Biomedical subjects

Connie Nakano

Publications and source records attributed to Connie Nakano.

3 recordsLinked to original sources

PubMed2005

Current realities of delivering mammography services in the community: do challenges with staffing and scheduling exist?

PURPOSE: To evaluate the current (2001-2002) capacity of community-based mammography facilities to deliver screening and diagnostic services in the United States. MATERIALS AND METHODS: Institutional review board approvals and patient consent were obtained. A mailed survey was sent to 53 eligible mammography facilities in three states (Washington, New Hampshire, and Colorado). Survey questions assessed equipment and staffing availability, as well as appointment waiting times for screening and diagnostic mammography services. Criterion-related content and construct validity were obtained first by means of a national advisory committee of academic, scientific, and clinical colleagues in mammography that reviewed literature on existing surveys and second by pilot testing a series of draft surveys among community mammography facilities not inclusive of the study facilities. The final survey results were independently double entered into a relational database with programmed data checks. The data were sent encrypted by means of file transfer protocol to a central analytical center at Group Health Cooperative. A two-sided P value with alpha = .05 was considered to show statistical significance in all analyses. RESULTS: Forty-five of 53 eligible mammography facilities (85%) returned the survey. Shortages of radiologists relative to the mammographic volume were found in 44% of mammography facilities overall, with shortages of radiologists higher in not-for-profit versus for-profit facilities (60% vs 28% reported). Shortages of Mammography Quality Standards Act-qualified technologists were reported by 20% of facilities, with 46% reporting some level of difficulty in maintaining qualified technologists. Waiting times for diagnostic mammography ranged from less than 1 week to 4 weeks, with 85% performed within 1 week. Waiting times for screening mammography ranged from less than 1 week to 8 weeks, with 59% performed between 1 week and 4 weeks. Waiting times for both diagnostic and screening services were two to three times higher in high-volume compared with low-volume facilities. CONCLUSION: Survey results show shortages of radiologists and certified mammography technologists.

Breast Neoplasms↗

PubMed2005

Community-based mammography practice: services, charges, and interpretation methods.

OBJECTIVE: The purpose of our study was to accurately describe facility characteristics among community-based screening and diagnostic mammography practices in the United States. MATERIALS AND METHODS: A survey was developed and applied to community-based facilities providing screening mammography in three geographically distinct locations in the states of Washington, Colorado, and New Hampshire. The facility survey was conducted between December 2001 and September 2002. Characteristics surveyed included facility type, services offered, charges for screening and diagnostic mammography, information systems, and interpretation methods, including the frequency of double interpretation. RESULTS: Among 45 responding facilities, services offered included screening mammography at all facilities, diagnostic mammography at 34 facilities (76%), breast sonography at 30 (67%), breast MRI at seven (16%), and nuclear medicine breast scanning at seven (16%). Most facilities surveyed were radiology practices in nonhospital settings. Eight facilities (18%) reported performing clinical breast examinations routinely along with screening mammography. Only five screening sites (11%) used computer-aided detection (CAD) and only two (5%) used digital mammography. Nearly two thirds of facilities interpreted screening mammography examinations on-site, whereas 91% of facilities interpreted diagnostic examinations on-site. Only three facilities (7%) interpreted screening examinations on line as they were performed. Approximately half of facilities reported using some type of double interpretation, although the methods of double interpretation and the fraction of cases double-interpreted varied widely across facilities. On average, approximately 15% of screening examinations and 10% of diagnostic examinations were reported as being double-interpreted. CONCLUSION: Comparison of this survey's results with those collected a decade earlier indicates dramatic changes in the practice of mammography, including a clear distinction between screening and diagnostic mammography, batch interpretation of screening mammograms, and improved quality assurance and medical audit tools. Diffusion of new technologies such as CAD and digital mammography was not widespread. The methods of double-interpretation and the fraction of cases double-interpreted varied widely across study sites.

Breast Neoplasms↗

PubMed2003

Asian American and Pacific Islander seafood consumption -- a community-based study in King County, Washington.

This paper describes and quantifies seafood consumption rates, and acquisition and preparation habits of 202 first- and second-generation Asian American and Pacific Islanders (AAPI) from 10 ethnic groups (Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, Laotian, Mien, Samoan, and Vietnamese) in King County, Washington in 1997. Participants were all seafood consumers. Average and median seafood consumption rates were 117.2 and 89 g/day, respectively, based on the average body weight (62 kg) of participants. Shellfish comprised 45.9% and "all finfish" 43.3% of all seafood consumed. Consumption rates varied significantly between ethnic groups with Vietnamese (2.63 g/kg/day) and Japanese (2.18 g/kg/day) having the highest average consumption rates, and Mien (0.58 g/kg/day) and Hmong (0.59 g/kg/day) the lowest. The most frequently consumed finfish and invertebrates were salmon (93% of respondents), tuna (86%), shrimp (98%), crab (96%), and squid (82%). Fish fillets were eaten with the skin 55%, and the head, bones, eggs, and/or other organs 20% of the time. Crabmeat including the hepatopancreas (accumulates lipophilic chemicals such as organochlorine compounds) was consumed 43% of the time. This paper was a product of a Community-University Partnership. Community guidance in study design and data collection was essential for successful participation by the AAPI Community. Data reported here not only will provide risk assessors with AAPI-specific seafood consumption rates but with insights into cultural consumption/acquisition habits that may alter risk assessment assumptions for the AAPI Community.

Asian↗