Re-expansion of balloon-expandable stents after growth

AbstractObjectives. The purpose of this study was to evaluate the feasibility of re-expansion of balloon expandable intravascular stents and to examine the gross and histologic effects of re-expansion on vascular integrity.Background. Intravascular stents have been used successfully as an adjunct to balloon dilation of congenital pulmonary artery branch stenosis and postoperative stenosis of the pulmonary arteries in children. However, use of rigid stents in children could result in development of relative stenosis at the site of stent implantation with subsequent growth of the child.Methods. Stainless steel “iliac” stents were placed in the thoracic aorta of 10 normal juvenile swine by a transcatheter technique. Angiography and re-expansion were performed at a mean of 11 weeks (n = 9) and again at 18 weeks (n = 5). After euthanasia, the aortic specimens were removed for gross and histologic examination.Results. Stents were successfully implanted in 10 swine. Re-expansion was successfully performed in each animal at 11 weeks and at 18 weeks. Aortic growth produced a relative constriction of the aorta of 20% ± 10% (mean ± SD) at the site of stent implantation at both 11 and 18 weeks. Re-expansion produced a significant increase in mean stent diameter from 10.1 ± 1 mm to 12.3 ± 1.2 mm at 11 weeks and from 11.2 ± 0.7 to 13.5 ± 1.1 mm at 18 weeks after implantation (p < 0.001). Balloon dilation produced a relative increase in stent diameter of 21% ± 7% at 11 weeks and 18% ± 4% at 18 weeks. Stent re-expansion was accompanied by plastic deformation of the neointima without neointimal dissection. Where neointima was thick, there was no evidence of neointimal abrasion, but where neointima was thin, areas of localized neointimal abrasion were observed with focal fibrin and platelet adherence to the stent struts. There was no evidence of medial or adventitial hemorrhage or dissection produced by re-expansion.Conclusions. Re-expansion of intravascular stents is feasible after growth in juvenile swine without significant injury to neointima, media or adventitia. The results of this study support careful and selective use of intravascular stents as an adjunct to balloon dilation of congenital stenoses in children

The Role of Values in Coping with Health and Economic Threats of COVID-19

The current research examined the role of values in guiding people’s responses to COVID-19. Results from an international study involving 115 countries (N = 61,490) suggest that health and economic threats of COVID-19 evoke different values, with implications for controlling and coping with the pandemic. Specifically, health threats evoked prioritization of communal values related to caring for others and belonging, whereas economic threats predicted prioritization of agentic values focused on competition and achievement. Concurrently and over time, prioritizing communal values over agentic values was associated with enactment of prevention behaviors that reduce virus transmission, motivations to help others suffering from the pandemic, and positive attitudes toward outgroup members. These results, which were generally consistent across individual and national levels of analysis, suggest that COVID-19 threats may indirectly shape important responses to the pandemic through their influence on people’s prioritization of communion and agency. Theoretical and practical implications are discussed

Impact of national pandemic lockdowns on perceived threat of immigrants: a natural quasi-experiment across 23 countries

Xenophobia and anti-immigrant attacks rose during the COVID-19 pandemic, yet this may not be solely due to the disease threat. According to theories of frustration and scapegoating, situational obstructions and deprivation can motivate prejudice against outgroups. Using a global natural quasi-experimental design, this study tests whether the restrictiveness of national lock-downs can explain higher individual-level perceptions of immigrant threat. Data of 45,894 participants from 23 countries were analyzed. Both lockdown duration and lockdown severity were positively associated with individuals’ perceived threat of immi-grants. The lockdown effects were independent of objective and subjective measures of disease threat, and there was no evi-dence that disease threat drives people’s prejudice toward immigrants. Subgroup analysis suggested the lockdown effects were reliable in Europe and the Americas, but not in Asia. These findings suggest a need to mitigate frustration and scapegoating when implementing lockdowns, and to distinguish the influence of societal restrictions from disease threat

Trust in government and its associations with health behaviour and prosocial behaviour during the COVID-19 pandemic

Previous studies suggested that public trust in government is vital for implementations of social policies that rely on public's behavioural responses. This study examined associations of trust in government regarding COVID-19 control with recommended health behaviours and prosocial behaviours. Data from an international survey with representative samples (N=23,733) of 23 countries were analysed. Specification curve analysis showed that higher trust in government was significantly associated with higher adoption of health and prosocial behaviours in all reasonable specifications of multilevel linear models (median standardised β=0.173 and 0.244, P<0.001). We further used structural equation modelling to explore potential determinants of trust in government regarding pandemic control. Governments perceived as well organised, disseminating clear messages and knowledge on COVID-19, and perceived fairness were positively associated with trust in government (standardised β=0.358, 0.230, 0.055, and 0.250, P<0.01). These results highlighted the importance of trust in government in the control of COVID-19

Politicization of COVID-19 health-protective behaviors in the United States: Longitudinal and cross-national evidence

During the initial phase of the COVID-19 pandemic, U.S. conservative politicians and the media downplayed the risk of both contracting COVID-19 and the effectiveness of recom-mended health behaviors. Health behavior theories suggest perceived vulnerability to a health threat and perceived effectiveness of recommended health-protective behaviors determine motivation to follow recommendations. Accordingly, we predicted that—as a result of politicization of the pandemic—politically conservative Americans would be less likely to enact recommended health-protective behaviors. In two longitudinal studies of U.S. residents, political conservatism was inversely associated with perceived health risk and adoption of health-protective behaviors over time. The effects of political orientation on health-protective behaviors were mediated by perceived risk of infection, perceived severity of infection, and perceived effectiveness of the health-protective behaviors. In a global cross-national analysis, effects were stronger in the U.S. (N = 10,923) than in an interna-tional sample (total N = 51,986), highlighting the increased and overt politicization of health behaviors in the U.S

