Microcirculation Abnormality Using Laser Doppler Flowmetry

Severe neck-shoulder pain induces functional limitations in both life and work. The purpose of this study was to determine the characteristics of shoulder microcirculation abnormality in workers. This study recruited 32 workers and patients, both n = 16. Questionnaires were administered, and Laser Doppler Flowmetry (LDF) was used to measure microcirculatory blood flow (MBF) at the myofascial trigger points (MTrPs) on the shoulders. The absolute-deviationMMBF represented the mean MBF (MMBF) variability among subjects. The differences in the life characteristics, shoulder pain level, and microcirculatory characteristics at MTrPs between the two groups were compared. It was found that shoulder pain level was significantly higher in the patient than in the control group (p < 0.001). Deviation of the MMBF value beyond the postulated “normal range” of 60–80 was significantly higher in the patient than in the control group (p < 0.001). The MMBF deviation was significantly correlated with shoulder pain level, pain duration, and the symptom effect (p < 0.01, n = 32). A normal range for the MMBF of 60–80 on the shoulder near MTrPs is hypothesized for the first time based on this study. Noninvasive LDF can be used to assess abnormality in the MBF on shoulder MTrPs at an early stage.

Assessing the relationship between measures of healthcare access and functional limitations among individuals with Chronic Obstructive Pulmonary Disease (COPD)

Objectives: Functional limitation from COPD manifests more from physical rather than respiratory impairment. To what extent health access affects the functional limitation among individuals with COPD is yet to be known. This study aims to assess the relationship between healthcare access and functional limitations among individuals with COPD. Study Design: Retrospective analysis of a cross-sectional population-based survey Methods: This study pooled 11 years of (2008 to 2018) data from the Integrated Public Use Microdata Series, National Health Interview Survey (IPUMS NHIS). We restricted the data to respondents with self reported COPD, aged 40 years and older. The independent variables were sociodemographic and behavioral characteristics. The exploratory variables were measures of healthcare access ( healthcare coverage, delayed appointment, affordable care, and a usual place for care). The outcome variable was the presence or absence of functional limitations. Results: The age, race, educational attainment, marital status, smoking status, and poverty income ratio had a significant association with functional limitation (p<0.001) We found statistically significant associations between functional limitation and healthcare coverage, delayed appointment, affordable care, and a usual place for care. Poverty modified the relationship between functional limitations and the four measures of healthcare access, with the odds of functional limitation increased among the poor with no healthcare coverage, delayed appointment, unaffordable care, and no usual place for care. Conclusions: A strong relationship exists between the quartet of healthcare coverage, delayed appointment, affordable care, and usual place for care and self reported functional limitation among individuals with COPD. Poverty was an effect modifier, with the odds of functional limitation worse among the poor.

New Frontiers in Cementitious and Lime-Based Materials and Composites

Cement and lime currently are the most common binders in building materials. However, alternative materials and methods are needed to overcome the functional limitations and environmental footprint of conventional products. This Special Issue is entirely dedicated to “New frontiers in cementitious and lime-based materials and composites” and gathers selected reviews and experimental articles that showcase the most recent trends in this multidisciplinary field. Authoritative contributions from all around the world provide important insights into all areas of research related to cementitious and lime-based materials and composites, spanning from structural engineering to geotechnics, including materials science and processing technology. This topical cross-disciplinary collection is intended to foster innovation and help researchers and developers to identify new solutions for a more sustainable and functional built environment.

Mouse Models of Osteoarthritis: A Summary of Models and Outcomes Assessment

Osteoarthritis (OA) is a multidimensional health problem and a common chronic disease. It has a substantial impact onpatient quality of life and is a common cause of pain and mobility issues in older adults. The functional limitations, lack of curative treatments, and cost to society all demonstrate the need for translational and clinical research. The use of OA models in mice is important for achieving a better understanding of the disease. Models with clinical relevance are needed to achieve 2 main goals: to assess the impact of the OA disease (pain and function) and to study the efficacy of potential treatments. However, few OA models include practical strategies for functional assessment of the mice. OA signs in mice incorporate complex interrelations between pain and dysfunction. The current review provides a comprehensive compilation of mousemodels of OA and animal evaluations that include static and dynamic clinical assessment of the mice, merging evaluationof pain and function by using automatic and noninvasive techniques. These new techniques allow simultaneous recordingof spontaneous activity from thousands of home cages and also monitor environment conditions. Technologies such as videographyand computational approaches can also be used to improve pain assessment in rodents but these new tools must first be validated experimentally. An example of a new tool is the digital ventilated cage, which is an automated home-cage monitor that records spontaneous activity in the cages.

