Do no harm.
In an increasingly multicultural society, physicians are challenged by a variety of complex new factors in their mission to provide good medical care. Over the past several years, Glenn Flores, an associate professor of pediatrics and public health at the Schools of Medicine and Public Health, has been developing ways to help doctors better understand how language and cultural beliefs affect the quality of medical care, and creating methodologies so that doctors can communicate more effectively with parents of different cultural backgrounds.
Flores and Yolanda Requena-Kassarjian, a pediatrics resident at Boston Medical Center and Boston Children's Hospital, recently published a paper describing the experience of an infant who was hospitalized with severe aspiration pneumonia after being given olive oil, a Guatemalan folk remedy for vomiting. They point out that when such cultural issues are not considered, serious problems can arise. The beliefs of patients or parents can profoundly affect clinical care, including prevention, therapy, and seeking medical care. Several home treatments for common childhood symptoms can result in clinical findings that are easily confused with child abuse, and some folk remedies can cause serious outcomes, even death.
By becoming aware of cultural issues, says Flores, physicians are better able to establish rapport with parents, elicit more accurate information about the patient's condition, and identify beliefs that may affect patient care. For example, in the case of the baby with pneumonia, knowing that it is dangerous to give an infant olive oil by mouth, the physician might suggest an abdominal massage using the oil, a culturally acceptable alternative.
Flores emphasizes five components for culturally competent health care. In order to elicit the necessary information, the physician needs an understanding of the family's normative cultural values, and unless fluent in the patient's primary language, must use interpreters to avoid misunderstanding. Further, physicians need access to information about common folk illnesses and remedies as well as other cultural beliefs held by patients from the various cultural groups in the patient population. Finally, he advises that doctors be vigilant for provider practices that produce ethnic disparities in screening, prescriptions, procedures, and outcomes.
The paper by Flores and Requena-Kassarjian appeared in the September 2001 issue of Clinical Pediatrics.
CAS Assistant Astronomy Professor Lynne Deutsch and her team -- graduate student Mark Kassis (GRS'03), Joseph Adams, a CAS research associate, and Joseph Hora from the Harvard/Smithsonian Center for Astrophysics -- recently celebrated the successful achievement of "first light" for a new camera system they designed and built to help them in their quest to understand how stars evolve. First light, the term used by astronomers to describe the first data collected by a new instrument on a telescope, was achieved at the Mt. Lemmon Observing Facility outside Tucson, Ariz.
The new camera system, MIRSI, is a highly sensitive system that operates in the midrange of the infrared spectrum, at wavelengths that can penetrate the dusty environments that surround very young and very old stars. The camera's optics take in a larger field of view than any existing instrument operating at these wavelengths, and it also has spectroscopic capabilities, enabling Deutsch and her colleagues to do infrared spectral analyses of the areas in view.
Deutsch's key targets are circumstellar envelopes in molecular clouds, the environments in which new stars are born. The molecular clouds are composed of gases and dust, some of which were previously ejected from dying stars. The dust and gases continuously cycle between star and cloud, altering their properties in the process. Since new stars ultimately form from the material ejected by evolved stars, understanding how the materials within the cloud change and interact should help clarify the processes that lead to the evolution of stars.
MIRSI is also uniquely suited to study a range of other important astrophysical phenomena, including planetary nebulae, created by some stars during the last stages of evolution. It will also study hydrocarbon emission and silicate absorption in starburst galaxies and the dust disks around young stars in extrasolar systems. Closer to home, MIRSI will be a valuable tool for learning more about the atmospheres of the planets in our solar system, scanning the surfaces of planets for mineral emissions, and studying comets.
Further observations with MIRSI are planned at the NASA Infrared Telescope Facility, Mauna Kea, Hawaii, in the fall of 2002.
Briefs" is written by Joan Schwartz in the Office of the Provost. To read
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