Humanistic burden of haemophilia A without inhibitors: A cross-sectional analysis of the HemoLIFE study.

AIM: To evaluate the impact of haemophilia A without inhibitors on humanistic outcomes in patients and caregivers. Herein, we report a cross-sectional analysis of the baseline data of persons with haemophilia (PWH) participating in the prospective study HEMOLIFE. METHODS: These data are part of a prospective, observational, and multicentre study currently being conducted in 20 hospitals in Spain by haematologists. We included subjects 12 years or older diagnosed with haemophilia. The evaluations included the Maladjustment Scale, Haemophilia-Specific Quality of Life Questionnaire for Adults (HaemoQol)/HaemoQol Short Form (Children), haemophilia-specific version of the Work Productivity and Impairment Questionnaire plus the Classroom Impairment Questionnaire (WPAI+CIQ:HS), Haemophilia Activity List (HAL)/Paediatric Haemophilia Activities List (pedHAL), visual analogue scale (VAS) for evaluating pain, Coping Pain Questionnaire-Reduced (CAD-R), and Hospital Anxiety and Depression Scale (HADS). RESULTS: A total of 81 PWH were recruited at 18 centres; 66 PWH were ≥18 years (i.e., adults), and PWH 15 were <18 years (i.e., paediatric patients). Out of the 79 evaluable subjects, 16 (20%) showed an impact of haemophilia on daily life, and the areas most affected were "leisure time" (58% showed maladjustment) and "work/studies" (47% showed maladjustment). Patients reported a higher impact of haemophilia on quality of life (mean [SD] of the transformed score) in the dimensions of "sport" (49.4 [28.6]), "physical health" (40.5 [25.8]) and "future" (37.7 [28.9]). In adults, according to HAL scores, greater impairment of function was observed in "lying/sitting/kneeling/standing," "function of legs" and "leisure activities and sports," with mean normalized scores of 64.7, 65.1 and 69.0, respectively. Productivity was mostly impacted by presenteeism. The pain was infrequent and moderate. According to the HADS scores, nine (11.5%) patients had clinical anxiety and depression. CONCLUSION: PWH without inhibitors exhibited impairments in adjustment, quality of life and functionality, especially related to leisure and sports activities, and exhibit relevant levels of anxiety and depression.

Anticoagulation and Antiplatelet Regimen in Cardiac Transplant. Clinical Characteristics, Outcomes, and Blood Product Transfusion.

BACKGROUND: We aimed to evaluate the characteristics, clinical outcomes, and blood product transfusion (BPT) rates of patients undergoing cardiac transplant (CT) while receiving uninterrupted anticoagulation and antiplatelet therapy. METHODS: A retrospective, single-center, and observational study of adult patients who underwent CT was performed. Patients were classified into four groups: (1) patients without anticoagulation or antiplatelet therapy (control), (2) patients on antiplatelet therapy (AP), (3) patients on vitamin K antagonists (AVKs), and (4) patients on dabigatran (dabigatran). The primary endpoints were reoperation due to bleeding and perioperative BPT rates (packed red blood cells (PRBC), fresh frozen plasma, platelets). Secondary outcomes assessed included morbidity and mortality-related events. RESULTS: Of the 55 patients included, 6 (11%) received no therapy (control), 8 (15%) received antiplatelet therapy, 15 (27%) were on AVKs, and 26 (47%) were on dabigatran. There were no significant differences in the need for reoperation or other secondary morbidity-associated events. During surgery patients on dabigatran showed lower transfusion rates of PRBC (control 100%, AP 100%, AVKs 73%, dabigatran 50%, p = 0.011) and platelets (control 100%, AP 100%, AVKs 100%, dabigatran 69%, p = 0.019). The total intraoperative number of BPT was also the lowest in the dabigatran group (control 5.5 units, AP 5 units, AVKs 6 units, dabigatran 3 units; p = 0.038); receiving significantly less PRBC (control 2.5 units, AP 3 units, AVKs 2 units, dabigatran 0.5 units; p = 0.011). A Poisson multivariate analysis showed that only treatment on dabigatran reduces PRBC requirements during surgery, with an expected reduction of 64.5% (95% CI: 32.4%-81.4%). CONCLUSIONS: In patients listed for CT requiring anticoagulation due to nonvalvular atrial fibrillation, the use of dabigatran and its reversal with idarucizumab significantly reduces intraoperative BPT demand.

