Low muscle mass in COVID-19 critically-ill patients: Prognostic significance and surrogate markers for assessment.

INTRODUCTION: Low muscle mass is a common condition in the critically ill population and is associated with adverse clinical outcomes. The primary aim of this study was to analyze the prognostic significance of low muscle mass using computed tomography (CT) scans in COVID-19 critically ill patients. A second objective was to determine the accuracy and agreement in low muscle mass identification using diverse markers compared to CT as the gold standard. METHODS: This was a prospective cohort study of COVID-19 critically ill patients. Skeletal muscle area at the third lumbar vertebra was measured. Clinical outcomes (intensive care unit [ICU] and hospital length of stay [LOS], tracheostomy, days on mechanical ventilation [MV], and in-hospital mortality) were assessed. Phase angle, estimated fat-free mass index, calf circumference, and mid-upper arm circumference were measured as surrogate markers of muscle mass. RESULTS: Eighty-six patients were included (mean age ± SD: 48.6 ± 12.9; 74% males). Patients with low muscle mass (48%) had a higher rate of tracheostomy (50 vs 20%, p = 0.01), prolonged ICU (adjusted HR 0.53, 95%CI 0.30-0.92, p = 0.024) and hospital LOS (adjusted HR 0.50, 95% CI 0.29-0.86, p = 0.014). Bedside markers of muscle mass showed poor to fair agreement and accuracy compared to CT-assessed low muscle mass. CONCLUSION: Low muscle mass at admission was associated with prolonged length of ICU and hospital stays. Further studies are needed to establish targeted nutritional interventions to halt and correct the catabolic impact of COVID-19 in critically ill patients, based on standardized and reliable measurements of body composition.

Respuesta humoral inducida por la vacuna BBIBP-CorV/Sinopharm COVID-19 en trabajadores de primera línea / BBIBP-CorV/Sinopharm COVID-19 vaccine-induced humoral response in frontline workers

Con la llegada de la vacuna contra el COVID-19 se evidenció la disminución de casos de Infección por SARS-CoV-2. El objetivo del estudio fue cuantificar la producción de anticuerpos neutralizantes (An) e inmunoglobulina G (S-IgG) en trabajadores de primera línea inmunizados con dos dosis de la vacuna BBIBP-CorV/Sinopharma. Se realizó un estudio observacional analítico transversal en personal de salud inmunizado con la vacuna inactivada (BBIBP-CorV). Sus muestras sanguíneas se recogieron tres meses después de la segunda dosis, para medir las respuestas de anticuerpos (An, S-IgG). De un total de 172 personas evaluadas, 110 (64%) personas ya habían tenido COVID-19 antes de ingresar al estudio, los títulos de An fueron superiores a 10 AU/mL en el 60,5% de los vacunados y el 89,3% mostró S-IgG superior a 50 UA/mL. Los trabajadores mayores de 60 años fueron el grupo que no desarrolló suficientes anticuerpos. La correlación de An y S-IgG fue positiva (r=0,84) (p<0,001). La administración de dos dosis de la vacuna inactivada BBIBP-CorV/Sinopharma provocó una notable respuesta An y S-IgG, excepto en mayores de 60 años(AU)

With the arrival of the vaccine against COVID-19, the decrease in cases of SARS-CoV-2 infection was evidenced. The objective of the study was to quantify the production of neutralizing antibodies (An) and immunoglobulin G (S-IgG) in frontline workers immunized with two doses of the BBIBP-CorV/Sinopharma vaccine. A cross-sectional analytical observational study was carried out in health personnel immunized with the inactivated vaccine (BBIBP-CorV). Their blood samples were collected three months after the second dose, to measure antibody responses (An, S-IgG). Of a total of 172 people evaluated, 110 (64%) people already had COVID-19 before entering the study, An titers were greater than 10 AU/mL in 60.5% of those vaccinated and 89, 3% showed S-IgG greater than 50 AU/mL. Workers older than 60 years were the group that did not develop enough antibodies. The correlation of An and S-IgG was positive (r=0.84) (p<0.001). The administration of two doses of the inactivated BBIBP-CorV/Sinopharma vaccine caused a notable An and S-IgG response, except in those over 60 years of age(AU)

Cancer blues? A promising judgment bias task indicates pessimism in nude mice with tumors.

