Observer Studies in Mammography

Abstract

Background: Cognitive Muscular TherapyTM (CMT) is an integrated behavioural intervention developed for knee osteoarthritis. CMT teaches patients to reconceptualise the condition, integrates muscle biofeedback and aims to reduce muscle overactivity, both in response to pain and during daily activities. This nested qualitative study explored patient and physiotherapist perspectives and experiences of CMT.Methods: Five physiotherapists were trained to follow a well-defined protocol and then delivered CMT to at least two patients with knee osteoarthritis. Each patient received seven individual clinical sessions and was provided with access to online learning materials incorporating animated videos. Semi-structured interviews took place after delivery/completion of the intervention and data were analysed at the patient and physiotherapist level.Results: Five physiotherapists and five patients were interviewed. All described a process of changing beliefs throughout their engagement with CMT. A framework with three phases was developed to organise the data according to how osteoarthritis was conceptualised and how this changed throughout their interactions with CMT. Firstly, was an identification of pain beliefs to be challenged and recognition of how current beliefs can misalign with daily experiences. Secondly was a process of challenging and changing beliefs, validated through new experiences. Finally, there was an embedding of changed beliefs into self-management to continue with activities. Conclusion:This study identified a range of psychological changes which occur during exposure to CMT. These changes enabled patients to reconceptualise their condition, develop a new understanding of their body, understand psychological processes, and make sense of their knee pain.

A review of mammographic positioning image quality criteria for the craniocaudal projection

“…11,12,57,58,71,78 Differences in the criteria suggest varying image quality outcomes with the potential for cancer detection performance to be questioned. The call for a uniform and validated system prevails, 10,11,13,57 as this would support those in the education and practice of mammography. 42,79 Regardless of any such future considerations, the impetus for this review has been to determine optimum positioning for the CC projection with renewed attention required to establish which of the three identified criteria might have merit to successfully confirm inclusion of posterior breast tissue.…”

“…One of the most reported is a system where images are ranked as perfect, good, moderate or inadequate (PGMI). 9,10 Whilst there had appeared to be greater conformity for the mediolateral oblique (MLO) criteria reported, 11,12 a recent study by Taylor et al 13 has proposed a new scoring system of perfect, good, adequate or inadequate with new positioning quantitative metrics added for the MLO view. In the meantime, ambiguity and differences in description and expectations from specific criteria for the craniocaudal (CC) view continue.…”