RESUMO
Research indicates that misperceptions that become part of people's initial mental models about an issue tend to persist and influence their attitudes even after the misperception has been corrected. Recent work on evolving mental models suggests that communication efforts about the ongoing COVID-19 pandemic and its aftermath may be improved by crafting messages that acknowledge biases and misunderstandings about the virus and other infectious diseases that may remain among members of the target audience. This study was designed to provide insight into such biases by: (1) establishing salient categories of COVID-related misperceptions in the earliest months of the pandemic in the United States among (a) the general population, and (b) demographic sub-populations at high risk of severe health outcomes; (2) identifying demographic predictors of misperceptions; and (3) examining the relationship between consumption of different television news outlets and agreement with misperceptions about COVID-19. A national sample of 1,000 adults in the United States (48.1% male; M age = 47.32, SD = 18.01; 72.9% White/Caucasian, 14.3% Black/African American, 15.9% Hispanic/Latinx) completed a survey between March 19 and March 25, 2020. Results identify prevalent classes of salient early COVID-19 misperceptions. Adjusting for numerous covariates, data indicated individuals over the age of 60 held the fewest COVID-related misperceptions among various demographic sub-populations, misperceptions were most prevalent among Black respondents, and increased consumption of television network news was associated with lower levels of misperception. Consumption of some 24-hour news networks (FOX and MSNBC) were significant positive correlates of misperceptions.
Assuntos
COVID-19 , Desinformação , Meios de Comunicação de Massa , Televisão , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , COVID-19/epidemiologia , COVID-19/psicologia , Pandemias , SARS-CoV-2 , Estados Unidos/epidemiologia , IdosoRESUMO
The coronavirus (COVID-19) outbreak poses a substantial threat to public health. Individual efforts to engage in COVID-19 precautionary behaviors are necessary to flatten the pandemic's curve in the waiting period before a vaccine is developed. This study sought to apply the Theory of Motivated Information Management to investigate the relationships among COVID-19 illness uncertainty, information management, and actual precautionary behaviors, both preparatory and preventative. The results of a national opt-in online panel demonstrate that uncertainty discrepancy, anxiety, and information management strategies are key predictors of the adoption of COVID-19 preparation and prevention behaviors. The results further identify diverging associations across age groups with respect to associations between information management and precautionary behaviors. Implications for theory and practice are discussed.
Assuntos
Ansiedade/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Informação de Saúde ao Consumidor/organização & administração , Incerteza , Adaptação Psicológica , Adolescente , Adulto , Fatores Etários , Idoso , COVID-19/psicologia , Informação de Saúde ao Consumidor/normas , Feminino , Humanos , Comportamento de Busca de Informação , Masculino , Saúde Mental , Pessoa de Meia-Idade , Motivação , Pandemias , Medição de Risco , Comportamento de Redução do Risco , SARS-CoV-2 , Fatores Socioeconômicos , Adulto JovemRESUMO
Since its 1975 release, One Flew Over the Cuckoo's Nest (dir. Milos Forman) has maintained an intertextual relationship with the psychiatric discipline, serving as an icon of anti-authoritarianism and a barometer of the state of the field. The film's popularity in the 1970s drew on a context of youth protest on one hand and anti-psychiatry mobilization on the other, both of which it also spurred. Yet how might One Flew read in a different historical moment? Here, in dialogue with my students' reactions and analysis, I argue that the aftermath of dehospitalization and contemporary gender and racial politics have rendered One Flew a more ambivalent cultural artifact. Changing responses to the film in turn reflect the ways in which we draw on the discipline's past in confronting our psychiatric present.