In humans, affective states can bias responses to ambiguous information: a phenomenon termed judgment bias (JB). Judgment biases have great potential for assessing affective states in animals, in both animal welfare and biomedical research. New animal JB tasks require construct validation, but for laboratory mice (Mus musculus), the most common research vertebrate, a valid JB task has proved elusive. Here (Experiment 1), we demonstrate construct validity for a novel mouse JB test: an olfactory Go/Go task in which subjects dig for high- or low-value food rewards. In C57BL/6 and Balb/c mice faced with ambiguous cues, latencies to dig were sensitive to high/low welfare housing: environmentally-enriched animals responded with relative 'optimism' through shorter latencies. Illustrating the versatility of this validated JB task across different fields of research, it further allowed us to test hypotheses about the mood-altering effects of cancer in male and female nude mice (Experiment 2). Males, although not females, treated ambiguous cues as intermediate; and males bearing subcutaneous lung adenocarcinomas also responded more pessimistically to these than did healthy controls. To our knowledge, this is the first evidence of a valid mouse JB task, and the first demonstration of pessimism in tumor-bearing animals. This task still needs to be refined to improve its sensitivity. However, it has great potential for investigating mouse welfare, the links between affective state and disease, depression-like states in animals, and hypotheses regarding the neurobiological mechanisms that underlie affect-mediated biases in judgment.

Knowledge of the Brain Death Concept in Dominican Immigration Residents in Spain and Florida.

The Latin American population has a double way of immigration, one toward the United States by proximity and another toward Spain by sociocultural affinity. This population increase is affecting organ donation and transplantation in receiving countries. OBJECTIVE: To analyze the brain death (BD) concept knowledge in the Dominican Republic immigrant population in Florida (United States) and Spain. METHOD: Population under study: Population born in the Dominican Republic, resident in Florida (United States) and in Spain. INCLUSION CRITERIA: Population older than 15 years stratified by age and sex. Assessment instrument: Donation attitude questionnaire PCID-DTO-Ríos. Fieldwork: Random selection based on stratification. Immigration support association collaboration in Florida and Spain was needed to locate potential respondents. Completion was anonymous and self-administered, with verbal consent. RESULTS: A total of 123 respondents, 57 residents in Spain and 66 in Florida, have been included in the study. The 27% (n = 33) of the respondents knowledgeable of the BD concept consider it the death of an individual. Of the remainder, 52% (n = 64) do not know about it, and the remaining 21% (n = 26) believe it does not mean the death of a patient. No differences were observed regarding migration countries (P > .05). There was no association of the BD concept with other psychosocial factors analyzed or with the attitude toward organ donation. CONCLUSIONS: Knowledge of the BD concept among the Dominican immigrant population is similar in Spain and Florida, and, unlike most studies, there is no objective association with the attitude toward organ donation.

Multivariate Analysis of Factors Affecting Attitude Toward Living Kidney Donation Among the Puerto Rican Population Resident in Florida.

Puerto Rican and Cuban populations are 2 of the most important migration groups in Florida. Awareness about organ donation among them is fundamental. It is important to determine the factors that influence attitudes toward organ donation. OBJECTIVE: To analyze the attitude toward living kidney donation (LKD) among Florida's Puerto Rican residents. METHODS: Study population: Population born in Puerto Rico resident in Florida (United States). INCLUSION CRITERIA: A sample of population older than 15 years was obtained randomly and stratified by age and sex. Instrument valuation: LKD attitude questionnaire Proyecto Colaborativo Internacional Donantesobre Donación de Vivo Renal, Rios. SETTING: for the study: Random selection based on stratification. Immigration support associations in Florida were needed to locate potential respondents. Anonymized and self-administered with verbal consent completion. RESULTS: Of the 259 respondents, 55% (n = 143) are in favor of related LKD (family or friends). The following factors were associated with this attitude: marital status (P = .008); educational level (P < .001); personal experience with organ donation and transplantation (P < .001); attitude toward deceased organ donation (P < .001); realization of prosocial activities (P = .02); family comments about organ donation (P < .001) and comments within couples (P < .001); not being concerned about possible mutilation of the body after donation (P < .001); believing that one's own religion was in favor of donation and transplantation (P < .001); economic incentives of donation (P < .001), and evaluation of the risk from living kidney donation (P < .001). In the multivariate analysis, only marital status is featured as an independent variable (odds ratio, 32.258; P < .001). CONCLUSIONS: The attitude toward related LKD among the Puerto Rican population who resides in Florida is not very favorable; only 55% would do it.

