A Qualitative Study Exploring the Experiences and Perceptions of Patients with Hemophilia Regarding Their Health-Related Well-Being, in Salamanca.

Hemophilia is a chronic, congenital/hereditary and X-linked disease, characterized by an insufficiency of factors VIII or IX, which are necessary for blood clotting. Those affected by hemophilia often suffer from particular psychosocial problems, both in the acceptance, coping, treatment and self-management of their disease and in their family and social relationships, which are often mediated by these circumstances. The aim of this study was to explore the experiences of people with hemophilia or their family members, of in a specific region of Spain, regarding the impact of having hemophilia. Structured interviews were conducted and developed, using the studies of the World Federation of Hemophilia and Osorio-Guzmán et al. as a guide, as well as a literature review of qualitative work on hemophilia. Data were analyzed using a six-step thematic analysis. A total of 34 interviews were thematically analyzed. The results showed that three key themes emerged from the data: (1) the daily impact of having hemophilia, (2) uncertainty about the disease, (3) the role of associations and (4) support from institutions. The results make it clear that the disease has a major impact on their lives (work, family, leisure and personal environment). The main conclusion is that hemophilia has a negative impact on the daily lives of patients, families and caregivers.

Neurosensory Affectation in Patients Affected by Wolfram Syndrome: Descriptive and Longitudinal Analysis.

Wolfram syndrome (WS) is a rare neurodegenerative disease usually of autosomal recessive origin. There is limited research about sensorineural hearing loss, despite it being a fundamental entity. It is important to broaden the study of this disease and specify a set of tests required for an adequate assessment of patients for efficient monitoring and control. The fundamental objective of this research is to understand WS from a biomedical perspective in order to help in its diagnosis, follow-up, and control. Pure tones audiometry, tympanometry, speech perception, the speech intelligibility index without aid, and testing at high frequencies were among the audiological measurements utilised since they were deemed suitable for standardised follow-up. Mixed linear models were used to examine the effects of age, time, or mean interaction in pure-tone (IPT), the average of high frequencies (HFA), auditory brainstem response (ABR), and brainstem auditory evoked potentials (BAEP). The genetic analysis allowed mutations to be classified into three phenotype-genotype groups, where the phenotype indicated the severity of the hearing loss. Patients with homozygous gene changes had a more severe neurosensory phenotype. The early discovery of sensorineural hearing loss and WS is crucial since it allows intensive follow-up and treatment of the person affected from the start.

Perception of Social and Educational Quality of Life of Minors Diagnosed with Rare Diseases: A Systematic Review and Meta-Analysis.

This study explores the perception of social and educational quality of life in minors with rare diseases (RDs). Two meta-analyses were performed, applying the random effects model. Results: Regarding the social Quality of Life, the meta-sample consisted of k = 40 samples, with a total population of 1943 children (mean age = 9.42 years), of whom 687 (35.3%) were girls, 615 (31.4%) were boys and 641 (33%) did not report their sex. The effect size was large (mean size = 7.68; p < 0.000; 99% Confidence Interval; lower limit = 7.22; upper limit = 8.14). The results of the meta-regression and model analysis showed the importance of the measurement instrument (Paediatric Quality-of-Life Inventory and Prototypes of the Quality of life) and the dissimilarity of perception among caregivers. The nationality and the type of RD were not relevant. With respect to the educational Quality of Life, the meta-sample consisted of k = 19 samples, with 699 minors (mean age = 10.3 years), of whom 266 (38%) were girls, 242 (34.6%) were boys and 191 (27.4%) did not report their sex. The effect size was large (mean size = 7.15; p < 0.000; 99% CI; lower limit = 6.35; upper limit = 7.94). The meta-regression and comparison of models showed that the type of RD was essential. The measurement instrument was a moderating variable, especially the Parent version Paediatric Quality-of-Life Inventory. This study reveals the need for further research on RDs and their social−educational effects.

Socio-historical analysis of the social importance of pharmacovigilance.

