Effects of 3-week total meal replacement vs. typical food-based diet on human brain functional magnetic resonance imaging food-cue reactivity and functional connectivity in people with obesity.

OBJECTIVES: Calorie restriction via total meal replacement (TMR) results in greater reduction of food cravings compared to reduced-calorie typical diet (TD). Direct evidence of the impact of these interventions on human brain fMRI food-cue reactivity (fMRI-FCR) and functional connectivity is absent. We examined the effects of a 3-week 1120 kcal/d TMR intervention as compared to an iso-caloric TD intervention using an fMRI-FCR paradigm. METHODS: Thirty-two male and female subjects with obesity (19-60 years; 30-39.9 kg/m2) participated in a randomized two-group repeated measures dietary intervention study consisting of 1120 kcal/d from either 1) TMR (shakes), 2) TD (portion control). Pre-intervention and following the 3-week diet fMRI-FCR, functional connectivity, food cravings (Food Craving Inventory) and weight were considered. RESULTS: Compared to TD, TMR showed increased fMRI-FCR of the bilateral dorsolateral prefrontal (dlPFC), orbitofrontal, anterior cingulate, primary motor and left insular cortices and bilateral nucleus accumbens regions in the post-intervention state relative to the pre-intervention state. Compared to TD, TMR was also associated with negative modulation of fMRI-FCR of the nucleus accumbens, orbitofrontal cortex and amygdala by dlPFC. Reduced body weight (4.87 kg, P < 0.001), body fat (2.19 kg, P = 0.004) and overall food cravings (0.41, P = 0.047) were seen in the TMR group. In the TD group reduced body weight (2.37 kg, P = 0.004) and body fat (1.64 kg, P = 0.002) were noted. Weight loss was significantly greater in TMR versus TD (2.50 kg, P = 0.007). CONCLUSIONS: Greater weight loss and reduced cravings, coupled with stronger activations and potential negative modulation of the food reward related regions by the dlPFC during exposure to visual food cues is consistent with increased executive control in TMR vs. TD.

Use of Online Media for Professional Development Amongst Medical Radiation Practitioners in Australia and Canada.

Online media allows access to professional development (PD) regardless of geographical location and has the potential to provide equitable, immediate and quality PD. Online media includes online information and social media. The purpose of this mixed methods research study was to investigate the perceptions and use of online media for PD amongst medical radiation practitioners within Australia and Canada. An online survey was circulated to members of the Canadian Association of Medical Radiation Technologists (CAMRT) and the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT). The survey collected data within three domains: current use, satisfaction of use, and future use. A four point Likert scale was used for both satisfaction with the online platform and frequency of use. Two hundred and thirty-nine responses were collected. Results indicated that the online mechanisms most frequently used by respondents for PD were Google, self-directed learning, and intranet. A correlating degree of satisfaction was indicated with the use of these platforms. The least used online media for PD were social media platforms including health related blogs, LinkedIn, Twitter, health related and professional applications, Facebook, and online journal clubs. Online media is well suited to PD for medical radiation practitioners. The platforms that are preferred offer speed and ease of access regardless of geographical location or occupation. Whilst inherent risks and instances of unprofessional online behaviour are acknowledged, Australian and Canadian practitioners are keen to learn what social media PD opportunities exist. Findings indicate that radiation therapists are more receptive to explore new social media platforms and tools than are radiographers. There is an opportunity to incorporate formal PD for medical radiation practitioners within recognised social media platforms.

Brain regions involved in ingestive behavior and related psychological constructs in people undergoing calorie restriction.