Attitude Toward Organ Donation in the Population of Cienfuegos, Cuba.

INTRODUCTION: The sensitization of the population toward organ donation is fundamental; for that reason, it is important to determine the factors that condition the opinion toward donation on the population scope in order to carry out cost-effective campaigns. OBJECTIVE: To analyze the attitude toward the donation of the proper organs for transplantation among the population residing in Cienfuegos, Cuba. METHOD: Population under study: Population who reside in Cienfuegos, Cuba. INCLUSION CRITERIA: Population over 15 years old as stratified by age and sex. Assessment instrument: The attitude questionnaire for organ donation for transplant-PCID-DTO Ríos. Fieldwork: A random selection based on stratification. The available data from the census were used. The completion was anonymous and self-administered. Verbal consent was requested to collaborate in the study. STATISTICS: Student t test, χ2, Fisher, and a logistic regression analysis. RESULTS: A sample of 636 respondents was included in the study, of which 71% (n = 453) are in favor of donating their organs after death, 16% (n = 103) are against, and 13% (n = 80) are undecided. This attitude is associated with different psychosocial variables (P < .001): age, marital status, having offspring, level of studies, carrying out prosocial activities, discussing with the family the subject of donation and transplantation, knowledge of the concept of brain death, the attitude toward the manipulation of the corpse, the religion of the respondent, and the attitude of the couple toward organ transplantation. The main independent factors obtained in the multivariate analysis (odds ratio >2.5): knowledge of the brain death concept, attitude toward the manipulation of the corpse, religion, and attitude of the couple toward transplantation. CONCLUSIONS: The attitude toward organ donation among the population of Cienfuegos, Cuba, is favorable and is conditioned by several psychosocial factors.

There Is Great Ignorance About the Brain Death Concept Among the Population in Santiago de Cuba (Cuba).

INTRODUCTION: The knowledge of the brain death (BD) concept is important when determining the attitude toward organ donation. OBJECTIVE: To analyze the level of knowledge of the BD concept among the population in Santiago de Cuba and determine the factors that condition it. METHODS: From the Collaborative International Donor Project, we obtained a sample of Cubans living in the area of Santiago de Cuba (n = 455). The attitude was assessed using a validated questionnaire (PCID-DTO-RIOS). The survey was self-administered and completed anonymously. Student t test, χ2, Fisher, and logistic regression analysis were used. RESULTS: Forty percent (n = 180) of the respondents know the BD concept and consider it as the death of an individual. Of the rest, 43% (n = 199) do not know about it, and the remaining 17% (n = 76) consider that it does not mean the death of a patient. The variables significantly related to the correct knowledge of BD in the multivariate analysis and considered as independent are: level of studies; the opinion of the couple toward organ donation; the religion of the respondent; having offspring; and a favorable attitude toward organ donation. CONCLUSION: There is ignorance about the brain death concept among the population of Santiago de Cuba. This lack of knowledge has a direct relationship with various psychosocial factors.

Multivariate Analysis of the Factors Affecting Attitude Toward Organ Donation Among the Ecuadorian Population Residing in Spain.

INTRODUCTION: Immigrants from Ecuador represent the largest group of Latin Americans in Spain and are, therefore, a subgroup of interest to understand their attitudes and influences in respect to organ donation and transplantation. OBJECTIVE: To analyze the attitude of nationals of Ecuador residing in Spain regarding deceased organ donation. METHODS: The study population included the Ecuadorian population residing in Spain. A sample of population older than 15 years was obtained randomly and stratified by age and sex (n=461). Attitude was assessed using a validated questionnaire on psychosocial aspects toward organ donation (PCID-DTO-Ríos). Assistance from immigration support associations in Spain was needed to advice on the location of potential respondents. RESULTS: Attitude toward cadaveric donation was favorable in 59% (n=271) of respondents, 12% (n=57) were against cadaveric donation, and 29% (n=133) were undecided. Several variables were associated with having a more favorable attitude. In the multivariate analysis, the following variables were independently associated with a more positive attitude toward organ donation: 1. level of formal education (odds ratio [OR]=6.849 [25.641-1.818]; P = .004); 2. being in favor of donating a family member's organs (OR=8.849 [20.833-3.717]; P < .001); 3. having commented at a family level about transplant (OR=3.717 [6.578-2.109]; P < .001); 4. not being concerned about the possible mutilation of the body after donation (OR=4.608 [8.547-2.487]; P < .001) and 5. knowing the attitude of one's religion toward donation (OR=7.462 [34.482-1.623]; P = .010). CONCLUSIONS: The attitude toward cadaveric organ donation among the Ecuadorian population residing in Spain is less favorable than that of the Spanish population and is determined by many different psychosocial variables.

