The Adolescent Health Care Broker-Adolescents Interpreting for Family Members and Themselves in Health Care.

Parents with limited English proficiency might rely on their adolescent children to interpret health information. We call this adolescent healthcare brokering. Using a mixed-methods, transformative research approach rooted in grounded theory, we sought to answer these questions: (a) "What is happening? What are people doing?" and (b) "What do these stories indicate? What might they suggest about social justice?" High school students from a community in which 53.4% speak another language at home were invited to participate in a survey and focus groups. Of 238 survey participants, 57.5% (n = 137) indicated they assisted with healthcare tasks. When doing so, 81.7% (n = 112) translated. Common tasks were reading prescriptions and talking to doctors. While some participants cited negative emotions associated with brokering, the net emotion was positive. Focus groups (n = 11) revealed that tasks varied broadly in complexity and type, emotional experiences were dichotomous, and access to interpreting services and other supports was inconsistent. This research adopts an advocacy lens and uses a mixed-methods, transformative research approach rooted in grounded theory to describe and call attention to a social justice phenomenon we call adolescent healthcare brokering. We define adolescent healthcare brokering as young people acting as linguistic interpreters in healthcare situations for themselves and for family members with limited English proficiency (LEP). In such situations, language acts as a barrier to health literacy and access to healthcare [17]. Despite this known barrier, there is a gap in the research regarding how to successfully address this situation (McKee, Paasche-Orlow, Journal of health communication 17(3):7-12, 2012).

Adolescent Healthcare Brokering: Prevalence, Experience, Impact, and Opportunities.

BACKGROUND: Limited health literacy disproportionately affects those with limited English proficiency (LEP). Parents with LEP might rely on their adolescent children to interpret health information. We call this adolescent healthcare brokering. This study uncovers the prevalence of brokering, kinds of tasks, emotional and academic impact, and desired support. METHODS: We invited 165 students from health classes (in a community in which 29.8% are foreign-born and 53.4% speak another language at home) to complete a survey. We used IBM SPSS to calculate descriptive statistics. RESULTS: Of the 159 who received parental consent and assented, 54.1% (N = 86) assist with healthcare tasks. When brokering, 80.2% (N = 69) translate. Most common tasks were talking to a doctor, reading prescriptions, and searching on the Internet. Participants were most confident reading prescriptions and talking to a doctor and least confident finding healthcare services. Among brokers, 29.1% (N = 24) missed school; 33.7% did not complete homework. They most wanted to learn about filling out insurance forms and talking to doctors. CONCLUSIONS: Despite assurances that children are not permitted to interpret, adolescents are acting as healthcare brokers. The impact can be academic and emotional. Findings indicate a need for further research and support for adolescents who want to learn about healthcare tasks.

A new cation-exchange method for accurate field speciation of hexavalent chromium.

A new method for field speciation of Cr(VI) has been developed to meet present stringent regulatory standards and to overcome the limitations of existing methods. The method consists of passing a water sample through strong acid cation-exchange resin at the field site, where Cr(III) is retained while Cr(VI) passes into the effluent and is preserved for later determination. The method is simple, rapid, portable, and accurate, and makes use of readily available, inexpensive materials. Cr(VI) concentrations are determined later in the laboratory using any elemental analysis instrument sufficiently sensitive to measure the Cr(VI) concentrations of interest. The new method allows measurement of Cr(VI) concentrations as low as 0.05 mug l(-1), storage of samples for at least several weeks prior to analysis, and use of readily available analytical instrumentation. Cr(VI) can be separated from Cr(III) between pH 2 and 11 at Cr(III)/Cr(VI) concentration ratios as high as 1000. The new method has demonstrated excellent comparability with two commonly used methods, the Hach Company direct colorimetric method and USEPA method 218.6. The new method is superior to the Hach direct colorimetric method owing to its relative sensitivity and simplicity. The new method is superior to USEPA method 218.6 in the presence of Fe(II) concentrations up to 1 mg l(-1) and Fe(III) concentrations up to 10 mg l(-1). Time stability of preserved samples is a significant advantage over the 24-h time constraint specified for USEPA method 218.6.

Sulfur geochemistry of hydrothermal waters in Yellowstone National Park, Wyoming, USA. III. An anion-exchange resin technique for sampling and preservation of sulfoxyanions in natural waters.

A sampling protocol for the retention, extraction, and analysis of sulfoxyanions in hydrothermal waters has been developed in the laboratory and tested at Yellowstone National Park and Green Lake, NY. Initial laboratory testing of the anion-exchange resin Bio-Rad™ AG1-X8 indicated that the resin was well suited for the sampling, preservation, and extraction of sulfate and thiosulfate. Synthetic solutions containing sulfate and thiosulfate were passed through AG1-X8 resin columns and eluted with 1 and 3 M KCl, respectively. Recovery ranged from 89 to 100%. Comparison of results for water samples collected from five pools in Yellowstone National Park between on-site 1C analysis (U.S. Geological Survey mobile lab) and IC analysis of resin-stored sample at SUNY-Stony Brook indicates 96 to 100% agreement for three pools (Cinder, Cistern, and an unnamed pool near Cistern) and 76 and 63% agreement for two pools (Sulfur Dust and Frying Pan). Attempts to extract polythionates from the AG1-X8 resin were made using HCl solutions, but were unsuccessful. Bio-Rad™ AG2-X8, an anion-exchange resin with weaker binding sites than the AG1-X8 resin, is better suited for polythionate extraction. Sulfate and thiosulfate extraction with this resin has been accomplished with KCl solutions of 0.1 and 0.5 M, respectively. Trithionate and tetrathionate can be extracted with 4 M KCl. Higher polythionates can be extracted with 9 M hydrochloric acid. Polythionate concentrations can then be determined directly using ion chromatographic methods, and laboratory results indicate recovery of up to 90% for synthetic polythionate solutions using AG2-X8 resin columns.