Efficacy and safety outcomes for acute ischemic stroke patients treated with intravenous infusion of tirofiban after emergent carotid artery stenting

Introduction Emergent stenting of the extracranial internal carotid artery (ICA) in stroke patients requires antiplatelet therapy to prevent in-stent thrombosis with a higher risk of intracranial haemorrhage. Aim of the Study Assess the efficacy and safety of emergent carotid stenting with intravenous tirofiban in acute ischemic stroke patients. Methods Primary endpoint: symptomatic hemorrhage. Secondary endpoints: 90-day functional outcome and mortality. Results Of the 62 patients, 21 (34%) received tirofiban as a single antiplatelet, and 41 (66%) received combined therapy. Premedication with anticoagulants and antiplatelets was significantly more frequent in the tirofiban-only group. The rate of symptomatic haemorrhage was significantly lower in the tirofiban-only group than in the combined group (4.8% vs. 27%, p = 0.046). The patients with tirofiban alone had a significantly better functional outcome at day 90 than the combined group (52% vs. 24%, p = 0.028). Mortality was equal (24%) in both groups. Pre-interventional NIHSS score (p = 0.003), significant blood pressure fluctuations (p = 0.012), tandem occlusion (p = 0.023), and thrombolysis (p = 0.044) showed relevant influence on the rate of symptomatic hemorrhage in the entire patient cohort. Conclusions A single antiplatelet therapy with tirofiban regardless of the premedication may improve the functional outcome in patients with stroke due to acute extracranial carotid lesion and emergent carotid stenting with lower rates of serious intracranial haemorrhage. For patients with high pre-interventional NIHSS score, tandem occlusion and after pre-interventional thrombolysis, caution is advised. Additionally, strict blood pressure monitoring should be conducted during the first 72 h after intervention

Discrepancies Between Explicit Feelings of Power and Implicit Power Motives Are Related to Anxiety in Women With Anorexia Nervosa

Background: Several studies identified low subjective feelings of power in women with anorexia nervosa (AN). However, little is known about implicit power motives and the discrepancy between explicit feelings of power and implicit power motives in AN. Aim: The study investigated the discrepancy between explicit feelings of power and implicit power motives and its relationship to anxiety in patients with AN. Method: Fifty-three outpatients and inpatients with AN and 48 participants without AN were compared regarding subjective feelings of power and anxiety. Explicit power [investigated with the Personal Sense of Power Scale (trait focus) and a visual analog scale (state focus)], implicit power motives [investigated with the Multi-Motive Grid (MMG)] and trait anxiety [measured with the State-Trait Anxiety Inventory (STAI)], were assessed. Results: Explicit feelings of power (state and trait level) were lower in patients with AN compared to non-AN participants. No differences in implicit power motives were found when comparing the groups against each other. However, looking at the groups separately, women with AN had similar levels of implicit fear of losing power and hope for power, whereas woman without AN had significantly lower fear of losing power than hope for power. Focusing on discrepancies between powerful feelings and power motives, results were mixed, depending on the subscale of the MMG. Lastly, discrepancies between implicit power motives and explicit feelings of power were positively correlated with trait anxiety in AN patients. Conclusion: These findings underline that individuals with AN display significantly lower explicit feelings of power, however, they show similar implicit power motives compared to individuals without AN. The discrepancy between explicit feelings of power and implicit power motives is related to anxiety in AN and may represent a vulnerability factor to illness maintenance

Bulletin der deutschen Slavistik 24.2018

Jahrbuch der Deutschen Slavistik mit Forumsbeiträgen zu Digital Humanities, Rubriken zu Personen, Publikationen, Preisen, Wirkungsorten, wissenschaftlichen Abhandlungen

Was ist SBT? Und was war SKT? „3rd wave“-Therapie bzw. kognitiv-behaviorale Therapie (CBT)der dritten Generation