Evaluating barriers to reaching women with public health information in remote communities in Mali.

Telecommunications offers an alternative or supplement to community-based interventions as a means of extending healthcare services and improving health outcomes in remote settings but can fail to reach target communities and achieve the desired impact if barriers to access are not overcome. We conducted seven focus group discussions and 26 interviews with community health workers, community leaders, and female members of the public who declared that they had or had not previously accessed free audio health messages provided via a mobile platform in two rural communities of Mali, Koulikoro and Bougouni. A content analysis showed that participants accessed and trusted health information from a range of sources, including radio, telephone and television, as well as town criers, local relays and community health centres. Barriers to access faced by women included economic factors, lack of network or electricity, and social factors such as illiteracy, cultural restrictions and being unaware of mobile communication. Through analysis and interpretation of the participants' responses, we have made recommendations for future campaigns for the dissemination of health-related information for women in remote settings.

A review of Musca sorbens (Diptera: Muscidae) and Musca domestica behavior and responses to chemical and visual cues.

Musca flies (Diptera: Muscidae) have been found culpable in the mechanical transmission of several infectious agents, including viruses, bacteria, protozoans, and helminths, particularly in low-income settings in tropical regions. In large numbers, these flies can negatively impact the health of communities and their livestock through the transmission of pathogens. In some parts of the world, Musca sorbens is of particular importance because it has been linked with the transmission of trachoma, a leading cause of preventable and irreversible blindness or visual impairment caused by Chlamydia trachomatis, but the contribution these flies make to trachoma transmission has not been quantified and even less is known for other pathogens. Current tools for control and monitoring of house flies remain fairly rudimentary and have focused on the use of environmental management, insecticides, traps, and sticky papers. Given that the behaviors of flies are triggered by chemical cues from their environment, monitoring approaches may be improved by focusing on those activities that are associated with nuisance behaviors or with potential pathogen transmission, and there are opportunities to improve fly control by exploiting behaviors toward semiochemicals that act as attractants or repellents. We review current knowledge on the odor and visual cues that affect the behavior of M. sorbens and Musca domestica, with the aim of better understanding how these can be exploited to support disease monitoring and guide the development of more effective control strategies.

Un modelo explicativo de resiliencia en jovenes y adolescentes / An explanatory model of resilience in youth and adolescents / Um modelo explicativo de resiliência em jovens e adolescentes

La resiliencia ha sido definida como la capacidad para superar y salir fortalecido de las adversidades. Esta capacidad es evolutiva y es influenciada por factores protectivos, tanto personales como ambientales. Si bien muchos de estos factores han sido identificados, poco se sabe acerca de las complejas interacciones entre ellos y la forma que contribuyen al desarrollo de la resiliencia. Con base en la evidencia científica más reciente, el objetivo del presente trabajo fue desarrollar un modelo explicativo de la resiliencia en jóvenes y adolescentes. Cada variable introducida en el modelo asienta sus bases en la evidencia teórica o empírica publicada. Por la naturaleza de las variables incluidas (optimismo, sentido del humor, emociones positivas, bienestar, inteligencia emocional), el modelo propuesto se enmarca dentro de los lineamientos de la Psicología Positiva. Se ofrecen sugerencias teóricas, metodológicas y epistemológicas para poner a prueba el modelo...

Resilience has been defined as the ability to overcome and emerge stronger from adversity. This capability is evolutionary and is influenced by protective factors, both personal and environmental. Although many of these factors have been identified, little is known about the complex interactions between them and the way that they contribute to the development of resilience. Based on the latest scientific evidence, the objective of this work was to develop an explanatory model of resilience in youth and adolescents. Each variable introduced in the model is rooted in theoretical or empirical evidence published. By the nature of the variables included (optimism, sense of humor, positive emotions, well-being, emotional intelligence), the proposed model fits within the guidelines of Positive Psychology. Theoretical, methodological, and epistemological suggestions are offered to test the model.

