Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry’s workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies and describes types of injuries experienced by workers (N = 284) and their surrounding circumstances. Results indicate that general injuries and musculoskeletal strains, sprains, and tears account for a majority of injuries among workers on thoroughbred farms. Upper limbs and extremities are most frequently injured, while direct contact with the horse accounted for over half of all injuries. No differences in the diagnoses or distribution of injury were found by ethnicity; however, Latinos were more often struck by or trampled by a horse while non-Latinos were more often injured by an insect or plant. Implications and opportunities for future research are discussed.

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Background The burden of lung cancer in the United States is staggering, with more Americans dying from lung cancer than the next four most common cancers combined. With endorsement of lung cancer screening by the United States Preventive Services Task Force and reimbursement by the Centers for Medicare and Medicaid Services (CMS), the number screened for lung cancer with low-dose computed tomography (LDCT) is anticipated to rise in the near future. Methods In 2015, we conducted a cross section study of mailed surveys to 112 American College of Radiology (ACR) computed tomography (CT) facilities across North Carolina to examine recommended guidelines for lung cancer screening, referral patterns, and patient tracking methods. We describe the survey results and compare findings with surveys of academic medical centers. Results Among 48 respondents (response rate=42.9%), 54.2% offer lung cancer screening with LDCT (93.1% community and 6.9% academic settings) and of these, 70.8% use ACR/CMS guidelines. In lung cancer screening facilities, reported patient volumes are low (average 8 patients screened per month, range: 0–30) and patient tracking occurs in 72% of facilities. Conclusion Among our predominately community based sample of facilities, we found variation in lung cancer screening guideline usage, number of patients screened, and tracking methods.

Purpose To determine whether the mammographic technologist has an effect on the radiologists’ interpretative performance of screening mammography in community practice. Materials and Methods In this institutional review board approved retrospective cohort study, we included Carolina Mammography Registry (CMR) data from 372 radiologists and 356 mammographic technologists from 1994 to 2009 who performed 1,003,276 screening mammograms. Measures of interpretative performance (recall rate, sensitivity, specificity, positive predictive value (PPV1), and cancer detection rate (CDR)) were ascertained prospectively with cancer outcomes collected from the state cancer registry and pathology reports. To determine if the mammographic technologist influenced the radiologists’ performance, we employed mixed effects logistic regression models, including a radiologist-specific random effect and taking into account the clustering of examinations across women, separately for screen-film mammography (SFM) and full field digital mammography (FFDM). Results Of the 356 mammographic technologists included, 343 performed 889,347 SFM examinations and 51 performed 113,929 FFDM examinations, and 38 performed both SFM and FFDM. A total of 4,328 cancers were reported for SFM and 564 cancers for FFDM. The technologists had a statistically significant effect on the radiologists’ recall rate, sensitivity, specificity and CDR for both SFM and FFDM (p-values<0.01). For PPV1, variability by technologist was observed for SFM (p-value<0.0001) but not for FFDM (p-value=0.088). Conclusion The interpretative performance of radiologists in screening mammography varies substantially by the technologist performing the examination. Additional studies should aim to identify technologist characteristics that may explain this variation.

BACKGROUND In response to the National Lung Screening Trial, numerous professional organizations published guidelines recommending annual lung cancer screening with low-dose computed tomography (LDCT) for high-risk patients. Prior studies found that physician attitudes and knowledge about lung cancer screening directly impacts the number of screening exams ordered. METHODS In 2015, we surveyed 34 pulmonologists and 186 primary care providers (PCPs) to evaluate opinions and practices of lung cancer screening in a large academic medical center. We compared PCP and pulmonologist responses using t-tests and ᵪ2 tests. RESULTS The overall survey response rate was 40% (39% for PCPs and 50% for pulmonologists). Pulmonologists were more likely than PCPs to report lung cancer screening as beneficial for patients (88.2% versus 37.7%, P < .0001) and as being cost-effective (47.1% versus 14.3%, P = .02). More pulmonologists (76%) reported ordering a LDCT for screening in the past 12 months compared to PCPs (41%, P = .012). Pulmonologists and PCPs reported similar barriers to referring patients for lung cancer screening, including patient costs (82.4% versus 77.8%), potential for emotional harm (58.8% versus 58.3%), high false positive rate (47.1% versus 69.4%), and likelihood for medical complications (47.1% versus 59.7%). LIMITATIONS Our results are generalizable to academic medical centers and responses may be susceptible to recall bias, non-response bias, and social desirability bias. CONCLUSION We found significant differences in opinions and practices between PCPs and pulmonologists regarding lung cancer screening referrals and perceived benefits. As lung cancer screening continues to emerge in clinical practice, it is important to understand these differences across provider specialty to ensure screening is implemented and offered to patients appropriately.