Higher Incidence of Stroke on the Last Day of the Month in Hungary—a Role for Psychosocial Factors and Financial Insecurity?
Background The seasonal cumulation of acute ischemic stroke events is a well-known phenomenon. Critical days are determined by both biological and psychosocial factors. We hypothesized that the financial stability of those with a monthly income living in an economically unpredictable environment ris...
Saved in:
Published in | Journal of stroke and cerebrovascular diseases Vol. 25; no. 5; pp. 1192 - 1195 |
---|---|
Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
01.05.2016
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Background The seasonal cumulation of acute ischemic stroke events is a well-known phenomenon. Critical days are determined by both biological and psychosocial factors. We hypothesized that the financial stability of those with a monthly income living in an economically unpredictable environment rises upon the arrival of their salary and decreases in the preceding days, leading to anxiety and existential insecurity, which may increase the incidence of acute ischemic stroke. Methods We assessed the daily average number of thrombolytic treatments due to acute ischemic stroke in Hungary between December 1, 2005, and November 30, 2013, calculating the ratio of thrombolytic treatments on the last day of the month (irrespectively whether it was the 28th-31st days) to thrombolytic treatments on the other days, and determined 95% confidence intervals. Results In this period, 7880 thrombolytic treatments were performed nationwide (2.70/day), out of which 1867 occurred on the last day of the month (19.45/day). If the 28th, 29th, or 30th was not the last day of the month, 15.8, 20.6, and 22 times less thrombolytic treatments, respectively, were performed than on the last day of that month. Conclusion We propose that financial insecurity on the days prior to the receipt of a salary might play a role in the elevation of stroke incidence observed on the last day of the month in Hungary. Further analysis of this phenomenon and its psychosocial effects is needed to adequately allocate healthcare resources and to take preventive measures in the high-risk population. |
---|---|
AbstractList | Background The seasonal cumulation of acute ischemic stroke events is a well-known phenomenon. Critical days are determined by both biological and psychosocial factors. We hypothesized that the financial stability of those with a monthly income living in an economically unpredictable environment rises upon the arrival of their salary and decreases in the preceding days, leading to anxiety and existential insecurity, which may increase the incidence of acute ischemic stroke. Methods We assessed the daily average number of thrombolytic treatments due to acute ischemic stroke in Hungary between December 1, 2005, and November 30, 2013, calculating the ratio of thrombolytic treatments on the last day of the month (irrespectively whether it was the 28th-31st days) to thrombolytic treatments on the other days, and determined 95% confidence intervals. Results In this period, 7880 thrombolytic treatments were performed nationwide (2.70/day), out of which 1867 occurred on the last day of the month (19.45/day). If the 28th, 29th, or 30th was not the last day of the month, 15.8, 20.6, and 22 times less thrombolytic treatments, respectively, were performed than on the last day of that month. Conclusion We propose that financial insecurity on the days prior to the receipt of a salary might play a role in the elevation of stroke incidence observed on the last day of the month in Hungary. Further analysis of this phenomenon and its psychosocial effects is needed to adequately allocate healthcare resources and to take preventive measures in the high-risk population. The seasonal cumulation of acute ischemic stroke events is a well-known phenomenon. Critical days are determined by both biological and psychosocial factors. We hypothesized that the