Human food intake is regulated by physiological energy homeostatic mechanisms and hedonic mechanisms. These are affected by both very short-term and longer-term calorie restriction (CR). To date, there are parallel discussions in the literature that fail to integrate across these disciplines and topics. First, much of the available neuroimaging research focusses on specific functional paradigms (e.g. reward, energy homeostasis). These paradigms often fail to consider more complex and inclusive models that examine how potential brain regions of interest interact to influence ingestion. Second, the paradigms used focus primarily on short-term CR (fasting) which has limited generalizability to clinical application. Finally, the behavioral literature, while frequently examining longer-term CR and related psychological constructs in the context of weight management (e.g. hedonic restraint, 'liking', 'wanting' and food craving), fails to adequately tie these phenomena to underlying neural mechanisms. The result is a less than complete picture of the brain's role in the complexity of the human experience of ingestion. This disconnect highlights a major limitation in the CR literature, where attempts are persistently made to exert behavioral control over ingestion, without fully understanding the complex bio behavioral systems involved. In this review we attempt to summarize all potential brain regions important for human ingestion, present a broad conceptual overview of the brain's multifaceted role in ingestive behavior, the human (psychological) experiences related to ingestion and to examine how these factors differ according to three forms of CR. These include short-term fasting, extended CR, and restrained eating. We aim to bring together the neuroimaging literature with the behavioral literature within a conceptual framework that may inform future translational research.

Strategies to Improve Radiographic Practices for Patients With Alzheimer's Disease: A Systematic Review.

BACKGROUND: Alzheimer's disease (AD) patients are one of the highest health care service users globally. In the context of radiography, there are many AD patients who undergo imaging procedures for common age-related conditions. However, there is currently no literature on how radiographers can effectively manage such patients in imaging situations. METHODOLOGY: This review examined the literature regarding the interaction between Alzheimer's patients and other health care professionals (eg, nurses) and the strategies that have been used to improve patient compliance and accommodate functional decline. FINDINGS: Many strategies relating to care of patients with AD are long term, and cannot be applied in a radiographic setting, where patients may only present once. Transferrable strategies for a radiographic setting include the support of carers during the examination process, a reduction in noise and use of calming music, and allowing the patient to personalize the examination room by bringing a photograph or an item of comfort. CONCLUSION: These simple strategies can reduce the level of anxiety experienced by AD patients, reduce typical behavioral symptoms of agitation, aggression and discomfort, and increase patient cooperation and responsiveness.

Patient-Centered Strategies to Improve Radiographic Practice for Patients with Down Syndrome: A Systematic Review.

BACKGROUND: Down syndrome is a common human genetic disorder caused by trisomy of chromosome 21. Individuals with Down syndrome can present with a range of health issues during their lives that may require imaging for diagnosis. Radiographers, therefore, play a significant role in the management and communication of Down syndrome patients' health. PURPOSE: This review identified patient-centered strategies that radiographers should use to provide quality imaging services for Down syndrome patients, who may have limited verbal ability and behavioral issues. METHOD: A systematic review using the established PRISMA guidelines was undertaken of current literature obtained through the Ovid and Scopus databases. A total of 189 articles were found, of which 41 were categorized and analyzed in detail. FINDINGS: A high level of care for Down syndrome patients will require longer than usual procedures, and the patients will not respond well to being rushed or ignored. Down syndrome patients have difficulty verbalizing, yet they understand more than is often thought. Individuals may require increased imaging time to give them time to respond, especially to pain. Patients are at risk of injury with AAI or other pathologies, and caution should be taken with flexion and extension spine x-rays. Radiographs may reveal undisclosed physical abuse. CONCLUSION: Specific strategies with verbal and nonverbal communication help to facilitate communication, reduce anxiety and fear, and improve compliance with Down syndrome patients. Patients may require an increased level of care; increased imaging time; and allowing support people to be present during the examination process.

Errors in Medical Imaging and Radiography Practice: A Systematic Review.

BACKGROUND: Errors in health care can harm patients and undermine public trust, yet many are preventable. In medical imaging and radiography, errors can cause increased radiation dose, misdiagnosis, and clinical mismanagement. AIM: The purpose of this review was to identify the type and prevalence of errors directly associated with radiography practice and the imaging cycle, with a view to developing recommendations to reduce common errors. METHOD: A systematic review was undertaken of current literature obtained through the Ovid Medline and PubMed databases. A total of 41 useable articles were analysed into a priori categories of the medical imaging cycle: preprocedural, procedural, and postprocedural. FINDINGS: This review found that errors may occur during any phase of the cycle and that communication breakdown, especially during handover periods, was the main contributing factor to errors. Although the importance of incident reporting is well recognised, feedback to users is often limited. CONCLUSIONS: A systematic approach to radiographic practice may assist in reducing communication-related errors. Future research is required to determine how extending radiographers' roles or using electronic ordering systems could also help to reduce errors.