Tem-se definido resiliência como a capacidade de superar as adversidades e sair delas mais fortalecido. Esta capacidade é evolutiva e é influenciada por fatores de proteção tanto pessoal como ambiental. Embora muitos desses fatores tenham sido identificados, pouco se sabe sobre as complexas interações entre eles e a maneira como contribuem para o desenvolvimento da resiliência. O bjetivo destes trabalho foi desenvolver, com base nos últimos dados científicos, um modelo explicativo da resiliência em jovens e adolescentes. Cada variável introduzida no modelo está enraizada na prova teórica ou empírica publicada. Pela natureza das variáveis incluídas (otimismo, senso de humor, emoções positivas, bem-estar e inteligência emocional), o modelo proposto enquadra-se nas diretrizes da Psicologia Positiva. Sugestões teóricas, metodológicas e epistemológicas são oferecidas para testar o modelo.

Resiliência e enfrentamento do estresse em adolescentes: efeitos mediadores dos valores culturais / Resiliencia y afrontamiento del estrés en adolescentes: efectos mediadores de los valores culturales / Resilience and coping with stress in adolescents: mediating effects of cultural values

Este estudo teve dois objetivos: a) analisar as relações entre resiliência e estratégias de enfrentamento do estresse e b) explorar o rol dos valores pessoais sobre tais relações. A investigação se deu por meio de uma amostra composta por 1 512 estudantes (484 argentinos, 363 brasileiros e 665 mexicanos), que preencheram uma seleção de instrumentos desenvolvidos para explorar resiliência, enfrentamento do estresse e valores pessoais. As análises de correlação mostraram relações significativas entre resiliência e estratégias positivas de enfrentamento do estresse. As análises de regressão mediada indicaram que tanto o individualismo horizontal como o coletivismo horizontal moderam as relações entre resiliência e enfretamento positivo. Tais resultados permitem concluir que o sentimento de igualdade (horizontalidade) entre os membros do grupo é o principal mediador entre o adolescente, as demandas do meio ambiente, seus recursos para enfrentá-las e o desenvolvimento da resiliência.

The aim of this study was twofold: a) to explore the relationships between resilience and coping strategies with stress; and b) to examine the role of personal values on such relationships. The research was conducted with a sample consisting of 1512 students (484 Argentines, 363 Brazilians, and 665 Mexicans) who filled a selection of recognized instruments developed to explore resilience, coping with stress and personal values. Correlation analysis showed significant relationships between resilience and positive coping strategies. Mediated regression analysis indicated that both, horizontal individualism and horizontal collectivism, are good mediators of the relationship between resilience and positive coping. These results strongly suggest that the sense of equality (horizontal) among members of the group is the main mediator between the adolescent, the demands of the environment, their resources to cope and develop resilience.

El objetivo del presente estudio fue doble: a) analizar las relaciones entre resiliencia y estrategias de afrontamiento del estrés, y b) explorar el rol de los valores personales sobre tales relaciones. La investigación se llevó a cabo con una muestra integrada por 1512 estudiantes (484 argentinos, 363 brasileros y 665 mexicanos), quienes completaron una selección de reconocidos instrumentos desarrollados para explorar resiliencia, afrontamiento del estrés y valores personales. Análisis de correlación mostraron significativas relaciones entre resiliencia y estrategias positivas de afrontamiento. Análisis de regresión mediada indicaron que tanto el Individualismo Horizontal, como el Colectivismo Horizontal moderan las relaciones entre resiliencia y afrontamiento. Tales resultados permiten concluir que el sentimiento de igualdad (horizontalidad) entre los miembros del grupo es el principal mediador entre el adolescente, las demandas del medio ambiente, sus recursos para afrontarlas y el desarrollo de la resiliencia.