Knowledge of the Concept of Brain Death: Is This an Obstacle in the Acceptance of Donation and Transplantation of Organs Among the Bolivian Population Residing in Spain?

INTRODUCTION: The Bolivian population is growing in Spain. The knowledge and acceptance of the concept of brain death are fundamental. OBJECTIVE: To analyze the level of understanding of the brain death concept among the population of Bolivians residing in Spain. METHODS: The study population was Bolivians living in Spain. The inclusion criteria were being older than 15 years, being born in Bolivia, and residing in Spain; participants were selected randomly from this group and stratified by age and sex. Knowledge of the concept of brain death was assessed using a validated questionnaire on psychosocial aspects toward organ donation. A group of people to be surveyed was randomly selected. Assistance from immigration support associations in Spain was needed to advise on the location of potential respondents. The survey was self-administered and completed anonymously. RESULTS: Of the 206 respondents, 27% understood brain death (BD) and believed that this was the death of an individual. Of the rest, 18% did not understand it and the remaining 55% believed it did not mean the death of a patient. Those who understood the concept of BD were more in favor of deceased donation than those who did not (52% vs 47%; P = .886). None of the sociopersonal variables analyzed is associated with knowledge of the concept of BD. A high percentage of respondents indicated fear of apparent death during organ donation. CONCLUSIONS: The majority of the Bolivian population residing in Spain does not understand the concept of BD. Contrary to most psychosocial studies, it is not associated with attitudes toward organ donation or other sociopersonal factors.

Attitude of the Citizens of Havana, Cuba, Toward Organ Donation: A Multivariate Analysis of the Psychosocial Factors Affecting Attitude.

INTRODUCTION: Because personal decisions affect the availability of organs for transplants, awareness about organ donations among the general population is fundamental. OBJECTIVE: To analyze attitudes toward organ donation among the citizens of Havana, Cuba. METHODS: The sample population was the residents of the city of Havana, Cuba. The inclusion criterion was being older than 15 years; the sample was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects of organ donation and transplant (PCID-DTO-Ríos). A random selection of people to be surveyed was carried out. RESULTS: A sample of 920 respondents was included in the study. Attitude toward cadaveric donation was favorable in 68% of respondents, while 14% were against and 18% were undecided. Several variables were associated with having a more favorable attitude. In the multivariate analysis, the following variables continue to feature as independent variables (P < .05): 1. level of studies; 2. knowledge of the concept of brain death; 3. attitude toward organ donation of a relative; 4. having discussed the issue of organ donation and transplantation with one's family; 5. the attitude of the couple toward organ donation and transplantation; 6. the religion of the respondent; 7. knowing the opinion of one's religion toward organ transplantation; 8. fear of manipulation of the body after death; and 9. acceptance of burial as a treatment of the body after the death. CONCLUSIONS: The attitude toward cadaveric organ donation among the residents of Havana is favorable and similar to that of the citizens of Spain. Improving the organ procurement system will increase donation rates given the population's awareness of the issue.

Psychosocial Factors Affecting Attitude Toward Organ Donation in Santiago, Cuba.

INTRODUCTION: Awareness about organ donation among the general population is fundamental to organ donation programs. It is important to determine the factors that influence attitudes toward organ donation within the general population in order to carry out cost-effective campaigns. OBJECTIVE: To analyze the attitude toward organ donation among Santiago, Cuba, citizens. METHODS: The study population encompassed residents in Santiago, Cuba. A sample population of residents older than 15 years was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects toward organ donation and transplant (PCID-DTO Ríos). Available census data were used. The survey was self-administered and completed anonymously. RESULTS: Of the 455 respondents, 70% of respondents are in favour of cadaveric donation, 16% are against, and 14% were undecided. Several variables were associated with having a more favorable attitude. And in the multivariate analysis, the following variables continue to feature as independent variables: 1. knowledge of the concept of brain death [OR = 2.386 (4.761-1.194); P = .014]; 2. being in favor of donating a family member's organs [OR = 3.067 (5.952-1.584); P = .001]; 3. a partner's favorable attitude [OR = 5.795 (1.477-22.731); P = .012]; 4. being an atheist/agnostic as the religious beliefs [OR = 1.845 (3.289-1.038); P = .037]; 5. not being concerned about the possible mutilation of the body after donation [OR = 7.437 (2.918-18.955); P < .001]; 6. not accepting other treatment options after death, such as inhumation [OR = 3.048 (5.714-1.626); P = .001]. CONCLUSIONS: The attitude toward cadaveric organ donation among the Santiago, Cuba population is favorable and it is associated with several psychosocial factors.