Pharmacovigilance is a scientific discipline that has changed a lot in recent years and is of great social importance. The case of the so-called sulfonamide elixir showed society the importance of this discipline. Since then, pharmacovigilance has evolved into a scientific discipline with a strong social character. In this paper, a historical review is made of several paradigmatic examples of this discipline to reflect on what pharmacovigilance could be like finally. We conclude that this discipline could be more closely related to other areas of the social sciences, which would help to promote a more democratic social environment taking into account the needs of individuals and social groups.

Investigación cualitativa sobre el impacto del confinamiento estricto en las entidades del tercer sector españolas relacionadas con las enfermedades raras / Qualitative research about the impact of strict enclosure in entities of the Spanish third sector related to rare diseases

Resumen A raíz de la pandemia producida por el impacto del nuevo coronavirus, se adoptaron medidas de confinamiento estricto en España desde el 15 de marzo de 2020. Las medidas afectaron, entre otros sistemas, a la actividad y gestión de las entidades del tercer sector dedicadas a la atención a las personas con enfermedades raras. En este estudio se trató de conocer este impacto, mediante el uso de metodología cualitativa y el software MAXQDA a partir de una muestra de 81 entidades participantes en el estudio. Del análisis de la información obtenida se pudo extraer que el confinamiento no ha supuesto un impacto homogéneo en la gestión de las entidades. Destaca la reducción de sus actividades de visibilidad con el consiguiente impacto social y psicoafectivo. Ello pone de manifiesto una debilidad estructural previa que con esta situación se ha visto agravada. Este estudio también profundiza en los ajustes que estas entidades han realizado para poder seguir prestando sus servicios de apoyo, así como el impacto que ha tenido en sus escasas plantillas y equipos directivos.

Abstract As a result of the pandemic caused by the impact of the SAR-Cov-2 orthocoranavirus, strict containment measures were adopted in Spain from March 15, 2020. These measures affected, among other systems, the activity and management of third sector entities dedicated to the care of people with rare diseases. In this study we tried to know this impact, using qualitative methodology and MAXQDA software from a sample of 81 entities participating in the study. From the analysis of the information obtained, it was possible to draw the conclusion that confinement has not had a homogeneous impact on the management of the organizations. The reduction of their visibility activities stands out, with the consequent social and psycho-affective impact. This highlights a previous structural weakness that has been aggravated by this situation. The study also delves into the adjustments that these entities have made in order to be able to continue providing their support services, as well as the impact this has had on their scarce staff and management teams.

Biosociological ethodiversity in the social system.

A comprehensive understanding of human sociality needs to embrace the coevolution of genes and culture. Recent advances in biological research about niche construction by organisms, and the development of the concepts of social niche and ethodiversity, can be integrated into a common approach to understand this coevolution, which implies the interaction between sociology and ecology in an integrative framework of knowledge. In this paper the authors propose such inclusive biosociological and heuristic framework to improve the understanding of the evolution of social niche construction. In addition, it allows a better understanding of the concept of sociotype in non-human organisms and explains some aspects of the social or presocial behavior through the concept of ethodiversity.

Biosemiotics comprehension of PrP code and prion disease.

Prions or PrPSc (prion protein, Scrapie isoform) are proteins with an aberrant three-dimensional conformation that present the ability to alter the three-dimensional structure of natively folded PrPC (prion protein, cellular isoform) inducing its abnormal folding, giving raise to neurological diseases known as Transmissible spongiforms encephalopathies (TSEs) or prion diseases. In this work, through a biosemiotic study, we will analyze the molecular code of meanings that are known in the molecular pathway of PrPC and how it is altered in prion diseases. This biosemiotic code presents a socio-semiotic correlate in organisms that could be unraveled with the ultimate goal of understanding the code of signs that mediates the process. Finally, we will study recent works that indicate possible relationships in the code between prion proteins and other proteins such as the tau protein and alpha-synuclein to evaluate if it is possible that there is a semiotic expansion of the PrP code and prion diseases in the meaning recently expounded by Prusiner, winner of the Nobel Prize for describing these unusual pathological processes.