financial stability of those with a monthly income living in an economically unpredictable environment rises upon the arrival of their salary and decreases in the preceding days, leading to anxiety and existential insecurity, which may increase the incidence of acute ischemic stroke. We assessed the daily average number of thrombolytic treatments due to acute ischemic stroke in Hungary between December 1, 2005, and November 30, 2013, calculating the ratio of thrombolytic treatments on the last day of the month (irrespectively whether it was the 28th-31st days) to thrombolytic treatments on the other days, and determined 95% confidence intervals. In this period, 7880 thrombolytic treatments were performed nationwide (2.70/day), out of which 1867 occurred on the last day of the month (19.45/day). If the 28th, 29th, or 30th was not the last day of the month, 15.8, 20.6, and 22 times less thrombolytic treatments, respectively, were performed than on the last day of that month. We propose that financial insecurity on the days prior to the receipt of a salary might play a role in the elevation of stroke incidence observed on the last day of the month in Hungary. Further analysis of this phenomenon and its psychosocial effects is needed to adequately allocate healthcare resources and to take preventive measures in the high-risk population. BACKGROUNDThe seasonal cumulation of acute ischemic stroke events is a well-known phenomenon. Critical days are determined by both biological and psychosocial factors. We hypothesized that the financial stability of those with a monthly income living in an economically unpredictable environment rises upon the arrival of their salary and decreases in the preceding days, leading to anxiety and existential insecurity, which may increase the incidence of acute ischemic stroke.METHODSWe assessed the daily average number of thrombolytic treatments due to acute ischemic stroke in Hungary between December 1, 2005, and November 30, 2013, calculating the ratio of thrombolytic treatments on the last day of the month (irrespectively whether it was the 28th-31st days) to thrombolytic treatments on the other days, and determined 95% confidence intervals.RESULTSIn this period, 7880 thrombolytic treatments were performed nationwide (2.70/day), out of which 1867 occurred on the last day of the month (19.45/day). If the 28th, 29th, or 30th was not the last day of the month, 15.8, 20.6, and 22 times less thrombolytic treatments, respectively, were performed than on the last day of that month.CONCLUSIONWe propose that financial insecurity on the days prior to the receipt of a salary might play a role in the elevation of stroke incidence observed on the last day of the month in Hungary. Further analysis of this phenomenon and its psychosocial effects is needed to adequately allocate healthcare resources and to take preventive measures in the high-risk population. |
Author | Toldi, Gergely, MD, PhD Biczó, Dávid, MD Folyovich, András, MD Kis, Ibolya, MD Béres-Molnár, Anna K., MD Gimesi-Országh, Judit, MD Bajnok, Anna, MD Bessenyei, Dávid, MD |
Author_xml | – sequence: 1 fullname: Folyovich, András, MD – sequence: 2 fullname: Biczó, Dávid, MD – sequence: 3 fullname: Bajnok, Anna, MD – sequence: 4 fullname: Bessenyei, Dávid, MD – sequence: 5 fullname: Kis, Ibolya, MD – sequence: 6 fullname: Gimesi-Országh, Judit, MD – sequence: 7 fullname: Béres-Molnár, Anna K., MD – sequence: 8 fullname: Toldi, Gergely, MD, PhD |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26935123$$D View this record in MEDLINE/PubMed |
BookMark | eNqVUstu1DAUtVARffELyEuElGA7tZNsQFCYzkiDQC2sLce-6TjN2K2dVMoG9SP6hf0SnE5hgdiw8uOee47uOfcQ7TnvAKE3lOSUUPG2y7s4BH8FGgI0wd-qaGzMWarlhOWEkmfogPKCZRWndC_dCWdZQXi5jw5j7AihlFf8Bdpnoi44ZcUB-rm0lxsIeOW0NeA0YN_ii0cV7B0eNoDXKg74k5rmyvz-4t2wwdbh5eguVZge7u4VPvc94NYH_C1OeuOj11b1eKH04EPEyhm8sE65x9-Vi6DHYIfp_TF63qo-wsun8wj9WHz-frrM1l_PVqcf1pk-4fWQCaJpZeqKlnWlmraoaNOK8oSXhtdzSZS6LmrKGqGg0bQUpGqNaVvTGNaUTBVH6PWO9zr4mxHiILc2auh75cCPUdKySv2iLkmCftxBdfAxBmjldbDbNKekRM45yE7-Kwc55yAJkymHRPLqSW9stmD-UPw2PgHWOwCkqW8tBBm1nf03NoAepPH2__Te_UWne-usVv0VTBA7PwaX_JVUxtQgL-bNmBeDCkJILYriF9OXwCs |