An alternative approach to estimate any subdaily extreme of rainfall and wind from usually available records

A wide variety of engineering applications requires the use of maximum values of rainfall intensity and wind speed related to short recording intervals, which can often only be estimated from available less exhaustive records. Given that many locations lack exhaustive climatic records that would allow accurate empirical correlations between different recording intervals to be identified, generic equations are often used to estimate these extreme values. The accuracy of these generic estimates is especially important in fields such as the study of wind-driven rain, in which both climatic variables are combined to characterise the phenomenon. This work assesses the reliability and functionality of some of these most widespread generic equations, analysing climatic datasets gathered since 2008 in 109 weather stations in Spain and the Netherlands. Considering multiple recording intervals at each location, it is verified that most of these generic estimations, used especially in the study of wind-driven rain, have functional limitations and can cause significant errors when characterising both variables for subdaily intervals and extreme conditions. Finally, an alternative approach is proposed to accurately extrapolate extreme values of both variables related to any subdaily recording interval in a functional manner and from any available records.

Associations Between Midlife Functional Limitations and Self-Reported Health and Cognitive Status: Results from the 1998–2016 Health and Retirement Study

Background: Life-course approaches to identify and help improve modifiable risk factors, particularly in midlife, may mitigate cognitive aging. Objective: We examined how midlife self-rated physical functioning and health may predict cognitive health in older age. Methods: We used data from the Health and Retirement Study (1998–2016; unweighted-N = 4,685). We used survey multinomial logistic regression and latent growth curve models to examine how midlife (age 50–64 years) activities of daily living (ADL), physical function, and self-reported health affect cognitive trajectories and cognitive impairment not dementia (CIND) and dementia status 18 years later. Then, we tested for sex and racial/ethnic modifications. Results: After covariates-adjustment, worse instrumental ADL (IADL) functioning, mobility, and self-reported health were associated with both CIND and dementia. Hispanics were more likely to meet criteria for dementia than non-Hispanic Whites given increasing IADL impairment. Conclusion: Midlife health, activities limitations, and difficulties with mobility are predictive of dementia in later life. Hispanics may be more susceptible to dementia in the presence of midlife IADLs. Assessing midlife physical function and general health with brief questionnaires may be useful for predicting cognitive impairment and dementia in later life.

Gambaran Keseimbangan Pada Pasien Post Stroke Setelah Pemberian Latihan Berbasis Virtual Reality: Literature Review

Post-stroke is a condition where the stroke patient has gone through an emergency so that he is in a stable condition. Post-stroke patients can experience various functional limitations, one of which is balance disorders. Patients experiencing this type of disorder can be given balance exercises based on virtual reality. Virtual reality will provide visual, proprioceptive, and auditory stimulation trough computer hardware and software to engage in artificial environments that appear and feel similar to real world objects and events. This study aimed to describe balance of post-stroke patients after being given virtual reality-based exercises. The method used in this study was a literature review analysis with the PICO method. Five articles were obtained to be reviewed from several data bases such as PubMed (n=2) and Google Scholar (n=3). The results of the analysis of the five articles showed that the average age of the respondents was > 60 years; 51.7% were female and 48.3% were male; and the average value of pre-test as well as post-test were 42.1 and 47.2 with an increase of 5.1. In conclusion, there was an increase in the balance of post-stroke patients after undergoing virtual reality-based exercises with significant results. . Therefore, researchers or practitioners are suggested to develop a Virtual Reality method on balance disorders in post-stroke patients in the form of treatment and subsequent research.Keywords: Balance; Post Stroke; Virtual Reality AbstrakPost stroke merupakan kondisi dimana pasien stroke telah melalui keadaan darurat sehingga pasien dalam keadaan stabil. Pasien post stroke dapat mengalami berbagai keterbatasan fungsional salah satunya gangguan keseimbangan yang dapat diberikan latihan keseimbangan berbasis Virtual Reality. Virtual Reality akan memberikan stimulasi visual, proprioseptif, dan pendengaran melalui perangkat keras dan perangkat lunak komputer untuk terlibat dalam lingkungan buatan yang muncul dan terasa mirip dengan objek dan peristiwa dunia nyata. Peneltian ini bertujuan untuk mengetahui gambaran keseimbangan pada pasien post stroke setelah pemberian latihan berbasis Virtual Reality. Metode yang digunakan dalam penelitian ini yaitu analisis literature review dengan metode PICO, didapatkan lima artikel untuk direview dari beberapa data base seperti PubMed (n=2) dan Google Scholar (n=3). Hasil analisis lima artikel didapatkan responden rata-rata usia > 60 tahun dan jenis kelamin perempuan 51,7% dan laki-laki 48,3%, nilai rata-rata pre test dan post test 42,1 dan 47,2 dengan peningkatan sebesar 5,1. Kesimpulannya didapatkan gambaran adanya peningkatan keseimbangan pasien post stroke setelah pemberian latihan berbasis Virtual Reality dengan hasil yang signifikan. Saran untuk peneliti atau praktisi bisa mengembangkan metode Virtual Reality pada gangguan keseimbangan pasien post stroke dalam bentuk treatmen dan penelitian berikutnya.Kata kunci: Keseimbangan; Post Stroke; Virtual Reality