Predictors of adherence to public health behaviors for fighting COVID-19 derived from longitudinal data

The present paper examines longitudinally how subjective perceptions about COVID-19, one's community, and the government predict adherence to public health measures to reduce the spread of the virus. Using an international survey (N = 3040), we test how infection risk perception, trust in the governmental response and communications about COVID-19, conspiracy beliefs, social norms on distancing, tightness of culture, and community punishment predict various containment-related attitudes and behavior. Autoregressive analyses indicate that, at the personal level, personal hygiene behavior was predicted by personal infection risk perception. At social level, social distancing behaviors such as abstaining from face-to-face contact were predicted by perceived social norms. Support for behavioral mandates was predicted by confidence in the government and cultural tightness, whereas support for anti-lockdown protests was predicted by (lower) perceived clarity of communication about the virus. Results are discussed in light of policy implications and creating effective interventions

Politicization of COVID-19 health-protective behaviors in the United States:Longitudinal and cross-national evidence

During the initial phase of the COVID-19 pandemic, U.S. conservative politicians and the media downplayed the risk of both contracting COVID-19 and the effectiveness of recommended health behaviors. Health behavior theories suggest perceived vulnerability to a health threat and perceived effectiveness of recommended health-protective behaviors determine motivation to follow recommendations. Accordingly, we predicted that—as a result of politicization of the pandemic—politically conservative Americans would be less likely to enact recommended health-protective behaviors. In two longitudinal studies of U.S. residents, political conservatism was inversely associated with perceived health risk and adoption of health-protective behaviors over time. The effects of political orientation on health-protective behaviors were mediated by perceived risk of infection, perceived severity of infection, and perceived effectiveness of the health-protective behaviors. In a global cross-national analysis, effects were stronger in the U.S. (N = 10,923) than in an international sample (total N = 51,986), highlighting the increased and overt politicization of health behaviors in the U.S

Using machine learning to identify important predictors of COVID-19 infection prevention behaviors during the early phase of the pandemic

Before vaccines for coronavirus disease 2019 (COVID-19) became available, a set of infection-prevention behaviors constituted the primary means to mitigate the virus spread. Our study aimed to identify important predictors of this set of behaviors. Whereas social and health psychological theories suggest a limited set of predictors, machine-learning analyses can identify correlates from a larger pool of candidate predictors. We used random forests to rank 115 candidate correlates of infection-prevention behavior in 56,072 participants across 28 countries, administered in March to May 2020. The machine-learning model predicted 52% of the variance in infection-prevention behavior in a separate test sample—exceeding the performance of psychological models of health behavior. Results indicated the two most important predictors related to individual-level injunctive norms. Illustrating how data-driven methods can complement theory, some of the most important predictors were not derived from theories of health behavior—and some theoretically derived predictors were relatively unimportant

COVID-19 stressors and health behaviors:A multilevel longitudinal study across 86 countries

Anxiety associated with the COVID-19 pandemic and home confinement has been associated with adverse health behaviors, such as unhealthy eating, smoking, and drinking. However, most studies have been limited by regional sampling, which precludes the examination of behavioral consequences associated with the pandemic at a global level. Further, few studies operationalized pandemic-related stressors to enable the investigation of the impact of different types of stressors on health outcomes. This study examined the association between perceived risk of COVID-19 infection and economic burden of COVID-19 with health-promoting and health-damaging behaviors using data from the PsyCorona Study: an international, longitudinal online study of psychological and behavioral correlates of COVID-19. Analyses utilized data from 7,402 participants from 86 countries across three waves of assessment between May 16 and June 13, 2020. Participants completed self-report measures of COVID-19 infection risk, COVID-19-related economic burden, physical exercise, diet quality, cigarette smoking, sleep quality, and binge drinking. Multilevel structural equation modeling analyses showed that across three time points, perceived economic burden was associated with reduced diet quality and sleep quality, as well as increased smoking. Diet quality and sleep quality were lowest among respondents who perceived high COVID-19 infection risk combined with high economic burden. Neither binge drinking nor exercise were associated with perceived COVID-19 infection risk, economic burden, or their interaction. Findings point to the value of developing interventions to address COVID-related stressors, which have an impact on health behaviors that, in turn, may influence vulnerability to COVID-19 and other health outcomes

Implications of Unconnected Micro, Molecular, and Molar Level Research in Psychology: The Case of Executive Functions, Self-Regulation, and External Regulation

The proliferation of research production in Psychology as a science has been increasing exponentially. This situation leads to the necessity of organizing the research production into different levels of analysis that make it possible to delimit each research domain. The objective of this analysis is to clearly distinguish the different levels of research: micro-analysis, molecular, and molar. Each level is presented, along with an analysis of its benefits and limitations. Next, this analysis is applied to the topics of Executive Functions, Self-Regulation, and External Regulation. Conclusions, limitations, and implications for future research are offered, with a view toward a better connection of research production across the different levels, and an allusion to ethical considerationsThis study was supported by R&D Project EDU2011-24805, PGC2018-094672-B-I00 (Ministry of Science and Education, Spain), and UAL18-SEJ-DO31-A-FEDER (University of Almería), and the European Social Fund