Are Dominicans in Favor of Xenotransplantation? A Study of the Attitude of Dominican Immigrants Residing in Spain and the United States.

Xenotransplantation carries many social and cultural implications. The immigrant population in countries with xenotransplantation programs, such as Spain and the United States, will play an important role in accepting such therapy. The objective of the study is to analyze the attitude toward xenotransplantation among the Dominican population residing in the United States and Spain. METHODS: The study population was born in the Dominican Republic and resides in the southeastern United States and Spain. A sample population older than 15 years was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects toward xenotransplantation (PCID-XENOTx-Ríos). A random selection of people to be surveyed was carried out. Assistance from immigration support associations was needed to advise on the location of potential respondents. RESULTS: A total of 123 respondents were included in the study: A sample was taken of residents of the population from the Dominican Republic residing in Florida, United States (n = 66), and in Spain (n = 57). If it was assumed that xenotransplanted organs functioned as well as human ones, 30% would be in favor. If the results were worse, only 7% would be in favor. This favorable attitude was related to the following variables (P < .05): level of education, an attitude in favor of deceased and living organ donation, and having spoken about donation and transplantation within the family. CONCLUSIONS: The attitude toward xenotransplantation among the population from the Dominican Republic who are residing in the southeastern United States and Spain is unfavorable.

Level of Acceptance of Solid Organ and Tissue Xenotransplantation Among the Bolivian Population Residing in Spain.

The Bolivian population is growing in Spain. Xenotransplantation of organs and/or tissues carries many social and cultural implications. It is important to find out the level of acceptance of xenotransplantation in immigrant populations, especially in populations where there are preclinical trials. The objective of the study is to analyze the attitude toward xenotransplantation of organs and tissues in the Bolivian population residing in Spain and the variables that influence their attitude. METHODS: We selected a sample of the Bolivian population living in Spain. A sample of the population older than 15 years was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects toward xenotransplantation (PCID-XENOTX-Ríos). RESULTS: Of the 206 respondents, 26% of respondents are in favor of xenotransplantation of organs if it was assumed that xenotransplanted organs functioned as well as human ones. If the results were worse, only 6% would be in favor. The following factors were associated with this attitude: (1) level of education (P = .008), (2) a favorable attitude toward human donation (P = .004), (3) a partner's favorable attitude toward transplantation (P < .001), and (4) a belief that one might need a transplant in the future (P = .01). The following were associated with attitude in the multivariate analysis: (1) having secondary education (odds ratio, 3.690; P = .004) and (2) a partner's favorable attitude toward transplantation (odds ratio, 6.024; P = .003). CONCLUSIONS: The attitude of Bolivian residents in Spain toward xenotransplantation is negative and is determined by educational and family factors.

Emigration From Puerto Rico to Florida: Multivariate Analysis of Factors That Condition Attitudes of the Puerto Rican Population Toward Organ Donation for Transplant.

BACKGROUND: The Puerto Rican population represents one of the largest immigration groups in Florida, and this has an impact on the organ transplant donation process. Our aim was to analyze attitudes toward organ donation among Puerto Ricans who currently reside in the state of Florida (USA). METHODS: The population screened consisted of individuals >15 years old, who were born in Puerto Rico, living in Florida, and awaiting organs for transplant. All participants completed the "PCID-DTO Rios" questionnaire. Random selection was done according to stratification. Support from immigration associations in Spain was needed for advice on the locations of potential respondents. Study participation was anonymized and self-administered. RESULTS: There were 259 respondents, 37% (n = 95) were in favor of donation, 36% (n = 93) were against donation, and 27% (n = 71) were undecided. The variables associated with these attitudes were: age (P = .017); civil status (P = .021); level of education (P < .001); previous experience with donation and transplant (P < .001); attitude toward organ donation of a relative (P < .001); carrying out pro-social activities (P < .001); discussing the issue of transplant with the family (P < .001) or couple (P < .001); attitude toward incineration (P < .001), burial (P < .001), and autopsy (P < .001); fear of mutilation after donation (P < .001); and religious beliefs (P < .001). In the multivariate study, it remained an independent variable to have discussed the issue at the family level (odds ratio = 11.627; P = .009). CONCLUSION: The Puerto Rican study population residing in Florida has an unfavorable attitude toward organ donation.

