Radiologist involvement is associated with reduced use of MRI in the acute period of low back pain in a non-elderly population.

PURPOSE: To test the hypothesis that "acute-period" lumbar MRI in non-elderly patients with low back pain is less frequently performed at clinics/hospitals with greater involvement of full-time radiologists in the imaging workflow. METHODS: In a national-level claims database, we identified 14,819 non-elderly patients (mean age: 38.7±8.0 years) who visited clinics/hospitals for low back pain in 2013-2015. We classified the clinics/hospitals into four groups based on the level of full-time radiologist involvement and MRI ownership, and compared the frequency of acute-period lumbar MRI using hierarchical logistic regression analysis. RESULTS: Patients visiting facilities without a full-time radiologist (n=2105) were significantly (p<0.001) more likely to undergo acute-period MRI than those visiting facilities with ≥1 radiologist partially managing imaging workflow (level-1, n=491) or ≥1 radiologist intensively involved in imaging workflow (level-2, n=1190) (15.7% vs. 6.9% and 7.3%; adjusted odds ratio of no-radiologist versus level-2: 2.93, p=0.018). No difference was observed between level-1 and level-2 involvement. CONCLUSIONS: Facilities with no full-time radiologist were more likely to perform acute-period MRI to assess for low back pain, while no difference was seen between facilities with varying levels of radiologist involvement in the imaging workflow. Radiologist involvement may contribute to optimal utilisation of medical imaging. KEY POINTS: • Lumbar MRI was more frequently performed at facilities without full-time radiologists. • Full-time radiologists may play an important role in appropriate utilisation of imaging. • Frequency of MRI was similar between moderate and intensive radiologist involvement.

The effect of short-time active listening training.

OBJECTIVES: We conducted mental health training incorporating active listening for managers at a site of a general chemical company with 1,400 employees. Our purpose was to clarify the effect of active listening training of 2.5h. METHODS: All subjects were managers. The mental health training was given to 229 managers, 21 times from May 2007 until March 2008. Surveys were conducted from May 2007 to September 2008. The training sessions were conducted in a company meeting room, starting at 2:00 p.m. The importance and significance of listening as a mental health measure and methods of active listening were explained in the training. Afterward, role-playing and follow-up discussions were done twice each. In summaries, participants wrote down what they noticed about listening and gave group presentations. The instructor commented on the presentations, and ended the session by passing out and explaining a paper summarizing what is important in listening. The training was evaluated with a questionnaire distributed at the completion of training, and questionnaires on implementation of what was learned were distributed 1, 3, and 6 mo later. The Active Listening Attitude Scale (ALAS; composed of two scales for method of listening and listening attitude) developed by Mishima et al. was also used before and 1, 3, and 6 mo after the training. RESULTS AND CONCLUSIONS: In questionnaires distributed on the same day after training, 60% of the 212 respondents said the training time was just right, and 30.1% felt it was too short. The difficulty level of the training was considered appropriate by 77.8%, and 79.7% intended to implement what they had learned. Overall satisfaction was high at 85.9%. In the questionnaire 6 mo after training, 81.4% of the 145 respondents remembered the content of the training and 49.7% said they were practicing what they had learned. They responded that their conversations with subordinates about non-work topics had increased, and communication and support at work had become smoother. ALAS was administered 4 times, from before training to 6 mo afterward, and analysis was conducted for 84 respondents. No significant difference was seen in attitude to listening, but the score increased compared with before the training. The score for method of listening increased significantly. The same results were seen when the analysis was expanded to 125 respondents before and 6 mo after the training. These results are similar to those reported previously for ALAS. The findings suggest that even short listening training of 2 h and 30 min has a positive lasting effect.

[Self-care for pollinosis of cedar and cypress--from a questionnaire survey].

For patients with pollinosis, self-care is important as well as medical care. In this study, we investigated the real situation of patients with pollinosis-how they manage their symptoms. A questionnaire-based examination was conducted among 488 patients who visited National Osaka-Minami hospital and Sano ENT clinic. The onset of pollen dispersion occurred 17th Feb. 34.6% of patients visited before the onset of pollen dispersion. 45.5% of them had a checkup for allergens. 84.8% of them utilized pollen information. 41.4% of them did self-care. The rate of patients who utilized pollen information and did self-care was higher in female compared with male. The rate of those who did self-care was significantly higher in the patients who visited before pollen dispersion, who had a checkup for allergens, who utilized pollen information, compared with the patients did not. It is necessary to show the information of self-care as well as pollen, and suggest the importance of self-care against pollen allergens.