CitedBy_id | crossref_primary_10_1016_j_neurol_2019_08_013 crossref_primary_10_1002_brb3_2104 crossref_primary_10_1016_j_encep_2023_09_004 |
Cites_doi | 10.1016/j.brainresbull.2003.12.001 10.1161/01.STR.0000257999.49706.3b 10.1176/ps.51.1.31 10.1289/ehp.01109463 10.1136/bmj.321.7276.1552 10.1016/j.ajem.2008.10.024 10.1159/000151637 10.1001/jama.2011.1282 10.1007/BF01400492 10.1056/NEJM199907083410206 10.1007/BF00919594 10.1067/mhj.2000.107545 |
ContentType | Journal Article |
Copyright | National Stroke Association 2016 National Stroke Association Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved. |
Copyright_xml | – notice: National Stroke Association – notice: 2016 National Stroke Association – notice: Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved. |
DBID | CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
DOI | 10.1016/j.jstrokecerebrovasdis.2016.02.010 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef MEDLINE - Academic |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef MEDLINE - Academic |
DatabaseTitleList | MEDLINE MEDLINE - Academic |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1532-8511 |
EndPage | 1195 |
ExternalDocumentID | 10_1016_j_jstrokecerebrovasdis_2016_02_010 26935123 S1052305716000963 1_s2_0_S1052305716000963 |
Genre | Journal Article |
GroupedDBID | --- --K --M .1- .55 .FO .~1 0R~ 1B1 1P~ 1~. 1~5 4.4 457 4G. 53G 5GY 5VS 7-5 71M 8P~ 9JM AACTN AAEDT AAEDW AAIKJ AAKOC AALRI AAOAW AAQFI AAQQT AAQXK AAXKI AAXUO ABBQC ABFNM ABMAC ABMZM ABTEW ABXDB ACDAQ ACJTP ACRLP ADBBV ADEZE ADMUD AEBSH AEKER AEVXI AFJKZ AFKWA AFRHN AFTJW AFXBA AFXIZ AGHFR AGUBO AGYEJ AHHHB AIEXJ AIKHN AITUG AJOXV AJRQY AJUYK ALMA_UNASSIGNED_HOLDINGS AMFUW AMRAJ ANZVX ASPBG AVWKF AXJTR AZFZN BKOJK BLXMC BNPGV CAG COF CS3 EBS EFJIC EJD EO8 EO9 EP2 EP3 F5P FDB FEDTE FGOYB FIRID FNPLU FYGXN G-2 G-Q GBLVA HVGLF HZ~ IHE J1W KOM L7B M2W M41 MO0 N9A O-L O9- OAUVE OP~ OZT P-8 P-9 P2P PC. Q38 R2- RIG ROL RPZ SDF SDG SEL SES SEW SNG SNH SPCBC SSH SSZ T5K X7M Z5R ~G- AAIAV ABLVK ABYKQ AHPSJ AISVY AJBFU EFLBG LCYCR NAHTW CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
ID | FETCH-LOGICAL-c459t-60c18d981798abf381bf67457d590c1867c93912b6aebc17608fddffdbd2b72a3 |
IEDL.DBID | AIKHN |
ISSN | 1052-3057 |
IngestDate | Fri Aug 16 01:06:58 EDT 2024 Thu Sep 26 15:54:49 EDT 2024 Sat Sep 28 07:58:12 EDT 2024 Fri Feb 16 04:41:21 EST 2024 Tue Oct 15 22:54:09 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 5 |
Keywords | financial security last day of the month psychosocial risk Acute ischemic stroke |
Language | English |
License | Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved. |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c459t-60c18d981798abf381bf67457d590c1867c93912b6aebc17608fddffdbd2b72a3 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ORCID | 0000-0003-0178-1243 |
PMID | 26935123 |
PQID | 1783916970 |
PQPubID | 23479 |
PageCount | 4 |
ParticipantIDs | proquest_miscellaneous_1783916970 crossref_primary_10_1016_j_jstrokecerebrovasdis_2016_02_010 pubmed_primary_26935123 elsevier_sciencedirect_doi_10_1016_j_jstrokecerebrovasdis_2016_02_010 elsevier_clinicalkeyesjournals_1_s2_0_S1052305716000963 |
PublicationCentury | 2000 |
PublicationDate | 2016-05-01 |
PublicationDateYYYYMMDD | 2016-05-01 |
PublicationDate_xml | – month: 05 year: 2016 text: 2016-05-01 day: 01 |
PublicationDecade | 2010 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | Journal of stroke and cerebrovascular diseases |
PublicationTitleAlternate | J Stroke Cerebrovasc Dis |
PublicationYear | 2016 |
Publisher | Elsevier Inc |
Publisher_xml | – name: Elsevier Inc |
