The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction

Abstract Background: Atrial fibrillation (AF) and congestive heart failure often coexist due to their shared risk factors leading to potential worse outcome, particularly cerebrovascular events. The aims of this study were to calculate the rates of ischemic and severe bleeding events in ischemic stroke patients having both AF and reduced ejection fraction (rEF) (⩽40%), compared to ischemic stroke patients with AF but without rEF. Methods: We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding). Results: The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84–1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03–1.77). Conclusions: In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability

Etre un couple gay et adopter un enfant : l’expérience des parents homosexuels en Belgique

Cadre de la recherche : La présente recherche vise à analyser l’expérience de l’adoption homoparentale en Belgique, en mettant en lumière les défis auxquels les homoparents sont confrontés tout au long du processus adoptif ainsi qu’après l’adoption. Les données présentées dans cet article font partie d’une étude cross-nationale plus large menée dans trois pays européens : la Belgique, la France et l’Espagne. Objectifs : La présente étude vise à répondre aux questions de recherche suivantes :1. Quels sont les principaux facteurs de stress rencontrés par les couples de même sexe pendant le processus d’adoption en Belgique ?2. Quelles sont les difficultés et les besoins ressentis par ces parents après l’adoption ?Méthodologie : L’échantillon se compose de 14 parents adoptifs homosexuels (soit 7 couples gays) résidants en Belgique. Avec chaque couple, nous avons mené des entretiens semi-structurés et vidéo-enregistrés à domicile. Les entretiens ont été entièrement retranscrits verbatim et analysés selon une approche thématique inductive. Conclusions : Les résultats montrent que les adoptants homosexuels sont confrontés à des nombreux obstacles de nature institutionnelle, tels que le système de « quota gay », la grande quantité de refus des parents de naissance à confier leurs enfants à des couples de même sexe, ainsi que les attitudes « hétérosexistes » au sein des organismes d’adoption. En plus, les participants affirment ne pas se sentir convenablement accompagnés par les acteurs sociaux, dont le bagage théorico-expérientielle sur l’homoparentale serait, d’après eux, déficitaire. Contribution : Les résultats de cette recherche mettent en lumière deux aspects fondamentaux. Premièrement, l’urgence d’adopter des mesures pour éviter toute forme de discrimination ; deuxièmement, la nécessité d’incrémenter la formation des travailleurs sociaux ainsi que d’adapter le processus d’adoption afin de mieux répondre aux exigences de ces nouvelles réalités familiales. Research Framework: This study aims at analyzing the experience of same-sex adoption in Belgium, shedding light on the challenges encountered by sexual minorities during the adoption process and after adoption. Data presented in this article is part of a larger cross-national study conducted in three European countries: Belgium, France and Spain. Objectives: This study has the purpose of answering the following research questions:1. What are the main stressors experienced by same-sex couples during the adoption process in Belgium?2. What are the main difficulties and the needs encountered by these parents after adoption? Methodology: The sample is composed of 14 sexual minority adoptive parents (7 gay couples) living in Belgium. Semi-structured interviews were conducted with each couple at their home and video-registered. The interview verbatim was transcribed and analysed using an inductive thematic approach. Conclusions: Results show that same-sex adopters deal with many institutional barriers, such as the “gay quota”, the high refusal rate of birth parents to entrust their children to same-sex couples and the heterosexist attitudes from adoption agencies. Furthermore, participants report that they do not feel adequately supported by social actors, whose theoretical and experiential knowledge concerning same-sex parenting is, according to them, shortcoming. Contribution: The results of this research highlight two fundamental aspects. First, the urgency of adopting measures to avoid any form of discrimination; secondly, the need to increase the training of social workers and adapt the adoption process to better meet the demands of these new family configurations

Assessing Triadic Interactions and the Family Alliance among Belgian Lesbian Mothers and Their Donor-Conceived Children

Both empirical and clinical evidence with heterosexual parents and their biological children has shown the significant influence of early family interactions on children’s socioemotional and cognitive development during their first years. Yet, very little research has applied family-level assessment to families who are diverse with respect to parents’ gender and sexual orientation, and child’s method of conception. The present cross-sectional study compared 24 lesbian mother families with donor-conceived children and 24 heterosexual parent families with spontaneously conceived children with respect to triadic interaction quality and the family alliance (i.e., emotional and interactional coordination during family activities), as observed during the Lausanne Trilogue Play procedure. All parents were first-time parents, White, cisgender, residing in Belgium, had an upper-middle socioeconomic status, and a child aged 3–74 months (M = 21.00, SD = 17.72). Across family types, triadic interactions demonstrated similar scores in each family alliance dimension, characterized by appropriate levels of participation, organization, focalization, and affect sharing. The results have clinical implications for the use of the LTP as both a clinical assessment and a tool to reinforce and intervene with lesbian coparents. Family psychologists may find the results particularly informative when working to support coparenting relationships among diverse families

Assessing Triadic Interactions and the Family Alliance among Belgian Lesbian Mothers and Their Donor-Conceived Children