Assuntos
Hospitais Psiquiátricos , Transtornos Mentais , Filmes Cinematográficos , Política , Autoritarismo , Humanos , Medicina na Literatura , Memória , PsiquiatriaRESUMO
INTRODUCTION Objective clinical assessments should include patientreported outcome measures. VascuQol is an established diseasespecific questionnaire assessing the quality of life in patients with peripheral artery disease (PAD). Qualityoflife questionnaires require geographical localization and validation. OBJECTIVES The goal of this study was to validate the Polish version of the VascuQol: a patientreported healthrelated qualityoflife (HRQoL) instrument specific for PAD. PATIENTS AND METHODS The linguistic validation of VascuQol followed Mapi Institute methodology. Clinical validation process compared VascuQol, EQ5D3L, and SF36 questionnaires in 100 patients with both intermittent claudication and critical limbthreatening ischemia. Cronbach α coefficients for reliability, receiver operating characteristic curves for clinical discriminative performance, standardized response means for responsiveness, and Pearson correlations for construct validity were evaluated. Additionally, in a separate cohort of 58 patients with stable disease, the testretest was characterized with intraclass correlation, BlandAltman analysis, and Pearson correlation coefficients. RESULTS VascuQol proved to perform better than SF36 and EQ5D3L. Cronbach α coefficients showed good internal consistency (α values >0.9 for all summary scores). All testretest Pearson r values for VascuQol were above 0.70. The intraclass correlation of absolute agreement consistency exceeded 0.8. The BlandAltman 95% limits of agreement were between 2.72 and 4.87. There were strong and moderate correlations for total scores in all domains between VascuQol and SF36, and for most of the domains between VascuQol and EQ5D3L. CONCLUSIONS The Polish version of VascuQol is a sensitive, accurate, and reliable tool for assessing HRQoL in patients with PAD.
Assuntos
Claudicação Intermitente/psicologia , Doença Arterial Periférica/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de DoençaRESUMO
This article traces the history of Cuba's first and only Spiritist mental clinic, founded in the 1940s in the central province of Camagüey and shut down by the revolutionary government in the 1960s. It analyzes the history of the clinic with respect to the virtual absence of institutional psychiatric care outside of Havana in these decades, but also in the context of a more enduring problematic: the persistent preference shown by Cubans for religiously grounded forms of mental healing. Namely, "In the Shadow of the Double" explores the broader geography of mental care within which Spiritists defined the uniqueness of their healing practice, vis-à-vis both institutional psychiatry, to which they theorized a relationship of strategic complementarity, and other forms of religiously grounded healing, which they disparaged as "backwards" and even dangerous. It is precisely this liminal status within the psychotherapeutic marketplace, I argue, that made their healing practice uniquely appealing to some, but also vulnerable to revolutionary atheism and public health extension after 1959. (PsycINFO Database Record
Assuntos
Psiquiatria/história , Espiritualismo/história , Cuba , História do Século XXRESUMO
El nacimiento de la psiquiatría infantil en Cuba en los años 1920 refleja el desarrollo de la psiquiatría como una disciplina con importancia social. La extensión de la pericia psiquiátrica se entrelazó con la figura del "niño problema", quien se concibió como una metáfora para un estado soberano en desarrollo. Pero los reformadores sociales del momento frecuentemente tropezaron con el problema de la corrupción política en sus esfuerzos de rehabilitar a los niños enfermos y delincuentes. Al final, los psiquiatras y activistas que habían concebido al niño problema como un laboratorio poderoso para la regeneración política invertirían la dirección de su lógica causativa: fue el mismo estado que se tendría que rehabilitar para lograr sus metas médicas y sociales (AU)
The emergence of child psychiatry in 1920s Cuba mirrored the ascent of psychiatry as a discipline imbued with broader social relevance. The extension of psychiatric expertise was centrally concerned with the figure of the "problem child", posited as a synecdoche for a maturing sovereign state. As reformers set out to rehabilitate mentally ill and "delinquent" children, however, they frequently found themselves running up against the problem of political corruption as it impacted the institutions in which they sought to intervene. Ultimately, psychiatrists and social crusaders who had identified the problem child as a potent site for political regeneration were forced to reverse the causal direction of their reformist logic: it was the state itself that would have to be rehabilitated in order to achieve their medical and social goals (AU)
Assuntos
Humanos , Criança , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos Mentais/história , Hospitais Psiquiátricos/história , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/história , Cuba/epidemiologia , Delinquência Juvenil/história , Saúde Mental/históriaRESUMO
This article traces the battle over Freud within Cuban psychiatry from its pre-1959 origins through the "disappearance" of Freud by the early 1970s. It devotes particular attention to the visit of two Soviet psychiatrists to Cuba in the early 1960s as part of a broader campaign to promote Pavlov. The decade-long controversy over Freud responded to both theoretical and political concerns. If for some Freud represented political conservatism and theoretical mystification, Pavlov held out the promise of a dialectical materialist future. Meanwhile, other psychiatrists clung to psychodynamic perspectives, or at least the possibility of heterogeneity. The Freudians would end up on the losing side of this battle, with many departing Cuba over the course of the 1960s. But banishing Freud did not necessarily make for stalwart Pavlovians-or vanguard revolutionaries. Psychiatry would find itself relegated to a handmaiden position in the work of revolutionary mental engineering, with the government itself occupying the vanguard.
