A Call for the Structured Physicist Report

Introduction: The field of diagnostic radiology continues to struggle with the clinical adoption of the structured interpretive report, with many radiologists preferring a semistructured, free-text dictation style to a more rigid, highly structured approach that some professional leaders have promoted [1]. Although structured reporting compliance in the radiologist community has been difficult to achieve, diagnostic radiologists have been thinking about and discussing this important issue for many years; it is also a part of the ACR’s Imaging 3.0_ campaign [2]. In the breast imaging community, the well-established BI-RADS_ recommendations produce a very structured report, with a discussion of interpretive findings culminating in a numeric BI-RADS score ranging from 0 to 6 [3]. Unlike some interpretive radiology reports, which can be ambiguous in terms of the next course of action, the BI-RADS scale is not only a diagnostic scale but also prescriptive of what the necessary follow-up should be

Pilot and Feasibility Test of an Implementation Intention Intervention to Improve Fruit and Vegetable Intake Among Women with Low Socioeconomic Status

Fruit and vegetable intake (FVI), a modifiable risk factor for chronic diseases, is lower in low socioeconomic status (SES) populations. Implementation intentions (a specific type of planning that extends the Theory of Planned Behavior) has been studied to improve FVI, but not exclusively with low SES groups. Using mixed methods, we evaluated the feasibility, acceptability, and preliminary efficacy of an implementation intention intervention (versus a general plan) to increase FVI in women with low SES. For the pilot randomized controlled trial, demographics, body mass index, attitude, perceived behavioral control, goal intention strength, and FVI were measured at baseline and FVI again 1-month following the intervention. Feasibility data were collected for recruitment, randomization, retention, and assessment procedures and compared to predetermined targets. Semi-structured interview data was analyzed for emergent themes regarding acceptability of the trial. Preliminary efficacy of the intervention to improve FVI was analyzed descriptively. Feasibility targets were met for randomization (100% vs. ≥80% target), retention (93.5% vs. ≥70% target) and the assessment metrics missing data points (2% vs. ≤10% target) and days from intervention to follow up (mean=69.2, sd=42.6 vs.days). Targets for recruitment were not met with the exception of participants giving informed consent (100% vs. ≥70% target). Participants described the intervention as enjoyable and reported behavioral constructs outside of those measured as important to improve FVI. Limited efficacy analysis suggested that both groups increased their FVI (experimental: +0.17 servings per day, 95% CI: -0.85, 1.20; control: +0.50 servings per day, 95% CI: -0.56, 1.58). Further research which examines interventions based upon behavior change models to improve dietary health behaviors in marginalized groups is needed

Differences in treatment for substance use disorders by insurance status: Self-help only versus outpatient medical treatment

Background: The role of insurance on substance use disorders (SUD) treatment utilization generally is poorly understood and still less is known on how insurance status relates to the use of evidence-based treatment (i.e., medicalization approach) compared to other treatments, like single self-help groups, where the research on effectiveness is less supportive. This study examines associations between health insurance and any SUD treatment utilization as well as use of single self- help versus medicalization approach. Methods: A cross-sectional study design was used. Data were from the 2015-2017, public use National Surveys on Drug Use and Health (NSDUH). Adjusted logistic regressions were used to examine the associations controlling for socio-demographics, recent major depressive episode, and survey year. All analyses used survey weights to be representative of the US population and account for the NSDUH’s complex survey design. Results: After adjustment for covariates, those with publicly insured remained more likely to use any SUD treatment in the past year (odd ratio [OR] 1.82; 95% CI: 1.36-2.43), compared to those without insurance. Further, compared with uninsured, those with public insurance reported lower odds of using only self-help treatment (OR 0.42; 95% CI: 0.23-0.74) versus medicalization approach utilization. Conclusions: Publicly insured persons with SUD are more likely to use SUD treatment in the past year than the uninsured. Uninsured people with SUD are more likely to use single self-help as a substitute for medicalization approach.https://scholarscompass.vcu.edu/gradposters/1098/thumbnail.jp

A Randomized Trial Comparing Digital and Live Lecture Formats

Problem Statement and Background – Medical education is increasingly being conducted in community-based teaching sites making it difficult to provide a consistent curriculum. We conducted a randomized trial to assess whether digital lectures could replace live lectures. Methods – Students were randomized to either attending a lecture series at our main campus or viewing digital versions of the same lectures at community sites. Both groups completed an examination based on the lectures and the group viewing the digital lectures completed a feedback form. Results – The group who viewed the digital lectures performed slightly better than the live lecture group however the differences were not statistically significant. Despite technical problems the students who viewed the digital lectures overwhelmingly felt the digital lectures could replace live lectures. Conclusions – Digital lectures appear to be a viable alternative to live lectures as a means of delivering didactic presentations in a community-based setting

The Brachial Plexus: Development and Assessment of a Computer Based Learning Tool

The objective of the present study is to evaluate the use of multimedia technology to simplify study of the brachial plexus. A combination of newly-rendered illustrations, animations, explanatory text, and a set of printable sample questions were combined into a program to provide a tutorial for the brachial plexus. One aspect of the program is an animation showing the development of the brachial plexus from its developmental origins that illustrates limb rotation and the resulting adult anatomy and dermatomal arrangement. The cross-platform program requires Quicktime 3.0 and is packaged on CD-ROM. Student evaluation of the program highlights its ease of use and intuitive navigation. User evaluation provides validation that the use of illustrations and animations is beneficial to user’s understanding and retention of the material. Future plans involve incorporation of pathologic images in order to enhance the clinical relevance of the product

Determinants of Activity Levels in African Americans With Mild Cognitive Impairment.

