RESUMEN
Fine-needle aspiration (FNA) is a safe, cost-effective diagnostic procedure used in the evaluation of thyroid nodules. The number of thyroid FNAs has dramatically increased over the past few years. In the absence of standardized procedures regarding the number of needle passes needed for diagnosis and the lack of clarity on the use of conventional smears (CS) versus liquid-based preparations (LBP), the demand of thyroid FNAs has led to increased workload on cytology laboratories, which can negatively affect patient safety. We implemented a standardized two needle passes for CS and collection of all needle rinses and additional pass material in CytoRich Red for ThinPrep LBP and compared the non-diagnostic and diagnostic rates before and after this intervention. There were 290 pre-intervention cases and 348 post-intervention cases; of which, there were 17 (5.9%) non-diagnostic cases of the pre-intervention group and 27 (7.8) non-diagnostic cases of the post-intervention group. There was no statistically significant difference in non-diagnostic and diagnostic rates before and after the change (p = 0.347 by two-tailed Z test).
Asunto(s)
Glándula Tiroides , Nódulo Tiroideo , Humanos , Biopsia con Aguja Fina/métodos , Nódulo Tiroideo/patología , Nódulo Tiroideo/diagnóstico , Glándula Tiroides/patología , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/diagnósticoRESUMEN
Nonaccidental head injuries are significant causes of morbidity and mortality among young children. Despite broad agreement among medical experts, controversies remain over diagnostic criteria, including from autopsies, because of opinions expressed by a small group of expert witnesses who testify for defendants in suspected child homicide cases. We reviewed 249 autopsies in children 2 years old and younger from the files of our Medical Examiner office in the University of Missouri School of Medicine done between January 1, 2008 and December, 31, 2016. Because of gradually instituted mandatory examination of spinal cords and retinas, we had 127 autopsies with brain examinations by a neuropathologist plus retinal examinations of which 67 also had spinal cord examinations. Results were correlated with clinical records, police and EMS reports, and imaging. We found that subdural hematomas, cerebral edema, and retinal hemorrhages were mostly limited to autopsy findings in children who suffered from fatal head trauma, whether accidental (3 cases) or inflicted (14); they were not encountered in cases of homicide by other mechanisms or from natural diseases including infections, brain tumors, SIDS/SUID, or SUDC. Two cases with no other evidence of head trauma had focal retinal hemorrhages. We advocate for examination of retinas and spinal cords in all autopsies of children in this age group.
Asunto(s)
Maltrato a los Niños , Traumatismos Craneocerebrales , Enfermedades del Sistema Nervioso , Niño , Humanos , Lactante , Preescolar , Neuropatología , Hemorragia Retiniana , Missouri/epidemiología , Autopsia , Traumatismos Craneocerebrales/patología , Maltrato a los Niños/diagnósticoRESUMEN
Recent research suggests that individuals play an active role in their own personality development. Here, we investigated lay conceptions of this volitional personality change process. In Study 1, participants (N = 602) provided open-ended descriptions of their desired personality changes as well as the strategies they were using to achieve these changes. In Study 2, participants (N = 578) completed these same measures and provided narrative descriptions of the emergence of their desires for (and previous) personality changes. Desired changes were quantified in a manner consistent with the Five-Factor Model (though desires pertinent to Openness to Experience were rare), whereas reported strategies were distinguished on the basis of cognitive and behavioral content. Desires to increase in Extraversion corresponded negatively with the use of cognitive strategies and positively with the use of behavioral strategies, whereas desires to increase in Agreeableness exhibited the opposite pattern. Finally, desires for change were typically construed as stimulated by specific events, whereas previous personality changes were attributed to shifts in social roles. Laypersons hold a diverse range of desired changes and strategies. In addition, different categories of events are recognized as catalysts of desires for (and previous) changes.
Asunto(s)
Desarrollo de la Personalidad , Personalidad , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Autoimagen , Adulto JovenRESUMEN
We examined the prevalence and correlates of satisfaction with appearance and weight. Participants (N=12,176) completed an online survey posted on the NBCNews.com and Today.com websites. Few men and women were very to extremely dissatisfied with their physical appearances (6%; 9%), but feeling very to extremely dissatisfied with weight was more common (15%; 20%). Only about one-fourth of men and women felt very to extremely satisfied with their appearances (28%; 26%) and weights (24%; 20%). Men and women with higher body masses reported higher appearance and weight dissatisfaction. Dissatisfied people had higher Neuroticism, more preoccupied and fearful attachment styles, and spent more hours watching television. In contrast, satisfied people had higher Openness, Conscientious, and Extraversion, were more secure in attachment style, and had higher self-esteem and life satisfaction. These findings highlight the high prevalence of body dissatisfaction and the factors linked to dissatisfaction among U.S. adults.
