Caring for the Deaf, Hard-of-Hearing, Blind, and Low-Vision Patients in the Breast Center.

Two heterogeneous populations with widely varying needs are being increasingly encountered in breast care facilities: blind or low vision patients and deaf or hard of hearing patients. The Americans with Disabilities Act and the Rehabilitation Act mandate that all governments, businesses, and not-for-profit organizations provide effective communication to those facing hearing, vision, or speech communication disabilities and that the provided communication is equally effective as that provided to those lacking communication disabilities. It is vitally important that breast center providers understand the requirements put forth by these acts in the provision of patient care, which includes interactions with the patient as well as their family members and partner. Breast center providers must identify each patient's individual needs and preferred method of communication. Options to assist in communication for the deaf or hard of hearing include the use of text conversations, preprinted or accessible video health care education material, and dedicated American Sign Language or video interpreters. Attention to breast imaging facility design, access to large print or braille documents, and the use of qualified readers can aid in improving access and communication for the blind or low-vision individual. All members of the breast health team, from scheduling staff to front office personnel, technologists, and breast imaging radiologists, should understand how to respectfully communicate with and identify the needs of patients facing these challenges.

Hollow microneedles for intradermal injection fabricated by sacrificial micromolding and selective electrodeposition.

Limitations with standard intradermal injections have created a clinical need for an alternative, low-cost injection device. In this study, we designed a hollow metal microneedle for reliable intradermal injection and developed a high-throughput micromolding process to produce metal microneedles with complex geometries. To fabricate the microneedles, we laser-ablated a 70 µm × 70 µm square cavity near the tip of poly(lactic acid) (PLA) microneedles. The master structure was a template for multiple micromolded poly(lactic acid-co-glycolic acid) (PLGA) replicas. Each replica was sputtered with a gold seed layer with minimal gold deposited in the cavity due to masking effects. In this way, nickel was electrodeposited selectively outside of the cavity, after which the polymer replica was dissolved to produce a hollow metal microneedle. Force-displacement tests showed the microneedles, with 12 µm thick electrodeposition, could penetrate skin with an insertion force 9 times less than their axial failure force. We injected fluid with the microneedles into pig skin in vitro and hairless guinea pig skin in vivo. The injections targeted 90 % of the material within the skin with minimal leakage onto the skin surface. We conclude that hollow microneedles made by this simple microfabrication method can achieve targeted intradermal injection.