Browsing by keyword "culture"
Now showing items 1-5 of 5
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Characterization of Drug-Resistant Lipid-Dependent Differentially Detectable Mycobacterium tuberculosisAn estimated 15-20% of patients who are treated for pulmonary tuberculosis (TB) are culture-negative at the time of diagnosis. Recent work has focused on the existence of differentially detectable Mycobacterium tuberculosis (Mtb) bacilli that do not grow under routine solid culture conditions without the addition of supplementary stimuli. We identified a cohort of TB patients in Lima, Peru, in whom acid-fast bacilli could be detected by sputum smear microscopy, but from whom Mtb could not be grown in standard solid culture media. When we attempted to re-grow Mtb from the frozen sputum samples of these patients, we found that 10 out of 15 could be grown in a glycerol-poor/lipid-rich medium. These fell into the following two groups: a subset that could be regrown in glycerol after "lipid-resuscitation", and a group that displayed a heritable glycerol-sensitive phenotype that were unable to grow in the presence of this carbon source. Notably, all of the glycerol-sensitive strains were found to be multidrug resistant. Although whole-genome sequencing of the lipid-resuscitated strains identified 20 unique mutations compared to closely related strains, no single genetic lesion could be associated with this phenotype. In summary, we found that lipid-based media effectively fostered the growth of Mtb from a series of sputum smear-positive samples that were not culturable in glycerol-based Lowenstein-Jensen or 7H9 media, which is consistent with Mtb's known preference for non-glycolytic sources during infection. Analysis of the recovered strains demonstrated that both genetic and non-genetic mechanisms contribute to the observed differential capturability, and suggested that this phenotype may be associated with drug resistance.
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Considering Culture in Autism Screening: Lessons Learned by the MA Act Early TeamNon-English and non-Caucasian children are diagnosed with autism spectrum disorders (ASD) and other developmental disorders at later ages, and with lower prevalence than their counterparts. The Massachusetts Act Early state team sought to address this gap so that at-risk families from diverse backgrounds receive more effective autism screening. Presented at the Association of University Centers on Disability 2012 Conference.
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Culture, language, and the doctor-patient relationshipBACKGROUND: This review's goal was to determine how differences between physicians and patients in race, ethnicity and language influence the quality of the physician-patient relationship. METHODS: We performed a literature review to assess existing evidence for ethnic and racial disparities in the quality of doctor-patient communication and the doctor-patient relationship. RESULTS: We found consistent evidence that race, ethnicity; and language have substantial influence on the quality of the doctor-patient relationship. Minority patients, especially those not proficient in English, are less likely to engender empathic response from physicians, establish rapport with physicians, receive sufficient information, and be encouraged to participate in medical decision making. CONCLUSIONS: The literature calls for a more diverse physician work force since minority patients are more likely to choose minority physicians, to be more satisfied by language-concordant relationships, and to feel more connected and involved in decision making with racially concordant physicians. The literature upholds the recommendation for professional interpreters to bridge the gaps in access experienced by non-English speaking physicians. Further evidence supports the admonition that "majority" physicians need to be more effective in developing relationships and in their communication with ethnic and racial minority patients.
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Removing Barriers to Provider Communication with Multicultural PatientsVideo includes Symposium welcome and introductions. Navigate to 12:20 in the video for beginning of keynote presentation. Dr. Margarita Alegria has been instrumental in conducting research to eliminate disparities in mental health care. During this presentation, she will discuss major challenges of working across ethnic boundaries and propose alternative approaches to overcome them. The therapeutic relationship has long been recognized as an essential factor in facilitating client engagement and retention in care. We know the challenges of establishing a relationship are amplified when cultural differences exist between client and provider, as an unfamiliarity and/or discomfort with a client’s beliefs, practices, understanding of etiology, acceptable approaches of treatment, and communication style create additional complexity. Recent studies have highlighted the unfortunate manifestations of such cultural disconnects, including: the presence of diagnostic bias with clients of color; and, structural and interpersonal barriers that get in the way of establishing rapport. This presentation is designed to help improve shared decision making in the clinical encounter. Dr. Alegria will cover a variety of topics, including perspective taking; frequent attributional errors that providers make; and increasing receptivity to client participation and collaboration in decision making. Ways to improve the ability to listen, empathize and ask questions effectively will be discussed as will increased awareness of provider perceptions and misperceptions. These skills are not only important for patients and providers, but for everyone, particularly when interacting with those who are different in culture, background, and life circumstances.
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Season 2, Episode 6: Hiya: Saving Face, Anxiety, and Asian-AmericansQiuwei Yang ('22) and Laël Ngangmeni ('23, MD/PhD) are joined by family physician Dr. Henry Del Rosario to discuss an interesting experience at a car dealership, as well as how his creative side and his faith impact his perspectives on healing. Recorded October 2021. Dr. Del Rosario's piece "Hiya: Saving Face, Anxiety, and Asian-Americans" was first published on his blog. The Workers of Worcester website created by Dr. Del Rosario and Dr. An-Hoa Giang is available at: https://www.workersofworcester.org/. The transcript for this episode is available for download as an additional file.
