The association of the persecutory ideation questionnaire with clinically-relevant and other outcomes: the moderating role of confidence.

One of the most used self-administered instruments to assess persecutory delusions is the Persecutory Ideation Questionnaire (PIQ). Individual differences in PIQ scores are important because they predict the severity of symptoms associated with psychosis-related disorders. The current research demonstrates that PIQ is associated with two new outcomes: Satisfaction with life (Studies 1 and 2) and therapy length needed for hospital discharge (Study 2). Most relevant, we introduce meta-cognitive confidence in one's scale responses as a construct capable of improving the predictive validity of the PIQ. Across two studies, participants from the general population (Study 1) and from a clinical sample (Study 2) completed the PIQ and then reported the confidence in their responses. As expected, the PIQ was associated with satisfaction with life in both cases and duration of therapy required to receive hospital discharge for the clinical sample. Most importantly, confidence further moderated the extent to which the PIQ scores were linked with both outcomes, with greater consistency between the PIQ and the dependent measures obtained for those with higher confidence. Therefore, asking a single item about the confidence associated with responses to the PIQ enhances the association of PIQ scores and relevant consequences across domains.

Predictors of bleeding and thrombotic events among patients admitted to the hospital with COVID-19 and elevated D-dimer: insights from the ACTION randomized clinical trial.

Therapeutic anticoagulation showed inconsistent results in hospitalized patients with COVID-19 and selection of the best patients to use this strategy still a challenge balancing the risk of thrombotic and hemorrhagic outcomes. The present post-hoc analysis of the ACTION trial evaluated the variables independently associated with both bleeding events (major bleeding or clinically relevant non-major bleeding) and the composite outcomes thrombotic events (venous thromboembolism, myocardial infarction, stroke, systemic embolism, or major adverse limb events). Variables were assessed one by one with independent logistic regressions and final models were chosen based on Akaike information criteria. The model for bleeding events showed an area under the curve of 0.63 (95% confidence interval [CI] 0.53 to 0.73), while the model for thrombotic events had an area under the curve of 0.72 (95% CI 0.65 to 0.79). Non-invasive respiratory support was associated with thrombotic but not bleeding events, while invasive ventilation was associated with both outcomes (Odds Ratio of 7.03 [95 CI% 1.95 to 25.18] for thrombotic and 3.14 [95% CI 1.11 to 8.84] for bleeding events). Beyond respiratory support, creatinine level (Odds Ratio [OR] 1.01 95% CI 1.00 to 1.02 for every 1.0 mg/dL) and history of coronary disease (OR 3.67; 95% CI 1.32 to 10.29) were also independently associated to the risk of thrombotic events. Non-invasive respiratory support, history of coronary disease, and creatinine level may help to identify hospitalized COVID-19 patients at higher risk of thrombotic complications.ClinicalTrials.gov: NCT04394377.

Effect of Obesity on Lung Function in the Pediatric and Adult Populations with Asthma: A Review.

Obesity and asthma are major global health concerns, particularly in industrialized nations. Obesity has been shown to have detrimental effects on the respiratory system and lung function owing to metabolic issues and immunological consequences. Research has indicated that obese patients with asthma (atopic or T2-high and non-atopic or T2-low) have diminished lung function in terms of functional residual capacity (FRC), residual volume (RV), expiratory reserve volume (ERV), the FEV1/FVC ratio, and FEF 25-75% due to mechanical fat loading on the diaphragm and central adiposity when compared to non-obese asthmatic patients. Therefore, it is plausible that changes in lung function are the result of a combination of mechanical (fat loading on the diaphragm, central adiposity, bronchial hyper-reactivity, and an increase in cholinergic tone), environmental (diet and exercise), and inflammatory factors (local and systemic), which can lead to the obesity-related asthma phenotype characterized by severe asthma symptoms, poor response to corticosteroid treatment, loss of lung function, and poor quality of life from an early age.

Positive Mental Health of Frontline Healthcare Professionals during COVID-19 First Wave and Second Wave in Spain: The Protective Role of Social Recognition.