Assuntos
Comunismo , Psiquiatria/história , Cuba , História do Século XX , Psiquiatria/métodos , Psiquiatria/organização & administraçãoRESUMO
This article traces the battle over Freud within Cuban psychiatry from its pre-1959 origins through the disappearance of Freud by the early 1970s. It devotes particular attention to the visit of two Soviet psychiatrists to Cuba in the early 1960s as part of a broader campaign to promote Pavlov. The decade-long controversy over Freud responded to both theoretical and political concerns. If for some Freud represented political conservatism and theoretical mystification, Pavlov held out the promise of a dialectical materialist future. Meanwhile, other psychiatrists clung to psychodynamic perspectives, or at least the possibility of heterogeneity. The Freudians would end up on the losing side of this battle, with many departing Cuba over the course of the 1960s. But banishing Freud did not necessarily make for stalwart Pavloviansor vanguard revolutionaries. Psychiatry would find itself relegated to a handmaiden position in the work of revolutionary mental engineering, with the government itself occupying the vanguard.(AU)
Assuntos
História da Medicina , Psiquiatria/história , Filosofia , CubaRESUMO
BACKGROUND: From December 2013 through May 2014, physicians, dermatopathologists, and public health authorities collaborated to characterize an outbreak of Mycobacterium marinum and other nontuberculous mycobacterial skin and soft tissue infections (SSTIs) associated with handling fish in New York City's Chinatown. Clinicopathologic and laboratory investigations were performed on a series of patients. METHODS: Medical records were reviewed for 29 patients. Culture results were available for 27 patients and 24 biopsy specimens were evaluated by histopathology, immunohistochemistry (IHC) staining for acid-fast bacilli (AFB), and mycobacterial polymerase chain reaction (PCR) assays. RESULTS: All patients received antibiotics. The most commonly prescribed antibiotic regimen was clarithromycin and ethambutol. Of the 29 patients in this case series, 16 (55%) received surgical treatment involving incision and drainage, mass excision, and synovectomy. Of these, 7 (44%) had deep tissue involvement. All patients showed improvement. For those with culture results, 11 of 27 (41%) were positive for M. marinum; the remainder showed no growth. Poorly formed granulomas (96%), neutrophils (75%), and necrosis (79%) were found in 24 biopsies. Of 15 cases that were culture-negative and analyzed by other methods, 9 were PCR positive for M. marinum group species, 8 were IHC positive, and 3 were positive by AFB stains. CONCLUSIONS: A multidisciplinary approach was used to identify cases in an outbreak of M. marinum infections. The use of histopathology, culture, and IHC plus PCR from full thickness skin biopsy can lead to improved diagnosis of M. marinum SSTIs compared to relying solely on mycobacterial culture, the current gold standard.
Assuntos
Surtos de Doenças , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Dermatopatias Bacterianas/epidemiologia , Infecções dos Tecidos Moles/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Braço , Terapia Combinada , Feminino , Pesqueiros , Mãos , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/patologia , Infecções por Mycobacterium não Tuberculosas/terapia , Cidade de Nova Iorque/epidemiologia , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/patologia , Dermatopatias Bacterianas/terapia , Infecções dos Tecidos Moles/diagnóstico , Infecções dos Tecidos Moles/patologia , Infecções dos Tecidos Moles/terapiaRESUMO
BACKGROUND: Solitary epidermolytic acanthoma is thought to be an uncommon lesion. It can present as a solitary, localized or disseminated process that is unrelated to the genetic form of icthyosis. METHODS: A retrospective review of solitary epidermolytic acanthomas was performed at the Ackerman Academy of Dermatopathology, NY, over a 2 year period. The clinical and histopathological features of solitary epidermolytic acanthomas were described in 64 biopsies from 60 individuals. In situ hybridization for human papillomavirus (HPV) was performed on all genital lesions. RESULTS: The incidence of epidermolytic acanthomas in our series was higher than previously reported (27.8/100,000). Genital location was the most common and the incidence of genital lesions was 8/100,000. In situ hybridization showed no evidence of genital HPV types within the lesions. The histological features of solitary epidermolytic acanthoma were re-evaluated. CONCLUSIONS: Genital skin was the most common location for solitary epidermolytic acanthoma, but we found no evidence to suggest a role for genital HPV types. A strong male predominance was noted, and the lesions demonstrate a wide range of clinical and pathological findings.