References | Phillips, Christenfeld, Ryan (bib0055) 1999; 341 Huynen, Martens, Schram (bib0030) 2001; 109 (bib0040) 2015 Jiminez-Conde, Ois, Gomis (bib0020) 2008; 26 Pan, Sun, Okereke (bib0070) 2011; 306 Witte, Bots, Hoes (bib0045) 2000; 321 Manfredini, Manfredini, Boari (bib0050) 2009; 27 Maynard, Cox (bib0060) 2000; 51 Tsementzis, Kennet, Hitchcock (bib0010) 1991; 111 Kopp, Réthelyi (bib0075) 2004; 62 Azevedo, Ribeiro, Lopes (bib0015) 1995; 242 Maynard (bib0065) 2000; 140 Kettunen, Lanki, Tiittanen (bib0025) 2007; 38 (bib0035) 1989 Kettunen (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0025) 2007; 38 Maynard (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0060) 2000; 51 Jiminez-Conde (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0020) 2008; 26 Witte (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0045) 2000; 321 (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0035) 1989 Manfredini (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0050) 2009; 27 Huynen (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0030) 2001; 109 Phillips (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0055) 1999; 341 Maynard (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0065) 2000; 140 Azevedo (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0015) 1995; 242 Pan (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0070) 2011; 306 Kopp (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0075) 2004; 62 Tsementzis (10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0010) 1991; 111 |
References_xml | – volume: 341 start-page: 93 year: 1999 end-page: 98 ident: bib0055 article-title: An increase in the number of deaths in the United States in the first week of the month. An association with substance abuse and other causes of death publication-title: N Engl J Med contributor: fullname: Ryan – volume: 38 start-page: 918 year: 2007 end-page: 922 ident: bib0025 article-title: Associations of fine and ultrafine particulate air pollutions with stroke mortality in an area of low air pollution levels publication-title: Stroke contributor: fullname: Tiittanen – volume: 242 start-page: 217 year: 1995 end-page: 221 ident: bib0015 article-title: Cold: a risk factor for stroke? publication-title: J Neurol contributor: fullname: Lopes – volume: 26 start-page: 348 year: 2008 end-page: 354 ident: bib0020 article-title: Weather as a trigger of stroke. Daily meteorological factors and incidence of stroke subtypes publication-title: Cerebrovasc Dis contributor: fullname: Gomis – volume: 111 start-page: 80 year: 1991 end-page: 83 ident: bib0010 article-title: Seasonal variation of cerebrovascular diseases publication-title: Acta Neurochir (Wien) contributor: fullname: Hitchcock – year: 1989 ident: bib0035 publication-title: Statistics with confidence – volume: 27 start-page: 244 year: 2009 end-page: 246 ident: bib0050 article-title: The Monday peak in the onset of ischemic stroke is independent of major risk factors publication-title: Am J Emerg Med contributor: fullname: Boari – volume: 140 start-page: 196 year: 2000 end-page: 199 ident: bib0065 article-title: Association between week of the month and death from acute myocardial infarction in Washington state, 1988 to 1997 publication-title: Am Heart J contributor: fullname: Maynard – volume: 62 start-page: 351 year: 2004 end-page: 367 ident: bib0075 article-title: Where psychology meets physiology: chronic stress and premature mortality—the Central-Eastern European health paradox publication-title: Brain Res Bull contributor: fullname: Réthelyi – volume: 306 start-page: 1241 year: 2011 end-page: 1249 ident: bib0070 article-title: Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review publication-title: JAMA contributor: fullname: Okereke – volume: 321 start-page: 1552 year: 2000 end-page: 1554 ident: bib0045 article-title: Cardiovascular mortality in Dutch men during 1996 European football championship: longitudinal population study publication-title: BMJ contributor: fullname: Hoes – volume: 51 start-page: 31 year: 2000 ident: bib0060 article-title: Association between week of the month and hospitalization for substance abuse publication-title: Psychiatr Serv contributor: fullname: Cox – year: 2015 ident: bib0040 article-title: Employment, earnings (1960-2014) – volume: 109 start-page: 463 year: 2001 end-page: 470 ident: bib0030 article-title: The impact of heat waves and cold spells on mortality rates in the Dutch population publication-title: Environ Health Perspect contributor: fullname: Schram – volume: 62 start-page: 351 year: 2004 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0075 article-title: Where psychology meets physiology: chronic stress and premature mortality—the Central-Eastern European health paradox publication-title: Brain Res Bull doi: 10.1016/j.brainresbull.2003.12.001 contributor: fullname: Kopp – volume: 38 start-page: 918 year: 2007 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0025 article-title: Associations of fine and ultrafine particulate air pollutions with stroke mortality in an area of low air pollution levels publication-title: Stroke doi: 10.1161/01.STR.0000257999.49706.3b contributor: fullname: Kettunen – volume: 51 start-page: 31 year: 2000 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0060 article-title: Association between week of the month and hospitalization for substance abuse publication-title: Psychiatr Serv doi: 10.1176/ps.51.1.31 contributor: fullname: Maynard – volume: 109 start-page: 463 year: 2001 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0030 article-title: The impact of heat waves and cold spells on mortality rates in the Dutch population publication-title: Environ Health Perspect doi: 10.1289/ehp.01109463 contributor: fullname: Huynen – volume: 321 start-page: 1552 year: 2000 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0045 article-title: Cardiovascular mortality in Dutch men during 1996 European football championship: longitudinal population study publication-title: BMJ doi: 10.1136/bmj.321.7276.1552 contributor: fullname: Witte – volume: 27 start-page: 244 year: 2009 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0050 article-title: The Monday peak in the onset of ischemic stroke is independent of major risk factors publication-title: Am J Emerg Med doi: 10.1016/j.ajem.2008.10.024 contributor: fullname: Manfredini – volume: 26 start-page: 348 year: 2008 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0020 article-title: Weather as a trigger of stroke. Daily meteorological factors and incidence of stroke subtypes publication-title: Cerebrovasc Dis doi: 10.1159/000151637 contributor: fullname: Jiminez-Conde – year: 1989 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0035 – volume: 306 start-page: 1241 year: 2011 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0070 article-title: Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review publication-title: JAMA doi: 10.1001/jama.2011.1282 contributor: fullname: Pan – volume: 111 start-page: 80 year: 1991 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0010 article-title: Seasonal variation of cerebrovascular diseases publication-title: Acta Neurochir (Wien) doi: 10.1007/BF01400492 contributor: fullname: Tsementzis – volume: 341 start-page: 93 year: 1999 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0055 article-title: An increase in the number of deaths in the United States in the first week of the month. An association with substance abuse and other causes of death publication-title: N Engl J Med doi: 10.1056/NEJM199907083410206 contributor: fullname: Phillips – volume: 242 start-page: 217 year: 1995 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0015 article-title: Cold: a risk factor for stroke? publication-title: J Neurol doi: 10.1007/BF00919594 contributor: fullname: Azevedo – volume: 140 start-page: 196 year: 2000 ident: 10.1016/j.jstrokecerebrovasdis.2016.02.010_bib0065 article-title: Association between week of the month and death from acute myocardial infarction in Washington state, 1988 to 1997 publication-title: Am Heart J doi: 10.1067/mhj.2000.107545 contributor: fullname: Maynard |
SSID | ssj0011585 |
Score | 2.1232662 |