Both empirical and clinical evidence with heterosexual parents and their biological children has shown the significant influence of early family interactions on children’s socioemotional and cognitive development during their first years. Yet, very little research has applied family-level assessment to families who are diverse with respect to parents’ gender and sexual orientation, and child’s method of conception. The present cross-sectional study compared 24 lesbian mother families with donor-conceived children and 24 heterosexual parent families with spontaneously conceived children with respect to triadic interaction quality and the family alliance (i.e., emotional and interactional coordination during family activities), as observed during the Lausanne Trilogue Play procedure. All parents were first-time parents, White, cisgender, residing in Belgium, had an upper-middle socioeconomic status, and a child aged 3–74 months (M = 21.00, SD = 17.72). Across family types, triadic interactions demonstrated similar scores in each family alliance dimension, characterized by appropriate levels of participation, organization, focalization, and affect sharing. The results have clinical implications for the use of the LTP as both a clinical assessment and a tool to reinforce and intervene with lesbian coparents. Family psychologists may find the results particularly informative when working to support coparenting relationships among diverse families

Stress and Resilience Experiences during the Transition to Parenthood among Belgian Lesbian Mothers through Donor Insemination

The present research explored parenting, stress, and resilience experiences among 16 Belgian, lesbian, first-time parental couples with donor-conceived children aged 3–72 months. In each couple, both mothers participated in a conjoint, semi-structured interview focused on their parenthood desire; the impact of stigmatization and social support from families of origin, friends, and institutions; and couple and family resources. Interviews were audio recorded, transcribed, and analyzed using Braun and Clarke’s reflective thematic analysis. Four themes were identified: (1) “The precious baby”: Realizing the parenthood project; (2) “Can we show ourselves in public without prying eyes?”: Family social visibility; (3) “It’s complicated!”: Parental legal recognition and role imbalance; and (4) “How can we handle this?”: Family resilience. The themes indicated that the child’s donor conception, the parents’ coming out, the non-gestational mother’s role, the legal obstacles encountered, and the need to find a balance between the two mothers in childcare tasks generated stress and required mothers to develop resilience strategies. The results suggest several potential areas for mental health practitioners to explore in clinical contexts when supporting intended lesbian mothers in their transition to parenthood through donor insemination

Stress and Resilience Experiences during the Transition to Parenthood among Belgian Lesbian Mothers through Donor Insemination

The present research explored parenting, stress, and resilience experiences among 16 Belgian, lesbian, first-time parental couples with donor-conceived children aged 3–72 months. In each couple, both mothers participated in a conjoint, semi-structured interview focused on their parenthood desire; the impact of stigmatization and social support from families of origin, friends, and institutions; and couple and family resources. Interviews were audio recorded, transcribed, and analyzed using Braun and Clarke’s reflective thematic analysis. Four themes were identified: (1) “The precious baby”: Realizing the parenthood project; (2) “Can we show ourselves in public without prying eyes?”: Family social visibility; (3) “It’s complicated!”: Parental legal recognition and role imbalance; and (4) “How can we handle this?”: Family resilience. The themes indicated that the child’s donor conception, the parents’ coming out, the non-gestational mother’s role, the legal obstacles encountered, and the need to find a balance between the two mothers in childcare tasks generated stress and required mothers to develop resilience strategies. The results suggest several potential areas for mental health practitioners to explore in clinical contexts when supporting intended lesbian mothers in their transition to parenthood through donor insemination

Natural language processing to convert unstructured COVID-19 chest-CT reports into structured reports

Background: Structured reporting has been demonstrated to increase report completeness and to reduce error rate, also enabling data mining of radiological reports. Still, structured reporting is perceived by radiologists as a fragmented reporting style, limiting their freedom of expression. Purpose: A deep learning-based natural language processing method was developed to automatically convert unstructured COVID-19 chest CT reports into structured reports. Methods: Two hundred-two COVID-19 chest CT were retrospectively reviewed by two experienced radiologists, who wrote for each exam a free-form text radiological report and coherently filled the template provided by the Italian Society of Medical and Interventional Radiology, used as ground-truth. A semi-supervised convolutional neural network was implemented to extract 62 categorical variables from the report. Two iterations were carried-out, the first without fine-tuning, the second one performing a fine-tuning. The performance was measured using the mean accuracy and the F1 mean score. An error analysis was performed to identify errors entirely attributable to incorrect processing of the model. Results: The algorithm achieved a mean accuracy of 93.7% and an F1 score 93.8% in the first iteration. Most of the errors were exclusively attributable to wrong inference (46%). In the second iteration the model achieved for both parameters 95,8% and percentage of errors attributable to wrong inference decreased to 26%. Conclusions: The convolutional neural network achieved an optimal performance in the automated conversion of free-form text into structured radiological reports, overcoming all the limitation attributed to structured reporting and finally paving the way for data mining of radiological report

Sexual prejudice in portugal: Results from the first wave european study on heterosexual’s attitudes toward same-gender marriage and parenting

The objective of this study was to document the prevalence and evolution of sexual prejudice toward gay men and lesbian, same-gender marriage, and same-gender parenting among a large sample of Portuguese young adults. The sample consisted of 704 self-identified heterosexual individuals (24% men and 76% women), aged between 18 and 30 years (M = 22; SD = 3), who participated in an online survey. ANOVA results revealed that women were less sexually prejudiced, were less likely to endorse social etiological beliefs of homosexuality, and were more supportive of samegender marriage and same-gender parenting than were men. Further mediation analysis revealed that the effects of gender, religiosity, importance of religious beliefs, and political leaning on the support for same-gender marriage and same-gender parenting were partially mediated by etiological beliefs and attitudes toward gay men and lesbians. The complexity of attitudes toward same-gender marriage and same-gender parenting was highlighted, indicating how attitudes toward gay men and lesbians and the belief that homosexuality is controllable impact on the support for same-gender parented families. These results are important to inform affirmative polities designed to correct inequalities and recognize same-gender families.info:eu-repo/semantics/publishedVersio