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3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:882-896.

Aims and Objectives:To provide an overview and synthesis of the current evidence on healthcare aides' involvement in team decision-making in long-term care.Background: Healthcare aides provide the most direct care to residents in long-term care homes and are uniquely positioned to influence the quality of care. Yet, they are not typically included in team decisions for improving resident care. As demand for long-term care increases, it is essential that we have a comprehensive understanding of ways to support healthcare aides' role on the interprofessional team for decisionmaking about resident care.Design: Narrative review.Method: Five electronic databases were searched for articles published in English between 2008 and 2020. Thematic analysis was conducted to synthesise findings using an organising framework. Reporting followed the PRISMA-ScR. Results: Twelve studies were included. Results indicate that work environment factors that influenced (supported or hindered) healthcare aides' involvement in decisionmaking included information access/availability, hierarchical staffing structures and supervisor support/shared governance. Relational processes that influenced team decision-making included team communication and collaboration, information sharing and exchange, and the quality of work relationships among team members. Strategies are discussed that could address the identified barriers and support healthcare aides' active involvement in team decisions regarding resident care. Conclusions: This review highlights the pervasive underutilization of healthcare aides, who have the most knowledge of residents to support person-centred care. There remains a paucity of research on healthcare aides' involvement in team decisionmaking. Research is needed to examine the effectiveness of interventions to support healthcare aides' participation in decision-making and the impact on staff and resident outcomes.

Adrenal metastases cannot be reliably differentiated from adenomas at single-phase contrast-enhanced CT. Increased tumor size and heterogeneity were specific findings but showed unacceptably low sensitivity.

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Materials and Methods: With institutional review board approval, this study retrospectively compared 40 consecutive patients (mean age, 66 years 6 10 [standard deviation]) with metastases to 23 patients (mean age, 60 years 6 15) with lipid-poor adenomas at 1.5and 3-T MRI between June 2016 and March 2019. A blinded radiologist measured T2-weighted signal intensity (SI) ratio (SI nodule / SI psoas muscle), T2-weighted histogram features, and chemical shift SI index. Two blinded radiologists (radiologist 1 and radiologist 2) assessed T2-weighted SI and T2-weighted heterogeneity using five-point Likert scales. Results: Subjectively, T2-weighted SI (P , .001 for radiologist 1 and radiologist 2) and T2-weighted heterogeneity (P , .001, for radiologist 1 and radiologist 2) were higher in metastases compared with adenomas when assessed by both radiologists. Agreement between the radiologists was substantial for T2-weighted SI (Cohen k = 0.67) and T2-weighted heterogeneity (k = 0.62). Metastases had higher T2-weighted SI ratio than adenomas (3.6 6 1.

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