Retrospective analysis of immunosuppressive and anti-thrombotic protocols in nonassociative immune mediated hemolytic anemia in dogs.

BACKGROUND: Evidence supporting the effectiveness of therapeutic protocols for nonassociative immune-mediated hemolytic anemia (na-IMHA) is weak. HYPOTHESIS/OBJECTIVES: Investigate the efficacy of various drugs in na-IMHA. ANIMALS: Two hundred forty-two dogs. METHODS: Multi-institutional retrospective study (2015-2020). Immunosuppressive effectiveness was determined by time to packed cell volume (PCV) stabilization and duration of hospitalization through analysis by mixed model linear regression. Occurrence of disease relapse, death, and antithrombotic effectiveness, were analyzed using mixed model logistic regression. RESULTS: Use of corticosteroids vs a multi-agent protocol had no effect on time to PCV stabilization (P = .55), duration of hospitalization (P = .13), or case fatality (P = .06). A higher rate of relapse (P = .04; odds ratio: 3.97; 95% confidence interval [CI]: 1.06-14.8) was detected in dogs receiving corticosteroids (11.3%) during follow-up (median: 28.5 days, range: 0-1631 days) compared to multiple agents (3.1%) during follow up (median: 47.0 days, range: 0-1992 days). When comparing drug protocols, there was no effect on time to PCV stabilization (P = .31), relapse (P = .44), or case fatality (P = .08). Duration of hospitalization was longer, by 1.8 days (95% CI: 0.39-3.28 days), for the corticosteroid with mycophenolate mofetil group (P = .01) compared to corticosteroids alone. Use of clopidogrel vs multiple agents had no effect on development of thromboses (P ≥ .36). CONCLUSIONS AND CLINICAL IMPORTANCE: Addition of a second immunosuppressive agent did not alter immediate outcome measures but might be associated with a reduction in relapse. Use of multiple antithrombotic agents did not reduce incidence of thrombosis.

Happiness-To enjoy now or later? Consequences of delaying happiness and living in the moment beliefs.

How do people think about happiness? Is it something best enjoyed as an investment over time, or is it something fleeting that should be savored? When people view happiness as an investment, they may endorse delaying happiness (DH)-the belief that working hard and sacrificing opportunities for happiness now will contribute to greater future happiness. When people view happiness as fleeting, they may endorse living in the moment (LM)-the belief that one should seize proximal opportunities to experience happiness now, rather than later. Using a mix of cross-sectional, meta-analytic (Studies 1, 2a, 2b, 2c), experimental (Study 3), and daily diary methods (Study 4), people who endorsed DH or LM beliefs anticipated more positive affect upon goal attainment and experienced greater well-being, but only DH was related to more negative affect when pursuing nonfocal goals and less delay discounting of future rewards. Implications for self-regulation and emotion are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

An Examination of Whether Mindfulness Can Predict the Relationship Between Objective and Subjective Attitudinal Ambivalence.

Ambivalence is a mixed reaction toward an attitudinal object. Ambivalence is often viewed as aversive and people are motivated to reduce it. However, the presence of both strong positive and negative attitudes toward an object (objective ambivalence; OA) does not always lead to consciously experienced conflicted and torn feelings (subjective ambivalence; SA) or psychological discomfort. We hypothesized that the way people think about their inner experience can affect whether ambivalent attitudes lead to increased conflicted feelings. In five studies, we examined whether mindfulness predicts the relationship between objective and subjective ambivalence. We predicted that the acceptance aspect of mindfulness would attenuate the relationship between OA and SA, based on the idea that acceptance makes people more tolerant and less judgmental toward their inner states in general (and OA in particular). Although some findings across five studies were consistent with the prediction showing that acceptance attenuated the OA-SA relationship, other findings were not and even showed that acceptance strengthened the OA-SA relationship. A meta-analysis of the interaction effect across all studies failed to find support for predictions (r = -0.036 and 95% CI [-0.087; 0.022]). We discuss possible reasons for these mixed findings, and the implications of these studies.