Time to Throw in the Towel? No Evidence for Automatic Conceptual Metaphor Access in Idiom Processing.

The goal of the current research was to determine if conceptual metaphors are activated when people read idioms within a text. Participants read passages that included idioms that were consistent (blow your top) or inconsistent (bite his head off) with an underlying conceptual metaphor (ANGER IS HEATED FLUID IN A CONTAINER) followed by target words that were related (heat) or unrelated (lead) to the conceptual metaphor. Reading time (Experiment 1) or lexical decision time (Experiment 2) for the target words were measured. We found no evidence supporting conceptual metaphor activation. Target word reading times were unaffected by whether they were related or unrelated to underlying conceptual metaphors. Lexical decision times were facilitated for related target words in both the consistent and inconsistent idiom conditions. We suggest that the conceptual (target) domain, not a specific underlying conceptual metaphor, facilitates processing of related target words.

Immediate Interpretation and Results Communication Decreases Patient Anxiety: Experience in a Private Practice Community Hospital.

OBJECTIVE. The study objectives were to evaluate the percentage of patients interested in immediate radiologic results and to measure patient anxiety and hospital loyalty with this program in a private practice community hospital setting. SUBJECTS AND METHODS. Between December 2018 and May 2019, 100 patients 18-89 years old with a primary diagnosis of abdominal pain had imaging orders for CT, ultrasound, or nuclear medicine-hepatobiliary iminodiacetic acid scans and subsequently were asked if they wanted immediate results. Those who opted for immediate results were given a two-question survey before and after results delivery that asked about their anxiety level and imaging center loyalty. Data were entered using SurveyMonkey (SVMK) and analyzed using SAS software (version 9.4, SAS Institute). RESULTS. The majority (78%) of patients wanted immediate results. There were statistically significant differences in anxiety level before and after results delivery; 37% (p < 0.001) reported decreased anxiety after receiving imaging results, whereas 57% reported no change in anxiety (p < 0.001). The decision whether to come back to this imaging center (hospital loyalty) did not change before and after test results; 85% of participants strongly agreed that they would return. CONCLUSION. It is feasible for private practice radiologists to discuss CT, ultrasound, or nuclear medicine imaging results with patients in a community hospital setting. The majority of patients preferred immediate results over traditional methods of notification. Most patients reported anxiety about their imaging results, and a statistically significant number had decreased anxiety after discussing results with radiologists.

Pediatric golf cart trauma: Not par for the course.

INTRODUCTION: Golf cart trauma in southeast Georgia represents a significant source of morbidity in the pediatric population. We believe these events are related to the introduction of new state legislation that allows local authorities to govern golf cart operation. METHODS: We performed a retrospective review from 2010 to 2016 of children involved in golf cart traumas (n = 46). We recorded age, gender, Glasgow Coma Scale score (GCS), Injury Severity Score (ISS), location of event, and patient position during event. Outcomes included injury type and length of stay (LOS). RESULTS: The most common position in a golf cart was a passenger (52.2%). Events varied regionally and correlated with stringency of local legislation. Skull fractures afflicted 48% (n = 22) of children and traumatic brain injuries (TBIs) were noted in 35% (n = 17) of patients. TBIs (LOS = 4.6 days, p = 0.006) and abdominal injuries (LOS = 8.5 days, p = 0.017) lengthened mean hospital stay. Increasing ISS was associated with an increased probability of sustaining a TBI (OR 1.295, p = 0.004). Younger children were more likely to sustain a skull fracture (OR 1.170, p = 0.034) while older children incurred more orthopedic injuries (OR 1.217, p = 0.045). CONCLUSION: Skull fractures and TBIs are common following pediatric golf cart trauma. Georgia's varying municipality legislation likely contributes to the growing frequency of this trend. LEVEL OF EVIDENCE: Retrospective study, IV.

Decreasing Postoperative Opioid Prescribing through Education.

OBJECTIVES: To study how an educational intervention given to surgical residents affected postoperative opioid prescribing. To determine whether decreased opioid prescription amounts increased patients' rate of refills, emergency department visits, or readmissions. DESIGN: Prospective sequential cohort study. SETTING: Level 1 tertiary care center in Savannah, Georgia. PARTICIPANTS: Opioid-naive patients who underwent general surgery (appendectomy, cholecystectomy, colectomy, hernia repair, lumpectomy, and mastectomy) between November 2017 and February 2018. RESULTS: Over a 6 month period, morphine milligram equivalents (MME) prescribed after general surgery per patient was decreased by 21.8% on average, with the largest reductions seen after breast and gallbladder surgeries (38% and 25% respectively). Patients who underwent laparoscopic surgery were prescribed 18.3% fewer MME. There was no significant change in MME prescribed after open abdominal surgery. Smaller prescription amounts were not associated with an increased rate of opioid refills. There was no increase in pain-related calls to clinic offices, emergency department visits, or readmissions for pain. CONCLUSION: After a single education intervention given to surgical residents, MME prescribed after common general surgeries can be decreased significantly without increasing rates of refills or utilization of care.

Community distress predicts youth gun violence.

BACKGROUND: The purpose of this study was to investigate our institution's experience with pediatric firearm events. We sought to determine the relationship between a community's level of socioeconomic distress and the incidence of youth gun violence. METHODS: We performed a retrospective review of children <18 years involved in firearm events. Using visual cluster analysis, we portrayed all firearm events and violent firearm events (assaults + homicides). Distressed community indices (DCIs) were obtained from an interface that uses US Census Bureau data. Incident rate ratios (IRRs) were calculated for firearm circumstances (i.e. assault, homicide, suicide) using a DCI. Significant IRRs were analyzed to discern which DCI metrics contributed most to gun violence. RESULTS: There were 114 children involved in firearm events; 66 were county residents. The DCI of injury location significantly predicted total firearm events (IRR 1.02, 95% CI 1.01-1.03), assaults (IRR 1.02, 95% CI 1.01-1.05), and violent firearm events (IRR 1.03, 95% CI 1.01-1.05). The proportion of adults without a high school diploma, poverty rate, median income ratio, and housing vacancy rate were highly predictive of gun violence (VIP >1). CONCLUSION: Community distress significantly predicts pediatric firearm violence. Local interventions should target neighborhoods with high levels of distress to prevent further youth gun violence. LEVEL OF EVIDENCE: Retrospective study, IV.