Seit fünfzehn Jahren nutzen Psychotherapeuten im deutschsprachigen Raum das strategische Psychotherapiekonzept der Strategischen Kurzzeittherapie (SKT) als eine willkommene Horizonterweiterung für Verhaltenstherapeuten, wie sie auch Kanfer mit seinem Selbstregulationsmodell und Grawe mit seinem Entwurf einer Psychologischen Therapie ermöglichten. In diesen Jahren kam es parallel zur Veröffentlichung neuer behavioraler Therapieansätze, die sich über die Kognitive Therapie hinaus weiterentwickelt hatten (Linehan, Hayes, Jacobson, Kohlenberg und neuerdings auch Young, Wells und McCullough). Klinische Erfahrung und Studien zeigten, dass der Modus der Kurzzeittherapie für viele Patienten nicht ausreichte, weshalb es jetzt zu einer Umbenennung von Strategischer Kurzzeittherapie (SKT) in Strategisch-Behaviorale Therapie (SBT) gekommen ist. SBT weist eine sehr große Verwandtschaft mit den als 3rd wave bekannt gewordenen neueren Therapieansätzen auf (Akzeptanz und Achtsamkeit, Metakognition, Emotionsregulation, Beziehungsoptimierung, Entwicklung), wobei ihr funktionaler = strategischer Schwerpunkt sie fest in der Verhaltenstherapie verwurzelt und als stringente Therapie von Achse-I-Störungen ausweist

Improving interoceptive ability through the practice of power posing: A pilot study.

Interoception refers to the detection and perception of signals from the inner body. Deficits in this domain have been linked to psychopathologies, prompting the search for strategies to improve this ability. Preliminary studies have shown that interoception could be enhanced through the manipulation of subjective feelings of power. We tested the effects of adopting powerful postures on different facets of interoception. Firstly, we measured the impact of a single power posing session on interoceptive ability in 41 healthy females. Then, the same participants were randomly assigned to two conditions (daily power posing practice vs. no practice). After one week the conditions alternated. Interoceptive accuracy, measured by the heartbeat tracking task, interoceptive sensibility, measured by the Body Perception Questionnaire (BPQ) and confidence ratings, as well as subjective feelings of power were assessed at baseline, after a single power posing session and after one week of training. A single power posing session significantly increased individuals' interoceptive accuracy. Also, power posing reduced individuals' scores on the BPQ after one week of daily practice and increased subjective feelings of power after one session and one week of daily practice. These findings suggest that adopting powerful postures has the potential to increase interoceptive accuracy, as well as subjective feelings of power, and to reduce interoceptive sensibility, measured by questionnaire

SET-BASED PLANNING IN THE DECOMMISSIONING OF A NUCLEAR POWER PLANT

ABSTRACT Decommissioning of nuclear facilities is a rapidly growing field in which construction techniques are applied within a dangerous environment. Radiation and contamination complicate the design of the decommissioning process. The main objectives of decommissioning are to maintain a safe environment for workers and to avoid loosing material. Secondly, the decommissioning process shall minimize the amount of contaminated material that must be stored safely for a long time. Decommissioning processes, as well as construction processes, often consist of several inter-related tasks. During the decommissioning process planning, several feasible procedures for each task must be evaluated within the context of the overall system and regarding delivery of customer value. This paper documents a case-study during which a two staged set-based planning approach was applied to rigorously explore the planning space of a dismantling process at a nuclear power plant in Germany. The result of the planning process was then verified through a survey of experienced practitioners

Embodied Cognition and the Direct Induction of Affect as a Compliment to Cognitive Behavioural Therapy

We make the case for the possible integration of affect experience induced via embodiment techniques with CBT for the treatment of emotional disorders in clinical settings. Theoretically we propose a possible integration of cognitive behavioural theory, neuroscience, embodied cognition and important processes of client change outcomes such as the therapeutic alliance to enhance client outcomes. We draw from evidence of bidirectional effects between embodiment modes of bottom-up (sensory-motor simulations giving rise to important basis of knowledge) and top-down (abstract mental representations of knowledge) processes such as CBT in psychotherapy. The paper first describes the dominance and success of CBT for the treatment of a wide range of clinical disorders. Some limitations of CBT, particularly for depression are also outlined. There is a growing body of evidence for the added value of experiential affect-focused interventions combined with CBT. Evidence for the embodied model of cognition and emotion is reviewed. Advantages of embodiment is highlighted as a complimentary process model to deepen the intensity and valence of affective experience. It is suggested that an integrated embodiment approach with CBT enhances outcomes across a wide range of emotional disorders. A description of our embodiment method integrated with CBT for inducing affective experience, emotional regulation, acceptance of unwanted emotions and emotional mastery is given. Finally, the paper highlights the importance of the therapeutic alliance as a critical component of the change process. The paper ends with a case study highlighting some clinical strategies that may aid the therapist to integrate embodiment techniques in CBT that can further explore in future research on affective experience in CBT for a wider range of clinical disorders