Engaging in cognitive, social, and physical activities may prevent cognitive decline. In a sample of older African Americans with mild cognitive impairment (MCI; N=221), we investigated the cross-sectional relationships between activity levels and participants\u27 demographic, clinical, and neuropsychological characteristics. The average age of participants was 75.4 years (SD, 7.0); 177 (80.1%) were women. Participation in cognitive/social activities was positively associated with education, depression, literacy, mobility, instrumental activities of daily living (IADL), verbal learning, and subcomponents of executive function. A linear regression identified IADLs, education, depression, and verbal learning as independent predictors. Participation in physical activities was positively associated with sex, depression, IADLs, and subcomponents of executive function. An ordinal regression identified executive function and depression as independent correlates. These data suggest that unique characteristics are associated with cognitive/social and physical activities in older African Americans with MCI. These characteristics, coupled with low activity levels, may increase the risk of progression from MCI to dementia. Culturally relevant behavioral interventions to reduce cognitive decline in this high-risk population are needed

Does Exposure and Receptivity to E-cigarette Advertisements Relate to E-cigarette and Conventional Cigarette Use Behaviors among Youth? Results from Wave 1 of the Population Assessment of Tobacco and Health Study

Background: E-cigarettes (EC) are the most commonly used tobacco product among youth. Additionally, youth EC users are progressing to smoking conventional cigarettes (CC). Although known to target youth, there are no current restrictions in the US on EC marketing, including advertising. The purpose of this study is to evaluate the relationship between EC advertisements and youth EC and CC use behaviors. Methods: This study analyzed data from youth (12-17 years) aware of EC in Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) study (n=12,199). Weighted logistic regression models assessed whether exposure and receptivity to any of five randomized EC ads (two TV and three print) were associated with the outcomes of EC and CC behaviors of ever use, current (past 30 day) use, and susceptibility to future use. Additional analyses determined whether EC advertising exposure and EC and CC behaviors associations were moderated by EC advertising receptivity. All models were adjusted for sociodemographics, other combustible tobacco product use, and parent smoking. Results: EC advertisement exposure was significantly associated to ever and current EC use as well as susceptibility to EC and CC (p Conclusion: These findings demonstrate exposure to EC advertisements are particularly associated with EC use behaviors, but could play a role in future CC use as well. Youth who are receptive to EC advertisements appear particularly vulnerable. Further studies should focus on the role of receptivity to EC advertisements among youth in order to support regulatory policy targeting EC advertising

Assessment of the Employment Accessibility Benefits of Shared Autonomous Mobility Services

The goal of this study is to assess and quantify the potential employment accessibility benefits of Shared Autonomous Mobility Service (SAMS) commute modes across a large diverse metropolitan region considering heterogeneity in the working population. To meet this goal, this study employs a welfare-based (i.e. logsum-based) measure of accessibility, obtained via estimating a hierarchical work destination-commute mode choice model. The employment accessibility logsum measure incorporates the spatial distribution of worker residences and employment opportunities, the attributes of the available commute modes, and the characteristics of individual workers. This research further captures heterogeneity of workers using latent class analysis (LCA). The LCA model inputs include the socio-demographic characteristics of workers to subsequently account for different worker clusters valuing different types of employment opportunities differently. The accessibility analysis results indicate: (i) the accessibility benefit differences across latent classes are modest but young workers and low-income workers do see higher benefits than high- and middle-income workers; (ii) there are substantial spatial differences in accessibility benefits with workers living in lower density areas benefiting more than workers living in high-density areas; (iii) nearly all the accessibility benefits come from the SAMS-only mode as opposed to the SAMS+Transit mode; and (iv) the SAMS cost per mile assumption significantly impacts the magnitude of the overall employment accessibility benefits

Dissociation Between the Growing Opioid Demands and Drug Policy Directions Among the U.S. Older Adults with Degenerative Joint Diseases

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital stays among 65 and older in the nation, Oregon and Washington states from 2008 through 2017. Orthopedic operations (knee arthroplasty, total or partial hip replacement, spinal fusion or laminectomy) and opioid-related hospital stays were measured. The compound annual growth rate (CAGR) was used to quantify temporal trends of orthopedic operations by age groups as well as opioid-related hospital stays and was tested by Rao–Scott correction of χ2 for categorical variables. The CAGR (4.06%) of orthopedic operations among age 65 and older increased (P...) (See full abstract in article