RESUMEN
Background: Treatment for head and neck cancer (HNC) can lead to profound changes in swallowing function and nutrition. UK HNC standards recommend informational counselling is provided pre-treatment by the dietitian and speech and language therapist (SLT). Non-english speaking patients treated in English speaking countries have poorer treatment outcomes. UK guidance recommends all patients should have access to interpretation services where required. This audit aimed to investigate the language needs and utilisation of interpretation services for patients with HNC attending pre-treatment clinics. Methods: A retrospective casenote audit over two-years (2021-2023) of all patients attending pre-treatment clinics in a centralised London cancer centre. Information was collected from electronic hospital records on demographics, disease/treatment characteristics, first language; categorised as English primary language (EPL), non-English primary language (NEPL) and interpretation requirements; formal (professional interpreters) or informal (patients friends/relatives). Data was processed and collated using Microsoft Excel (Version 2308). Descriptive statistics were conducted using Excel Analysis ToolPak. Results: 408 patients were included. Most patients were male (67%), aged 61 ± 13 years. 18% (n = 74) had NEPL; 58 required interpretation services. Formal interpretation service was provided in 43% (n = 25), informal services in 33% (n = 19), and no service in 24% (n = 14). Non-adherence to formal services included lack of/inaccurate documentation of language needs, patient preference and lack of available interpreters. Conclusion: This audit indicated that barriers exist in utilising formal interpretation services. Future research should investigate how this can be optimised to ensure necessary language support is provided consistent with guidelines that promote equality, diversity, and inclusion.
RESUMEN
Aim: We evaluated the appropriateness of various chest compression (CC) depths among Thai population by comparing the calculated heart compression fraction (HCF) using mathematical methods based on chest computed tomography (CT) measurements. Methods: This multicenter retrospective cross-sectional study was conducted from September 2014 to December 2020. Chest parameters included external anteroposterior diameter (EAPD), internal anteroposterior diameter (IAPD), heart anteroposterior diameter (HAPD), and non-cardiac soft tissue measured at the level of maximum left ventricular diameter (LVmax). We compared the HCFs as calculated from CT parameters using different CC depths at 5 cm, 6 cm, 1/4 of EAPD, and 1/3 of EAPD, with further subgroup analysis stratified by sex and BMI. Results: A total of 2927 eligible adult patients with contrast-enhanced chest CT were included. The study group had mean age of 60.1 ± 14.7 years, mean BMI of 22 ± 4.4 kg/m2, and were 57% males. The mean HCFs were 41.5%, 53.5%, 42.4%, and 62.6%, for CC depths of 50 mm, 60 mm, 1/4 of EAPD, and 1/3 of EAPD respectively. HCF was significantly lower in male patients for all CC depths. Advanced age and higher BMI showed significant correlation with lower HCF for CC depths of 50 mm and 60 mm. Conclusion: The CC depth measure of 50-60 mm demonstrated efficacy in maintaining HCF and coronary perfusion in the general population except for geriatric and obese individuals. Adjusting CC depth to 1/4-1/3 of the EAPD yielded better outcomes. Future research should prioritize determining individualized CC depths based on EAPD proportion.
