| 1. |
- Marto, João Pedro, et al.
(författare)
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Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19: The Global COVID-19 Stroke Registry.
- 2023
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Ingår i: Neurology. - 1526-632X. ; 100:7
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Tidskriftsartikel (refereegranskat)abstract
- COVID-19-related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19.This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection. With a doubly robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT).Of a total of 15,128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19; of those, 5,848 (38.7%) patients received IVT-only and 9,280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted OR 1.53; 95% CI 1.16-2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20-2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23-1.99), 24-hour mortality (OR 2.47; 95% CI 1.58-3.86), and 3-month mortality (OR 1.88; 95% CI 1.52-2.33). Patients with COVID-19 also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26-1.60).Patients with AIS and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non-COVID-19 patients receiving treatment. Current available data do not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in patients with COVID-19 or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring, and establishing prognosis.The study was registered under ClinicalTrials.gov identifier NCT04895462.
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| 2. |
- Carvalho, Sérgio A., et al.
(författare)
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Self-as-context and depressive symptoms in the general population : A further analysis of the self experiences questionnaire
- 2022
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Ingår i: Current Psychology. - : Springer. - 1046-1310 .- 1936-4733. ; 41:12, s. 8897-8907
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Tidskriftsartikel (refereegranskat)abstract
- The current study aims to contribute to the psychometric validation of the Self Experiences Questionnaire (SEQ), a measure of self-as-context as conceptualized by Acceptance and Commitment Therapy, and to contribute to a better understanding of the relationship between self-as-context, other psychological flexibility processes, and depressive symptoms. The sample (N = 266; 72.6% women) was obtained through paper-pencil and online collection methods in the general Portuguese population. Confirmatory factor analysis, reliability analyses, and convergent and divergent analyses were conducted. A mediation analysis of the effects of self-as-distinction and self-as-observer on depression symptoms through openness to experience, behavioral awareness, and valued action (while controlling for brooding) was performed using PROCESS. Items 8, 12 and 15 were removed to achieve the best model fit, which resulted in a 12-item final version of the SEQ. This version appears to be a psychometrically valid two-dimensional measure of self-as-distinction and self-as-observer, as well as a one global measure of self-as-context. Results from mediation analyses suggested that the relationship of self-as-observer and self-as-distinction with depressive symptoms is mediated by the ability to be behaviorally aware and to act according to personal values, but not by the ability to be open to experience. The behaviorally-oriented aspects of psychological flexibility seem to have particular importance on the presentation of depressive symptoms. More studies are nonetheless needed to analyze SEQ's structure and validity in order to attain a consensual version of the questionnaire.
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| 3. |
- Coutinho, Mariana, et al.
(författare)
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Experiential avoidance, committed action and quality of life : Differences between college students with and without chronic illness
- 2021
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Ingår i: Journal of Health Psychology. - : Sage Publications. - 1359-1053 .- 1461-7277. ; 26:7, s. 1035-1045
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to explore, through structural equation modelling, experiential avoidance and committed action's effects on the association between anxiety and psychological quality of life and whether this relationship presents significant differences across a sample of 115 college students with chronic illness and a sample of 232 students without illness. Students with chronic illness presented higher levels of anxiety and experiential avoidance and lower levels of quality of life. The association between anxiety and psychological quality of life was partially explained by experiential avoidance and committed action. This path model was shown to be invariant between the two groups of students.
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| 4. |
- Irion, Kristina, et al.
(författare)
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The independence of media regulatory authorities in Europe
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This IRIS Special focuses on the independence of regulatory authorities and bodies in the broadcasting and audiovisual media sector in Europe. These entities have proliferated according to the different legal traditions of the respective countries they belong to. They do not, therefore, conform one, single model. Nonetheless, they reflect a common approach of sorts with regard to the institutional set-up of regulatory governance. The independence of these entities is particularly important because it contributes to the broader objective of media independence, which is in itself an essential component of democracy.The creation, status and functioning of these regulatory authorities and bodies were shaped pursuant to the constitutional requirements and/or administrative practices of the countries that established them. As a result, each has distinct characteristics and levels of independence that differ according to where they are located. But when is an authority to be considered independent? The measurement of an entity's independence requires careful analysis of the legal texts setting it up, but also of the practices that are rooted in reality and reflect the sensitivities of the societies in question.This IRIS Special aims to enlighten the reader on the definition of the independence of a regulatory authority or body, on the criteria used to assess its independence, and on the legal framework embodying this independence at the European level, as well as provide analysis of the status and functioning of regulatory authorities and bodies in a selection of nine European countries: Bosnia and Herzegovina, Spain, Hungary, Ireland, Italy, the Netherlands, Poland, Sweden, and Slovenia. This sample reflects the different levels of independence that can be found across Europe. © European Audiovisual Observatory (Council of Europe), Strasbourg, September 2019
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| 5. |
- Nguyen, Thanh N, et al.
(författare)
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Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: A 1-Year Follow-up.
- 2023
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Ingår i: Neurology. - 1526-632X. ; 100:4
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Tidskriftsartikel (refereegranskat)abstract
- Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020).We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases.There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1-6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1-4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4-5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6-0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31-1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82-2.97], 5,656/195,539) of all stroke hospitalizations.There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year.This study is registered under NCT04934020.
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| 6. |
- Trindade, Inês A., 1990-, et al.
(författare)
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The impact of illness-related shame on psychological health and social relationships : Testing a mediational model in students with chronic illness
- 2018
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 25:3, s. 408-414
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the impact of illness-related shame on the quality of social relationships and psychological health in chronic patients. We aimed to examine the roles of fear of receiving compassion from others and experiential avoidance as potential mediators of this relationship. Although some studies have demonstrated the negative impact of chronic illness-related shame on psychological functioning, the mechanisms that may underlie this link remain understudied. The sample was comprised by 115 college students, which had been diagnosed with at least 1 chronic illness. Participants completed self-report measures on an online platform. This study's design was cross-sectional. A path analysis was conducted using structural equation modelling. Results showed that the impact of illness-related shame on both psychological health (R-2=.45) and the quality of social relationships (R-2=.33) was fully accounted by fear of compassion from others and experiential avoidance. This model revealed an excellent fit. Fear of receiving compassion from others was the main mediator of the illness-related shame link with the quality of social relationships (=-.22). The main mediator of the association between shame-related chronic illness and psychological health was experiential avoidance (=-.21).This study shed light on possible psychological mechanisms linking feelings of shame associated with having a chronic condition and impaired social relationships and mental health. On one hand, resisting feelings of compassion and care from others and, on the other hand, avoiding difficult internal experiences and situations that might trigger them seem to underlie the impact of shame on psychological and social functioning in chronic patients.
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| 7. |
- Van De Munckhof, Anita, et al.
(författare)
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Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase
- 2022
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Ingår i: Stroke. - : American Heart Association. - 0039-2499 .- 1524-4628. ; 53:10, s. 3206-3210
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization.Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0-2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization).Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94-194). Two patients died during follow-up (3% [95% CI, 1%-11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%-94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed).Conclusions: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up.
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