| Authors: |
Huzefa Cementwala OMS - II, Nicholas Engels OMS - II, Aimee Phillips OMS - II, Valerie Pichkhadze OMS - II, Bruno Pita OMS - II, Samantha Simpson OMS - II, Skyler Sorkin OMS - II |
|
Background: |
Physicians not sharing a common language or ethnic background with their patients can represent a significant barrier to the delivery of medical treatment and patient compliance. In the southeastern region of the United States, diverse cultural backgrounds are represented which increases the challenge. The purpose of the project is to investigate the relationship between physician language or ethnic concordance with their patients and how it affects patient compliance with medical treatment, specifically in the southeastern United States. In order to sufficiently address the challenge, patient populations in the southeastern region were analyzed and compared on the basis of physicians sharing the same language and/or ethnicity of their patients versus those who do not and how this impacts the compliance of patients with their care. Other factors impacting compliance, such as the overall cultural competency of physicians, were also investigated to determine the impact on patient compliance. |
|
Methods: |
In order to determine the impact of ethnic or language concordance or discordance on patient compliance, an extensive literature review was performed. Open Evidence was utilized to search for reputable peer-reviewed journal articles that were accessible through the National Institutes of Health. Specifically, articles concerning concordance vs. discordance in healthcare in relation to language barriers were chosen. Ten peer-reviewed journal articles were chosen and the data analyzed to apply to the research question. PolicyMap was also utilized to assess trends among fair/poor health status in comparison to language spoken. |
|
Results: |
Over the course of this project, study designs with differing populations across the world ere reviewed. The review identified physician-patient communication, cultural competencies, and agreements between language/ethnic as primary determinants of patient outcomes. The concordance of language was the most consistent and overall strongest predictor of improved adherence to medical advice, satisfaction ratings, and clinical outcomes. Ethnic concordance had a less consistent effect on compliance. However, a shared cultural background reduced miscommunication amongst providers and patients. Cultural competence in physicians’ awareness of sociobehavioral and patient cultural factors played a key role in enhancing patients’ trust, which then contributed in patient adherence to care. Other factors were identified as stronger predictors of patient satisfaction than ethnic and language alone, highlighting the multifaceted nature of healthcare disparities. |
|
Conclusion: |
Overall, language and ethnic differences play a significant role in shaping physician–patient communication and, consequently, patient health outcomes. To promote equitable and high-quality care across diverse populations, greater emphasis must be placed on multicultural education and on expanding access to resources that minimize language barriers and foster effective cross-cultural communication. Change can be pursued at three key levels. At the educational level, medical school curricula should more intentionally prepare students to recognize and address linguistic and cultural barriers in patient care. At the policy level, reforms in insurance and hospital systems are needed to ensure that institutions are adequately equipped to meet patients’ cultural and language needs through interpreters, training, and inclusive care models. Finally, systemic reforms, including Medicaid improvements and targeted investments in rural healthcare, are essential for advancing compliance and health quality in communities affected by cultural and linguistic disparities. Future research should evaluate long-term outcomes of solutions such as language-concordant provider assignments, telehealth services with translation support, and community-based health worker programs. |
| Authors: |
Rurik Rondan OMS-II, Ricaina Metayer OMS-II, Lauren Burch OMS-II, Michael Harris OMS-II, Christopher Robertson OMS-II, Zain Siddiqui OMS-II |
|
Introduction: |
Biofilm formation is important when it comes to bacterial growth on prosthetic devices. Prosthetics provide an ideal environment for bacterial growth and colonization. With any surgery, there comes a risk of microbial infection whether origination from instruments, improper sterilization, or aerosolized bacterial infection. For prosthetic replacements, another route of infection is introduced to the patient’s system. Certain bacteria replicate and have properties that allow biofilm formation and cause it to adhere tightly to prosthetics and repel certain antimicrobial treatments because of this layer of biofilm. Some of the most common pathogens include Staphylococcus, Streptococcus, and Pseudomonas Aeruginosa. There are many routes of administration of such antimicrobial treatment to prevent such infections. The routes examined in this study are: antimicrobial coating, local antibiotic administration, systemic prophylaxis. |
|
Methods: |
Data was found using peer-reviewed medical databases through Pubmed and PolicyMap websites. These databases were used due to the volume and validity of research material related to effective strategies to prevent biofilm formation on prosthetic devices. A comprehensive review of peer-reviewed studies published between 2000 and 2025 was conducted to assess strategies for preventing biofilm formation. Eligible studies included randomized controlled trials, systematic reviews, meta-analyses, and observational cohort studies. |
|
Results: |
Overall, research outcomes can be subdivided into two classifications: Primary outcome: incidence of periprosthetic joint infection (PJI) or surgical site infection (SSI) and Secondary outcomes: infection-related complications (anastomotic dehiscence, biofilm persistence), drug-resistant organisms, adverse drug events, and patient quality of life. Our findings for antimicrobial coatings found that silver-coated prosthetics significantly reduced infection rates - 9.2% vs 13.4%. Silver-coated implants demonstrated a limited but consistent reduction in periprosthetic infection rates in pooled analyses, suggesting a real-world benefit for reducing device-associated infection risk. For local antibiotic therapy, it was found that Vancomycin powder, Intraosseous regional antibiotic administration (IORA) achieved higher circulating levels of circulating drugs as opposed to IV administration. For systemic antibiotic prophylaxis, Cefuroxime timing was critical: administration 10-25 minutes before incision significantly lowered SSI rates. It was found that prolonged systemic prophylaxis (> 48 hours) after cardiovascular surgery did not reduce infection rates but promoted antimicrobial resistance. |
|
Conclusion: |
Based on these findings, upon examining these routes of administration- antimicrobial coating, local antibiotic administration, systemic prophylaxis- each varying degrees of effectiveness in preventing biofilm formation and infection rates. Silver coatings show moderate evidence for infection prevention, though there is a limited but consistent reduction in periprosthetic infection rates. Local vancomycin delivery is promising, especially in high-risk cases, but efficacy is inconsistent across trials. Systemic prophylaxis, specifically with Cefuroxime and optimizing timing, while prolonged or combined systemic prophylaxis shows limited benefit and greater risks. Future research must address such limitations, including sample size and lack of long-term data. In conclusion, combining local and systemic strategies may be the most effective approach to minimizing prosthetic-associated infections. |