Asunto(s)
Imagen Corporal/psicología , Peso Corporal , Carácter , Apego a Objetos , Satisfacción Personal , Apariencia Física , Autoimagen , Televisión , Adolescente , Adulto , Anciano , Índice de Masa Corporal , Femenino , Identidad de Género , Humanos , Masculino , Persona de Mediana Edad , Estadística como Asunto , Adulto JovenRESUMEN
BACKGROUND: The Situational Construal Model proposes that characteristics of persons and situations interact to influence construal of situations and resultant behavior. We apply this framework to the study of healthcare experiences in two studies. METHODS: In Study 1, mTurk users (N = 670) read vignettes of positive, neutral, or negative healthcare experiences, described their construal of the vignette, and completed individual difference measures. In Study 2, mTurk users (N = 292) recalled a recent healthcare visit and reported individual differences, visit characteristics, and outcomes following the visit. RESULTS: Across both studies, personality was related to the valenced construal of healthcare experiences. In Study 2, patient and visit characteristics predicted situational construal and self-reported visit outcomes, and situational construal statistically mediated relationships between patient and visit characteristics and outcomes. CONCLUSIONS: The current work supports the application of the Situational Construal Model to healthcare situations and demonstrates the importance of both person and situation variables for understanding key healthcare outcomes.
Asunto(s)
Atención a la Salud , Modelos Psicológicos , Personalidad , Relaciones Médico-Paciente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del PacienteRESUMEN
The present work demonstrates a method for constructing theoretically based situational classifications and exploring their behavioral implications. Fundamental motives theory (FMT; Kenrick, Griskevicius, Neuberg, & Schaller, 2010; Kenrick, Neuberg, Griskevicius, Becker, & Schaller, 2010) proposes that humans have evolved seven specific social motives that would be differentially evoked by different situations. Experts in FMT used the Riverside Situational Q-sort (RSQ) to describe prototypic motive-relevant situations and the Riverside Behavioral Q-sort (RBQ) to construct templates representing predictions of how people would behave in them. A sample of 201 undergraduate participants used the RSQ to describe situations they had experienced within the past 24 hours, and they described their behavior in each situation using the RBQ. For both the RSQ and RBQ, self-protection and disease avoidance templates were highly similar to each other and different from mate-seeking and affiliation templates. Participants more often reported experiencing situations similar to the mate-seeking, affiliation, and kin care templates and less often reported experiencing situations similar to the self-protection and disease avoidance templates. Participants' reported behavior was consistent with expectations from FMT. This study illustrates how relations between situations and behavior can be illuminated through the use of theoretically derived templates.
Asunto(s)
Motivación , Conducta Social , Medio Social , Clasificación , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
Cyclic strain has been shown to benefit tendon health. However, repetitive loading has also been implicated in the etiology of tendon overuse injuries. Recent studies demonstrated that in several cell lines cyclic strain was associated with an activation of stress-activated protein kinases (SAPKs). These SAPKs, in turn, were shown to be important upstream regulators of a variety of cell processes including apoptosis. To examine the effect of repetitive loading on SAPK activation in tendon cells in vitro, canine patellar tendon cells were cyclically strained, and the cellular stress response evaluated by measuring c-Jun N-terminal kinase (JNK) activation. The effects of strain frequency and strain magnitude as well as the role of calcium signaling in this mechanotransduction mechanism were also examined. Cyclic strain resulted in an immediate activation of JNK, which peaked at 30 min and returned to resting levels by 2 h. This activation was regulated by a magnitude-dependent but not frequency-dependent response and appeared to be mediated through a calcium-dependent mechanotransduction pathway. While transient JNK activation is associated with normal cell processes. persistent JNK activation has been linked to the initiation of the apoptotic cascade. A similar mechanism could be responsible for initiating the pathological events (localized cell death) seen in tendon overuse injury.
Asunto(s)
Señalización del Calcio , Ácido Egtácico/análogos & derivados , Fibroblastos/enzimología , Proteínas Quinasas Activadas por Mitógenos/biosíntesis , Tendones/enzimología , Animales , Western Blotting , Calcimicina/farmacología , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Citosol/metabolismo , Perros , Ácido Egtácico/farmacología , Fibroblastos/efectos de los fármacos , Fibroblastos/fisiología , Metabolismo/efectos de los fármacos , Proteína Quinasa 8 Activada por Mitógenos , Rótula , Estrés Mecánico , Tendones/efectos de los fármacos , Tendones/fisiología , Soporte de Peso , Proteínas Quinasas p38 Activadas por MitógenosRESUMEN
Imaging technologies such as cine-radiography, cine-MRI, and X-ray stereo photogrammetry have become popular diagnostic tools in biomechanical studies of musculoskeletal systems. However, their widespread use for research purposes has been restricted due to their high cost and somewhat limited availability. In an attempt to develop a reliable low cost system, a dual-fluoroscopic system capable of tracking the 3-D spatial motion of discrete landmark points in real time was developed. A simple methodology was developed to convert the analog fluoroscopic images to digital files for post-processing. A custom computer code based on the principles of X-ray stereo photogrammetry was also developed to predict 3-D coordinates from the 2-D images from the individual flouroscopes. The goal of the current study was to assess the accuracy and resolution of this system by using it to predict the motion of a test point following a known curvilinear trajectory. Our system predicted the time-varying motion and path of the test point within 0.25%. However, the current system is limited to studying low speed events only (max event frequency of 3Hz) due to the limited sampling frequency of the A/D conversion employed here.