Predictores de satisfacción laboral en médicos y enfermeros / Predictors of job satisfaction among physicians and nurses

Os objetivos da presente investigação foram: (a) identificar estressores e estratégias de enfrentamento comumente empregadas por parte dos profissionais de saúde; (b) explorar as vinculações entre o estresse assistencial, o bem-estar e satisfação laboral; e (c) individualizar as variáveis explicativas da satisfação laboral assistencial. Foi realizada uma verificação empírica com uma amostra integrada por 196 profissionais argentinos (97 médicos e 99 enfermeiros). A amostra respondeu uma bateria desenvolvida para avaliar estressores, enfrentamento, bem-estar e satisfação laboral. Foram realizadas análises descritivas, correlacionais e de regressão múltipla. Os resultados obtidos indicaram que os estressores que mais afligem aos profissionais da saúde são a sobrecarga, a falta de apoio e a percepção de injustiça organizacional. Tanto a estratégia de resolução de problemas como a de distanciamento surgiram como potenciadoras de satisfação e bem-estar. As variáveis que melhor explicaram a satisfação laboral foram a intenção de permanecer no cargo, a quantidade de horas de trabalho semanal e o apoio do grupo familiar. São apresentadas sugestões para futuras investigações na área.

The objectives of this research were: (a) to identify the major stressors and the coping strategies commonly used by health professionals; (b) to explore the links among health care stressors, subjective wellbeing and job satisfaction; and (c) to individualize the explanatory variables of care job satisfaction. Empirical verification was conducted with a sample of 196 Argentinean professionals (97 doctors and 99 nurses). The sample answered a battery developed for assessing stress, coping, wellbeing, and work satisfaction. Data were subjected to descriptive, correlation, and multiple regression analysis. The results indicated that work overload, lack of support, and perceptions of organizational injustice are the main health care stressors. The employment of problem-solving and distancing coping emerged as the best strategies for enhancing job satisfaction and wellbeing. The perception of familiar support, more working hours, and the intention to stay were the variables that proved to be the best predictors of work satisfaction. Suggestions are made for future research in the area.

Validación del inventario de bienestar subjetivo con muestras de jóvenes y adolescentes argentinos, brasileros y mexicanos / Validation of a subjective well-being inventory with youth and adolescents Argentinean, Mexican, and Brazilian samples

El objetivo del estudio fue adaptar el inventario de bienestar subjetivo de Nacpal y Shell para su empleo con jóvenes y adolescentes latinoamericanos. Se efectuó la equivalencia conceptual, semántica y operacional de la versión prototípica del instrumento. La versión definitiva fue administrada a una muestra de 1,891 jóvenes y adolescentes (730 mexicanos, 664 argentinos y 497 brasileros), quienes además respondieron una selección de reconocidos instrumentos desarrollados para explorar resiliencia, afrontamiento del estrés, sentido del humor, inteligencia emocional y valores culturales. El análisis de la validez factorial mostró una estructura de 6 factores que explicaron casi el 59% de la varianza total. La validez de constructo quedó demostrada a partir de las positivas y significativas correlaciones entre el bienestar subjetivo y la mayoría de las variables medidas. La confiabilidad del instrumento adaptado alcanzó niveles satisfactorios. A la luz de los resultados obtenidos, se efectúan algunas sugerencias para futuras investigaciones en el área.

The aim of this study was to adapt the Well-Being Inventory of Nacpal & Shell for using with Latinamerican youth and adolescents. The conceptual, semantic and operational equivalence of inventory prototype version was analized. The final version was administered to a sample of 1,891 students (730 Mexicans, 664 Argentines and 497 Brazilians) who also filled a set of recognized instruments developed to explore resilience, coping, sense of humor, emotional intelligence and cultural values.The exploration of factorial validity showed six orthogonal factors which explained almost 59% of total variance. Construct validity was demostrated through positive and significant correlations between subjective well-being and most of the variables considered. Reliability of the adapted instrument reached satisfactory levels. In light of the results some suggestions for future research in the area are made.