Snippet | Background The seasonal cumulation of acute ischemic stroke events is a well-known phenomenon. Critical days are determined by both biological and psychosocial... The seasonal cumulation of acute ischemic stroke events is a well-known phenomenon. Critical days are determined by both biological and psychosocial factors.... BACKGROUNDThe seasonal cumulation of acute ischemic stroke events is a well-known phenomenon. Critical days are determined by both biological and psychosocial... |
SourceID | proquest crossref pubmed elsevier |
SourceType | Aggregation Database Index Database Publisher |
StartPage | 1192 |
SubjectTerms | Acute ischemic stroke Anxiety - diagnosis Anxiety - economics Anxiety - epidemiology Anxiety - psychology Brain Ischemia - diagnosis Brain Ischemia - drug therapy Brain Ischemia - economics Brain Ischemia - epidemiology Cardiovascular Female financial security Humans Hungary - epidemiology Incidence last day of the month Male Mental Health Neurology psychosocial risk Risk Factors Salaries and Fringe Benefits Stress, Psychological - diagnosis Stress, Psychological - economics Stress, Psychological - epidemiology Stress, Psychological - psychology Stroke - diagnosis Stroke - drug therapy Stroke - economics Stroke - epidemiology Stroke - psychology Thrombolytic Therapy Time Factors |
Title | Higher Incidence of Stroke on the Last Day of the Month in Hungary—a Role for Psychosocial Factors and Financial Insecurity? |
URI | https://www.clinicalkey.es/playcontent/1-s2.0-S1052305716000963 https://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.02.010 https://www.ncbi.nlm.nih.gov/pubmed/26935123 https://search.proquest.com/docview/1783916970 |
Volume | 25 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrR3LatwwcEg2EHoJfXfTJKjQU8HdlW1JFj2UkGbZPpJD00BuQrJkummxw9o55BLyEfnCfklHlrylND0UepQlobHmKWkeAC-Z5oaJVCdFRnmSM5snEhkjkTatKl4yoQsfO3x0zOen-YczdrYGB0MsjHerjLI_yPReWscvk7ibk4vFYnJC-xtNhgZ_b4hn67CB6ijPR7Cx__7j_Hj1mEBZX5nTj0_8hE149cvN67ztls03V7olnkG9-6dd-CzelPepPH1g7d366m_2aK-XZvdhKxqUZD_A_ADWXP0QNo_ik_kjuA6eHAQFQagfSpqKnPTQkKYmaP-RT7rtyDt95Xt8G_m8-0oWNZmjJNDLqx83t5p8br47ghYuCSIz3LWTWSjXQ3RtyWxI3oFrtbEs3tvHcDo7_HIwT2LRhaTMmewSPi1pYWXhE5lpU6FCNxUXOROWSd_FRSkzSVPDtTMlFXxaVNZWlTU2NYj07AmM6qZ2z4AUqWOOcWG1P3RxoTOcZkqnfe7RvHBjeDNsrboIuTXU4HR2ru5CjPKIUdNUIWLGIAZsqCGKFOWeayMTtoqqFkeqPwhlDIermb_RmkI18k8QvBiIQCFT-pcWXbvmElcWhQ9olgLHPA3UsfrDlMsMraxs-z9B8Rzu-VZwwtyBUbe8dLtoKHVmD9ZfX9O9yA4_AUtvFw0 |
link.rule.ids | 315,786,790,4521,24144,27955,27956,45618,45712 |
linkProvider | Elsevier |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrR3JbtQw9KlMpdILYu-wGokTUjSTxXYsDqgqHaV0Zg60lXqz7NgRU1BSTdJDL4iP4Av5Ep5jZxCiHJA4OrblF7_V9lsAXlPFNOWJivI0ZlFGTRYJZIxImKSqWEm5yl3s8GLJirPswzk934KDIRbGuVUG2e9lei-tw5dJ2M3J5Wo1OYn7G02KBn9viKe3YDvDVjKC7f2j42K5eUyIaV-Z042P3IQdePPLzeui7dbNZ1vaNZ5BnfunWbks3jHrU3m6wNqb9dXf7NFeL83uwp1gUJJ9D_M92LL1fdhZhCfzB_DVe3IQFAS-fihpKnLSQ0OamqD9R-aq7ch7de16XBv5vPtEVjUpUBKo9fWPb98V-dh8sQQtXOJFpr9rJzNfroeo2pDZkLwD12pDWbx3D-Fsdnh6UESh6EJUZlR0EZuWcW5E7hKZKV2hQtcV47ixhgrXxXgpUhEnmimry5izaV4ZU1VGm0Qj0tNHMKqb2u4ByRNLLWXcKHfoYlylOE2XVrnco1lux_B22Fp56XNryMHp7ELehBjpECOniUTEjIEP2JBDFCnKPdsGJmxlLFscKf8glDEcbmb-RmsS1cg_QfBqIAKJTOleWlRtmytcmecuoFlwHPPYU8fmDxMmUrSy0if_CYqXcLs4Xczl_Gh5_BR2XY93yHwGo259ZZ-j0dTpF4EpfgL7KBj9 |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Higher+Incidence+of+Stroke+on+the+Last+Day+of+the+Month+in+Hungary%E2%80%94a+Role+for+Psychosocial+Factors+and+Financial+Insecurity%3F&rft.jtitle=Journal+of+stroke+and+cerebrovascular+diseases&rft.au=Folyovich%2C+Andr%C3%A1s&rft.au=Bicz%C3%B3%2C+D%C3%A1vid&rft.au=Bajnok%2C+Anna&rft.au=Bessenyei%2C+D%C3%A1vid&rft.date=2016-05-01&rft.issn=1052-3057&rft.volume=25&rft.issue=5&rft.spage=1192&rft.epage=1195&rft_id=info:doi/10.1016%2Fj.jstrokecerebrovasdis.2016.02.010&rft.externalDBID=n%2Fa&rft.externalDocID=10_1016_j_jstrokecerebrovasdis_2016_02_010 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1052-3057&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1052-3057&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1052-3057&client=summon |