According to the American Medical Association, Internet web site health information should be written at or below a 6th grade reading level. The purpose of this study was to evaluate the readability and quality of cochlear implant web site health information. Study Design: Cross-sectional web site analysis. Setting: Four Internet search engines involving the top 200 web sites (English and Spanish). Intervention/Methods: "Cochlear implant" was queried in four Internet search engines, and the top 200 English and Spanish web sites were aggregated. After removing duplicates, the web sites were evaluated for readability by using the following validated online readability calculators: Flesch Reading Ease score for English web sites and the Fernandez-Huerta Formula for Spanish web sites. Information quality was assessed using the validated DISCERN quality criteria and the presence of Health on the Net Code of Conduct (HONcode) certification. Results: A total of 80 non-industry-sponsored (43 English and 37 Spanish) and 11 industry-sponsored (4 English and 7 Spanish) cochlear implant health information web sites were included in the study. English web sites were written at a higher reading level (mean = 50.88, SD = 11.98) compared with Spanish web sites (mean = 59.79, SD = 6.04) ( p < 0.01). For both English and Spanish web sites, these scores correlate to the reading level of the average 10th to 12th grade student. Only 12% of Spanish web sites and 27% of English web sites were HONcode certified. The average DISCERN quality score was 41.67 for English web sites and 43.46 for Spanish, indicating significant concerns for quality. There was no association found between readability and quality of the web sites analyzed. Conclusions: Patient-directed English and Spanish web sites regarding cochlear implantation were written at reading levels that significantly exceed those recommended by the AMA. Furthermore, these web sites have significant quality shortcomings. Patients would benefit from more rigorous editing to improve readability and quality of content.
Introduction: The growing population of adults with congenital heart disease (CHD) often have lifelong experience of dealing with potentially traumatic health crises and medical uncertainty whilst facing increased vulnerability to post-traumatic stress disorder (PTSD). The COVID-19 pandemic presents additional challenges for this population including increased risk of health complications, shielding and strict social distancing, changes to medical care provision and social stigma. Despite such challenges, adults with CHD have the potential to also experience positive changes, yet little is known as to what helps cultivate positive adaptation and post-traumatic growth (PTG) within this context. Methods: The current study comprised a cross-sectional, anonymous, online study exploring psychosocial measures of traumatic experiences as well as protective factors that mitigate the risks to mental health on the mental health for adults with CHD (n=236) during the pandemic. Closed and open-ended questions and a series of standardised psychosocial measures of traumatic experiences, coping mechanisms, emotional regulation and PTG were measured.Results: Findings suggest the CHD population are at increased risk of PSTD which may be exacerbated by the COVID-19 pandemic. However, positive adaptation may promote post traumatic growth. In particular, health adversity is associated with greater appreciation whilst emotional regulation is associated with post-traumatic growth.Conclusions: We recommend a growth-focused, psychologically and trauma-informed approach to medicine and public health, recognising the importance of supporting mental health and promoting living well with CHD during the COVID-19 pandemic and beyond. These findings are likely generalisable to other lifelong health conditions and shielding populations.
Research focusing on COVID-19-associated complications has become a growing area of importance. One such complication is multisystem inflammatory syndrome, a rare immune-mediated condition that most commonly presents with Kawasaki-like symptoms in the pediatric population. Potential complications include myocarditis, renal impairment, and cytokine storm. Here we describe the first reported case of multisystem inflammatory syndrome in the West Texas region, presenting in a Hispanic 5-year-old female with a recent history of COVID-19. The patient arrived to the hospital with a 4 day history of high fever, a 2 day history of diffuse maculopapular rash, and complaints of fatigue, generalized body aches, decreased appetite, headache, and abdominal pain. Further physical exam revealed hepatosplenomegaly and cervical lymphadenopathy, while labs revealed elevated inflammatory markers, lymphopenia, left shift with bandemia and immature cells, thrombocytopenia, hypoalbuminemia, and transaminitis. The patient was admitted to the pediatric intensive care unit with a suspected Kawasaki-like illness and started on high dose aspirin and IV immunoglobulin. She was placed on methylprednisolone, albumin, and acetaminophen on hospital day 3. By hospital day 4, the patient defervesced, inflammatory markers decreased, and clinical symptoms improved. The patient was discharged on hospital day 10 with absent fever and improvement of clinical symptoms for 6 consecutive days. No complications were detected upon follow-up 2 weeks later. A low threshold of suspicion for this illness is required in any child with a history of SARS-CoV-2 infection, as the presentation is vague and early identification is necessary to prevent further complications.
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