Differences in Attitudes Toward Living Kidney Donation Among Dominican Immigrants Living in Spain and the United States.

BACKGROUND: The Dominican population has a double-emigration pathway: one is to the USA, by proximity, and the other is to Spain, by sociocultural identification. Our aim was to determine attitudes toward living organ donation among Dominicans residing in Florida (USA) and Spain. METHODS: All study participants were at least 15 years old and living in either Florida (USA) or Spain, and stratified by gender and age. A questionnaire on attitudes toward living kidney donation ("PCID-LKD Ríos") was used. The support of immigrant associations in Florida and Spain was required to advise on survey locations. Data obtained were anonymized and self-administered. RESULTS: The study questionnaire was completed by 123 Dominicans, 68% of whom were in favor of living related kidney donation. There were differences (P = .004) according to the country of residence. Eighty-one percent of Spain's Dominican residents were in favor, compared with 56% of Florida's residents. Factors associated with attitude toward donation were level of education (P < .001), previous experience with organ donation (P = .006), attitude toward cadaveric organ donation (P < .001), belief in the possibility of needing a transplant in the future (P = .016), discussing the issue with one's family (P = .007), discussing the issue with husband/wife/partner (P = .002), carrying out pro-social activities (P = .029), religious beliefs (P = .001), and understanding the risk of living kidney donation (P = .046). CONCLUSION: Attitudes toward living kidney donation among immigrant Dominicans varies between Spain and the USA, with the former showing a more positive view.

Factors That Affect the Attitudes of the Bolivian Population in Spain With Regard to Organ Donation for Transplant.

BACKGROUND: The Bolivian population is an emerging Latin American immigrant group in Spain, several of whom have been transplanted or are awaiting transplant. We aimed to assess attitudes toward organ donation among Bolivians currently residing in Spain. METHOD: The population screened was born in Bolivia but living in Spain, stratified by gender and age. The appraisal tool used was a questionnaire that assesses attitudes toward organ donation for transplant ("PCID-DTO Ríos"). Support from immigration associations in Spain was needed for advice on locations of potential respondents. Survey participation was anonymized and the questionnaire was self-administered. Verbal consent was obtained before participation. RESULTS: There were 206 respondents: 49% (n = 101) in favor of donating their organs after death; 21% (n = 44) against donation; and 30% (n = 61) undecided. Their attitudes were found to be associated with level of education (P = .008), previous experience with donation and transplant (P = .011), concern regarding mutilation after donation (P = .002), knowing the attitude of their religion toward transplant (P = .001), the opinion of their partner (P < .001), and the possibility of needing a future transplant (P = .050). In the multivariate study, the main factor was having a partner in favor of organ donation (odds ratio = 16.129; P = .003). CONCLUSION: Attitudes toward organ donation among Bolivians residing in Spain are far more negative compared with rest of the Spanish population, due to various factors.

Knowledge of the Brain Death Concept Among the Population of Havana, Cuba.

BACKGROUND: One of the main reasons against organ donation is the fear of apparent death due to ignorance of the brain death concept. Our aim was to assess knowledge about and acceptance of the brain death concept among the population of Havana, Cuba. METHODS: The population screened, stratified by gender and age, included those >15 years old and living in Havana, Cuba. The appraisal tool utilized was a questionnaire on attitude toward organ donation ("PCID-DTO Ríos"). A random selection of individuals were surveyed according to the stratification. Cuba's census data were used. The participation was anonymized and self-administered. The verbal consent of participants was provided. RESULTS: There were 920 respondents: 31% (n = 282) knew the concept of brain death and accepted it; 57% (n = 529) did not; and 12% (n = 109) had a misperception, or did not accept brain death as a person's death. Those who knew and accepted the concept had a more favorable attitude toward their own organ donation after death (85% vs 61%; P < .001). The psychosocial factors related to the knowledge of brain death concept were: the gender (P = .002), to make up for speaking at a family level about the organ transplant (P < .001), the couple's opinion about the organ donation (P < .001) and the religion (P < .001). CONCLUSION: The brain death concept is not well understood in the population of Havana, Cuba.

