Assessment of Musculoskeletal Discomfort and Evaluation of Radiology Workstation Ergonomics in a National Radiology Workforce.

RATIONALE AND OBJECTIVES: We assessed the presence of musculoskeletal discomfort and evaluated the ergonomics parameters of radiology workstations and the impact of poor radiology workstation ergonomics on musculoskeletal discomfort in a national radiology workforce. METHODS: This was a cross-sectional, questionnaire-based study. All radiologist and radiology trainee members of the Canadian Association of Radiologists were eligible to participate. Radiology workstation ergonomics parameters and self-reported data on musculoskeletal discomfort were recorded. A binary logistic regression model was fitted to the data to ascertain the impact of participants' radiology workstation ergonomics parameters on the likelihood of experience of musculoskeletal discomfort while adjusting for demographic variables. RESULTS: A total of 191 questionnaires were completed. The median (interquartile range) age of participants was 42.0 years (17.0 years) and 56.8% of participants were female. One hundred fifty participants (78.5%) self-reported the presence of musculoskeletal discomfort. Ergonomics parameters most commonly implemented included having monitors an arm's length away (82.6%) and hands being shoulder-width apart (77.1%). Binary logistic regression revealed participants either not having the top of the monitor screen at eye level when in a seated position or not having the wrists straight and relatively flat when using the mouse was associated with an increased likelihood of experience of musculoskeletal discomfort. The majority of participants (92.7%) self-reported their musculoskeletal discomfort to affect work productivity. CONCLUSION: A high proportion of musculoskeletal discomfort, limited implementation of ergonomics parameters of radiology workstations, and an association of two of these ergonomics parameters with an increased likelihood of experience of musculoskeletal discomfort were observed in a national radiology workforce.

Addressing Misinformation About the Canadian Breast Screening Guidelines.

Screening mammography has been shown to reduce breast cancer mortality by 41% in screened women ages 40-69 years. There is misinformation about breast screening and the Canadian breast screening guidelines. This can decrease confidence in screening mammography and can lead to suboptimal recommendations. We review some of this misinformation to help radiologists and referring physicians navigate the varied international and provincial guidelines. We address the ages to start and stop breast screening. We explore how these recommendations may vary for specific populations such as patients who are at increased risk, transgender patients and minorities. We identify who would benefit from supplemental screening and review the available supplemental screening modalities including ultrasound, MRI, contrast-enhanced mammography and others. We describe emerging technologies including the potential use of artificial intelligence for breast screening. We provide background on why screening policies vary across the country between provinces and territories. This review is intended to help radiologists and referring physicians understand and navigate the varied international and provincial recommendations and guidelines and make the best recommendations for their patients.

Quality improvement outcomes from the introduction of a geriatrician into a rehabilitation setting.

OBJECTIVES: Geriatrician impact on patient and system outcomes in formal rehabilitation settings has not been well described to date. We studied the effect of adding a geriatric medicine consultation service to a geriatric focused rehabilitation setting providing care to dialysis and non-dialysis patients. DESIGN/SETTING/PARTICIPANTS: A pre- and post-retrospective observational cohort study from January 1, 2009 to June 30, 2019 on all consecutively admitted adults aged 65 and older to general rehabilitation program, and adults aged 60 and older to specialized dialysis rehabilitation program, within a 25 bed general rehabilitation unit in a large urban academic rehabilitation center in Toronto, Ontario. Data were analyzed with quality improvement methodology including Statistical Process Control charts (XmR and U charts). INTERVENTION: Addition of a geriatric medicine service providing automatic comprehensive geriatric assessment and co-management consultative services for all admitted patients from admission onwards who met criteria for the intervention. The intervention commenced on August 1, 2013. MEASUREMENTS: Outcome measures were length of stay (days), service interruption frequency, and average functional independence measure (FIM) change (discharge FIM minus admission FIM) which uses the validated FIM score, a marker of functional ability. A 22 point change in FIM score is clinically relevant. RESULTS: Patient characteristics: general rehabilitation patients (n = 1395, mean age = 79.7, 50.1% female) and dialysis rehabilitation patients (n = 838, mean age = 72.8, 41.8% female). The average FIM change following intervention improved from 20.8 to 29.3 in the general rehabilitation cohort (40.6% improvement, SD = 5.51) and from 22.1 to 30.6 in the dialysis rehabilitation cohort (38.6% improvement, SD = 5.88). Changes in length of stay (24.9%-28.1% reduction) and service interruption frequency (34.3%-49.7% reduction) were also observed. CONCLUSION: Introduction of a geriatric medicine service for rehabilitation inpatients was associated with significant FIM score improvements. Our results suggest this intervention contributes to important gains in functional independence in reduced time for older adults receiving inpatient rehabilitative care.

A Library of Fluorinated Electrophiles for Chemical Tagging and Materials Synthesis.

Various applications could benefit from new fluorinated molecules that offer chemical handles for quickly functionalizing reactive surfaces and molecules. Herein, we report the synthesis of a library of fluorinated molecules that contain nonafluoro-tert-butyl groups and electrophilic handles, mostly acrylates and acrylamides. Featuring a variety of hydrophobic and hydrophilic linkers, these molecules could find use in polymer chemistry, biomaterials, biomedical imaging, and protein tagging.