BACKGROUND: The study of the COVID-19 disease consequences on healthcare professionals' mental health has drawn a great interest in psychology and other behavioral sciences. Previous studies mainly focused on professionals' health in terms of psychopathology, therefore, there is no research examining their positive mental health during both the first and the second wave. Also, there is no research studying healthcare professionals' social recognition during the pandemic and the influence of this variable on professionals' positive health. METHODS: Following the WHO's recommendations, our objective was to measure pathology (i.e., anxiety and traumatic intensity), positive health (i.e., Hedonic, Psychological and Social Well-being) and social recognition in a sample of 200 healthcare professionals in the frontline care of Covid-19 patients. RESULTS: In both waves, participants showed high levels of anxiety and traumatic intensity, although, as expected, in the second (vs. the first) wave psychopathological symptoms decreased. Concerning positive health indicators, in the second wave, health professionals showed more hedonic and psychological well-being than in the first one. However, in the second wave social well-being was lower than in the first wave, an expected though apparently paradoxical result, linked to the decrease in healthcare professionals' social recognition between the first and the second wave. In fact, bootstrapping procedures and Sobel Test confirm the mediating role of social recognition on the effect of Covid-19 wave on social well-being. CONCLUSIONS: Public institutions, governments, and society in general, should recognize health professionals' work, given that social recognition is a fundamental protection factor for social well-being.

Brief Version of the Ryff Psychological Well-Being Scales for Children and Adolescents: Evidence of Validity.

BACKGROUND: Well-being has become a core concept in the study of positive child health, however, previous instruments for well-being evaluation have been centered mainly on the hedonic component. Therefore, the objective of this study was to adapt the Psychological Well-being Scales for assessing eudaimonic well-being in children and adolescents using a single-item per dimension approach. METHOD: A total of 312 participants (52.9% girls; ages 10-18) from Spain completed the Psychological Well-Being Scales Short Form, the WHO-5 Well-Being Index, and their psychological well-being was evaluated via a semi-structured interview by a developmental psychologist who was an expert in positive psychology. RESULTS: Parallel analysis and exploratory factor analysis suggested a unidimensional structure that showed an excellent fit to the data. The new measure also demonstrated scalar invariance across gender and age. Moreover, the new scale significantly correlated with both WHO-5 and the expert´s ratings of psychological well-being, indicating adequate criterion validity. CONCLUSIONS: The Psychological Well-Being Scales Short Form is a useful, brief measuring instrument that reduces children cognitive fatigue during evaluation.

Brief Version of the Ryff Psychological Well-Being Scales for Childrenand Adolescents: Evidence of Validity / Versión Reducida de las Escalas de Bienestar Psicológico de Ryff ParaNiños y Adolescentes: Evidencias de Validez

Background: Well-being has become a core concept in the study of positivechild health, however, previous instruments for well-being evaluation havebeen centered mainly on the hedonic component. Therefore, the objectiveof this study was to adapt the Psychological Well-being Scales for assessingeudaimonic well-being in children and adolescents using a single-item perdimension approach. Method: A total of 312 participants (52.9% girls;ages 10-18) from Spain completed the Psychological Well-Being ScalesShort Form, the WHO-5 Well-Being Index, and their psychological well-being was evaluated via a semi-structured interview by a developmentalpsychologist who was an expert in positive psychology. Results: Parallelanalysis and exploratory factor analysis suggested a unidimensionalstructure that showed an excellent fit to the data. The new measure alsodemonstrated scalar invariance across gender and age. Moreover, thenew scale significantly correlated with both WHO-5 and the expert’sratings of psychological well-being, indicating adequate criterion validity.Conclusions: The Psychological Well-Being Scales Short Form is a useful,brief measuring instrument that reduces children cognitive fatigue duringevaluation.

Antecedentes: el bienestarse ha convertido en un concepto central para el estudio de la salud infantil,aunque los instrumentos previos para su evaluación se han centrado en sucomponente hedónico. Por ello, nuestro objetivo fue adaptar las Escalasde Bienestar Psicológico para su uso con niños y adolescentes utilizandoun enfoque de un único ítem por dimensión. Método: un total de 312participantes (52,9% mujeres; edades 10-18) españoles completaron lanueva versión reducida de las escalas de bienestar psicológico, el índicede bienestar de la OMS-5, y su bienestar fue evaluado mediante unaentrevista semiestructurada. Resultados: el análisis paralelo y el análisisfactorial exploratorio sugirieron una estructura unidimensional quemostró un ajuste excelente a los datos. Además, la nueva medida presentóinvariancia escalar para el género y la edad. La nueva escala correlacionósignificativamente con la escala de OMS-5, así como con la evaluacióndel experto externo sobre la satisfacción con la vida global, indicando unaadecuada validez de criterio. Conclusiones: la versión reducida de lasEscalas de Bienestar Psicológico para jóvenes ha mostrado unas excelentespropiedades psicométricas, siendo un instrumento de medición breve quereduce la fatiga cognitiva de los jóvenes durante la evaluación.

Anxiety, trauma and well-being in health-care professionals during COVID-19 first wave in Spain: the moderating role of personal protection equipment availability.

