Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients.

OBJECTIVES: Many patients have limited English proficiency and require an interpreter. The authors evaluated the effect of current interpreting practices on Spanish-speaking patients' satisfaction with the patient-provider relationship. METHODS: A cross-sectional survey was conducted of 457 patients seen in a public hospital emergency department. Measures were satisfaction with the provider's friendliness, respectfulness, concern, ability to make the patient comfortable, and time spent for the exam. RESULTS: A total of 237 patients communicated adequately with their provider without the use of an interpreter (group 1), 120 patients communicated through an interpreter (88% of whom were ad hoc interpreters; group 2), and 100 patients communicated directly with the provider but said an interpreter should have been called (group 3). Compared with patients in group 1, patients who communicated through an interpreter (group 2) rated their provider as less friendly, less respectful, less concerned for the patient as a person, and less likely to make the patient comfortable. Patients who said an interpreter should have been called (group 3) had the lowest satisfaction ratings; compared with group 2, they were less satisfied with their provider's friendliness, concern for the patient as a person, efforts to make the patient comfortable, and amount of time spent. CONCLUSIONS: Patients who communicated through an interpreter or who did not have an interpreter when they thought one was necessary were less satisfied with the patient-provider relationship. Further efforts are needed to ensure interpreter availability and proper interpretation technique.

[Bonding and enamel prisms: is the "bevel" still significant?]. / Collage et prismes de l'émail: le "biseau" a-t-il encore un intérêt?

Following a recall of the various preparations of the cavo-surface for posterior composites (straight, rounded, concave bevel, or without bevel), a study at the M.E.B. analysed the interface between the tooth and the filling in each case investigated. With the straight bevel with a slight angulation (40 degrees), the limit of the cavity-filling joint is clear. A disintegration of the material exists with the straight bevel having a 70 degrees angulation. The hiatus is even more marked with rounded or concave bevels. The absence of a bevel provides a clear occlusal joint without irregularity at the cavo-surface limit. In the light of this investigation and the results observed in the clinic in the medium and long term, it appears that the preparation of the cavo-surface margins of occlusal cavities of the pre-molars and molars for posterior composites may make do with a bevel which is not very extensive and not widely opened (40 degrees), or even the total absence of a bevel.

[Bonding and enamel prisms. Importance of cavity margin preparation for posterior composites]. / Collage et prismes de l'émail. Importance de la préparation des bords des cavités pour composites postérieurs.

Preparation of the cavo-surface margin for fillings with "composites resins" is an important operative step. The good peripheral fit of the restoration and the stability of the bond between tooth and material depend on that preparation. How should the "bevel" be shaped? Scan electron microscopy of long bevels and rounded bevels show that the former seem more favorable to the fit of the filling. The section of enamel prisms is clean. The aprismatic surface area disappears. This enables to etch the cristallites in a more favorable axis as opposed to the rounded bevel.