Assuntos
Acantoma/patologia , Neoplasias dos Genitais Femininos/patologia , Neoplasias dos Genitais Masculinos/patologia , Papillomaviridae , Infecções por Papillomavirus/patologia , Neoplasias Cutâneas/patologia , Acantoma/epidemiologia , Acantoma/virologia , Adulto , Idoso , Feminino , Neoplasias dos Genitais Femininos/epidemiologia , Neoplasias dos Genitais Femininos/virologia , Neoplasias dos Genitais Masculinos/epidemiologia , Neoplasias dos Genitais Masculinos/virologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Estudos Retrospectivos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/virologiaRESUMO
Elastic fibers are important components of the skin and are responsible for skin elasticity. Genetic defects are well-known in numerous hereditary elastic tissue disorders and skin biopsies are often the first step in the evaluation of those disorders. Verhoeff-Van Gieson elastic staining is a simple method that is used for visualizing elastic fibers. With the development of modern immunohistochemical methods, the value of routine histochemical staining is sometimes underestimated. Histochemical stains are less expensive, easy to perform and help to resolve numerous diagnostic quandaries in dermatopathology. This article focuses on the value of elastic tissue staining in dermatopathology, with a focus on primary elastic tissue disorders, alopecia, inflammatory skin disorders and neoplastic proliferations.
Assuntos
Dermatologia/métodos , Tecido Elástico/patologia , Patologia Clínica/métodos , Dermatopatias/diagnóstico , Coloração e Rotulagem/métodos , Humanos , Imuno-Histoquímica/métodosRESUMO
BACKGROUND: Closure with dermal sutures is time consuming, may increase the risks of inflammation and infection secondary to foreign body reaction, exposes the surgeon to possible needlestick injuries, and has variable cosmetic outcomes depending on each surgeon's technique. The absorbable INSORB dermal stapler is hypothesized to be faster and more cost effective than sutures for dermal layer closures and provides a safer and more consistent result. METHODS: This is a prospective, randomized, controlled study. Patients undergoing bilateral breast reconstruction with tissue expanders had one incision randomized to dermal closure with absorbable dermal staples. The contralateral side was closed with dermal sutures. During the expansion period, wounds were assessed by a blinded plastic surgeon using the 13-point Vancouver Scar Scale. At the time of implant exchange, both scars were excised and examined for histologic signs of inflammation. RESULTS: Eleven patients (22 incisions) were enrolled in the study. The dermal stapler was four times faster than standard suture closure, reducing closure time by 10.5 minutes (p Assuntos
Procedimentos Cirúrgicos Dermatológicos
, Técnicas de Sutura/economia
, Técnicas de Sutura/instrumentação
, Suturas/economia
, Implantes Absorvíveis
, Análise Custo-Benefício
, Desenho de Equipamento
, Humanos
, Estudos Prospectivos
, Método Simples-Cego
, Grampeadores Cirúrgicos
RESUMO
Primary effusion lymphoma (PEL) is a rare type of B-cell non-Hodgkin lymphoma (NHL), which predominantly occurs in HIV-infected individuals, and is pathogenetically linked with Kaposi sarcoma (KS)-associated herpes virus/human herpes virus-8 (KSHV/HHV-8) infection with or without evidence of Epstein-Barr virus (EBV) co-infection. Although uncommon, PELs have been reported in immunocompetent patients and recipients of solid organ allografts. Rare cases of KSHV(-) EBV(+) post-transplant effusion lymphomas resembling PEL have also been described, as have KSHV(-) EBV(-) effusion lymphomas, the latter including those arising in individuals with chronic liver disease. We report a unique KSHV(-) EBV(-) post-transplant effusion lymphoma associated with serum paraproteins, occurring in an HIV(-) individual, which had cytologic features and phenotype similar to PEL, and displayed a complex karyotype including isochromosome 12p and translocation t(8;22), resulting in rearrangement of c-MYC.