BackgroundPost-stroke cognitive impairment is common and a decisive prognostic factor. However, few studies have reported on post-stroke cognition in young adults, especially long-term cognition. This study was designed to investigate the influence of baseline factors, treatments, and functional outcome on the long-term cognitive outcome in young adults with ischemic stroke.Material/MethodsConsecutive patients aged 18–45 years between January 1, 2006 and December 31, 2010, with a first-ever ischemic stroke, were recruited for cognitive assessment by telephone from December 10 to December 31, 2013 using modified versions of “Telephone Instrument for Cognitive Status” (TICS-m) scale. The relationship of cognitive impairment with baseline factors, treatments, and functional outcome were evaluated.ResultsA total of 350 patients with an average age of 41.0±6.8 years (69.7% males and 30.3% females) were reviewed. The average follow-up period was 5.8±3.2 years, and cognitive impairment existed in 39.4% of patients at follow-up. Stroke severity on admission, functional outcome (modified Rankin Scale, mRS >2) at discharge, left anterior circulation syndrome, and stroke recurrence were markedly associated with post-stroke cognitive impairment (all P<0.01). Post-stroke cognition was also significantly related to mRS at follow-up (r=−0.563, P<0.001).ConclusionsPost-stroke cognition was related to functional outcome: hence, treatment directed toward reducing functional disability might also reduce cognitive impairment.
In the global competition of higher education, an increasing emphasis has been placed on university research excellence. Accordingly, academics have to engage in both research and teaching activities. The multiple and fragmented identities of academics can sometimes be contested, leading to identity tensions, and impeding their professional development. This raises the issue of how, and whether at all, academics integrate their professional identities in a culture of performativity. Against this backdrop, this qualitative study explored how a specific group of Chinese academics negotiate identity tensions as teachers and researchers through an emotional resilience lens. The narrative frames and interviews with 10 college English teachers yielded four types of identity negotiation in the continuum from identity conflicts to identity integration mediated by emotional resilience, including the disheartened performer, the miserable follower, the strenuous accommodator, and the fulfilled integrator. Emotional resilience as a mediator in professional identity tensions is discussed. Our findings offer a nuanced understanding of the complexity of academics developing an integrated professional identity. Policymakers should recognize the potential of emotional resilience in integrating academic professional identities and jointly support academics to cope with their identity tensions. However, if identity tensions are too complex for academics to solve, the policymakers should consider tensions as signals that the existing institutional policies may be counterproductive and need to be revised, rather than merely calling on academics’ resilience.
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