Factors That Condition the Attitude Toward Living Related Kidney Donation Among Santiago of Cuba's Population.

INTRODUCTION: Living kidney donation is currently the most important kidney donor source in Latin America, and it is necessary to further increase its rates. OBJECTIVE: To analyze the attitude toward living kidney donation among the Santiago de Cuba's population and to determine the sociopersonal factors with which it is associated. METHOD: The population over 15 years old residing in Santiago de Cuba, stratified by sex and age, was screened. The "PCID-LKD Ríos" attitude questionnaire toward living kidney donation was administered to a random selection of the people surveyed according to the stratification and the census data. The completion was anonymized and self-administered. Verbal consent was obtained. RESULTS: The study was completed by 445 people, of whom the 86% (n = 389) were in favor of living related kidney donation. This attitude is associated with the level of education (P < .001); previous experience with organ donation (P = .006); attitude toward cadaveric organ donation (P < .001); carrying out of prosocial activities (P = .010); discussion of the issue with the family (P < .001) and the significant other (P < .001); concern about mutilation after donation (P = .001); religious beliefs (P = .001); and assessment of the risk of living kidney donation (P < .001). In the multivariate study, the following variables persisted: (1) level of education; (2) attitude of cadaveric donation; (3) carrying out of prosocial activities; and (4) risk assessment of living donation. CONCLUSIONS: Living related donation is very well accepted among the Santiago de Cuba's population.

Does the Attitude Toward Organ Donation Change as a Function of the Country Where People Emigrate? Study Between Uruguayan Emigrants to the United States and Spain.

INTRODUCTION: The Uruguayan population is sensitized toward transplantation. However, it has not been studied how this awareness can change when emigrating to different countries. OBJECTIVE: To analyze the attitude toward cadaveric organ donation and living organ donation between the Uruguayan population residing in Florida (United States) and the Uruguayan population residing in Spain. METHOD: Adults born in Uruguay and residing in Florida and Spain were screened. The questionnaire "PCID-DTO Ríos" (donation of cadaveric organs) and "PCID-DVR Ríos" (living renal donation) were used. Subjects were randomly selected according to age and gender stratification. Support from Latin-American immigration associations in Spain and Florida was needed. The survey was anonymized and self-administered. Verbal consent was obtained to collaborate in the study. RESULTS: Because the emigrant population to Spain is far larger than the emigrant population to the United States, a 2:1 proportional sampling was performed (n = 132). Sixty-seven percent of residents in Spain were in favor of organ donation at the time of death compared with 50% among residents in Florida (P = .082), and 100% of residents in Spain were in favor of living renal donation compared with 50% of those living in Florida (P < .001). CONCLUSIONS: The attitude toward donation is more favorable among Uruguayan emigrants to Spain than emigrants to the United States, especially in related kidney donation.

Multivariate Analysis of Factors That Influence the Attitude of the Ecuadorian Population Resident in Spain Toward Living-Related Kidney Donation.

BACKGROUND: The Ecuadorian population is the largest Latin-American immigrant group in Spain. Currently, several Ecuadorians have received transplants or are awaiting transplants in Spain. The aim of this work was to analyze the attitude toward living kidney donation among the Ecuadorian population residing in Spain. METHODS: The population screened were born in Ecuador, residing in Spain, and >15 years old, stratified by gender and age, and appraised with the use of the questionnaire on attitude toward organ donation for transplantation "PCID-DVR-Ríos." Support from immigration associations in Spain was used to advise on the location of potential respondents. The completion was anonymous and self-administered. Verbal consent was obtained. Statistics included Student t test, χ2, Fisher exact test, and logistic regression analysis. RESULTS: A total of 461 respondents were included: 80% (n = 367) were in favor of living-related kidney donation (for a relative or close friend). This attitude was associated with psychosocial variables that persisted in the multivariate study: 1) female gender (odds ratio [OR], 3.086; P = .001); 2) considering oneself a potential kidney receptor in the future (OR, 16.949; P = .002); 3) economic incentive in the donation (OR, 100; P = .004); and 4) knowing the attitude of their religion toward transplantation (OR, 32.258; P < .001). CONCLUSIONS: Living-related donation is accepted among the Ecuadorian population residing in Spain and is associated with sociopersonal and religious factors.