BACKGROUND: The effect of COVID-19 on Health-Care Professionals' mental health has received increased attention in the last year's literature. However, previous studies essentially evaluated psychopathological symptoms and not the presence of positive mental health. Therefore, the first objective of the present research is to evaluate health-care professionals' mental illness (i.e., anxiety and traumatic intensity) and positive mental health (i.e., well-being) using the Complete State Model of Health. Our second objective is to study the effect of Personal Protection Equipment availability on professionals' mental health. METHODS: Two-hundred and thirty-two health-care professionals working in Spain in the first line of COVID-19 patient care participated in the study. To measure anxiety, traumatic intensity and well-being participants completed the State Trait Anxiety Inventory, the Davidson Trauma Scale, and the Mental Health Continuum-Short Form. Pearson correlations were used to examine the relationships between all scales. In order to test the two continua model of mental health, we used parallel analysis and exploratory factor analysis. To analyze anxiety, traumatic intensity, and well-being differences between health-care professionals with and without Personal Protection Equipment availability we conducted different ANOVAS. To test our hypothesis regarding the moderating role of Personal Protection Equipment availability in the effect of mental illness on positive mental health, data were subjected to a hierarchical regression analysis. RESULTS: As in previous studies, health-care professionals showed high levels of anxiety and traumatic intensity. They also presented low levels of well-being indicators. According to our hypothesis, results of parallel analysis and exploratory factorial analysis indicated that the measures of mental illness and positive mental health loaded on separate but correlated factors. Finally, Personal Protection Equipment availability moderated the effects of state anxiety and traumatic intensity on professionals' well-being. CONCLUSIONS: Health-care professionals' mental illness and positive mental health reflect distinct continua, rather than the extreme ends of a single spectrum. Therefore, it is essential to measure both psychopathology and the presence of positive health to comprehensively evaluate professionals' mental health. Finally, our results indicated that Personal Protection Equipment availability is essential not only for professionals' physical health, but also for their mental health.

Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial.

BACKGROUND: COVID-19 is associated with a prothrombotic state leading to adverse clinical outcomes. Whether therapeutic anticoagulation improves outcomes in patients hospitalised with COVID-19 is unknown. We aimed to compare the efficacy and safety of therapeutic versus prophylactic anticoagulation in this population. METHODS: We did a pragmatic, open-label (with blinded adjudication), multicentre, randomised, controlled trial, at 31 sites in Brazil. Patients (aged ≥18 years) hospitalised with COVID-19 and elevated D-dimer concentration, and who had COVID-19 symptoms for up to 14 days before randomisation, were randomly assigned (1:1) to receive either therapeutic or prophylactic anticoagulation. Therapeutic anticoagulation was in-hospital oral rivaroxaban (20 mg or 15 mg daily) for stable patients, or initial subcutaneous enoxaparin (1 mg/kg twice per day) or intravenous unfractionated heparin (to achieve a 0·3-0·7 IU/mL anti-Xa concentration) for clinically unstable patients, followed by rivaroxaban to day 30. Prophylactic anticoagulation was standard in-hospital enoxaparin or unfractionated heparin. The primary efficacy outcome was a hierarchical analysis of time to death, duration of hospitalisation, or duration of supplemental oxygen to day 30, analysed with the win ratio method (a ratio >1 reflects a better outcome in the therapeutic anticoagulation group) in the intention-to-treat population. The primary safety outcome was major or clinically relevant non-major bleeding through 30 days. This study is registered with ClinicalTrials.gov (NCT04394377) and is completed. FINDINGS: From June 24, 2020, to Feb 26, 2021, 3331 patients were screened and 615 were randomly allocated (311 [50%] to the therapeutic anticoagulation group and 304 [50%] to the prophylactic anticoagulation group). 576 (94%) were clinically stable and 39 (6%) clinically unstable. One patient, in the therapeutic group, was lost to follow-up because of withdrawal of consent and was not included in the primary analysis. The primary efficacy outcome was not different between patients assigned therapeutic or prophylactic anticoagulation, with 28 899 (34·8%) wins in the therapeutic group and 34 288 (41·3%) in the prophylactic group (win ratio 0·86 [95% CI 0·59-1·22], p=0·40). Consistent results were seen in clinically stable and clinically unstable patients. The primary safety outcome of major or clinically relevant non-major bleeding occurred in 26 (8%) patients assigned therapeutic anticoagulation and seven (2%) assigned prophylactic anticoagulation (relative risk 3·64 [95% CI 1·61-8·27], p=0·0010). Allergic reaction to the study medication occurred in two (1%) patients in the therapeutic anticoagulation group and three (1%) in the prophylactic anticoagulation group. INTERPRETATION: In patients hospitalised with COVID-19 and elevated D-dimer concentration, in-hospital therapeutic anticoagulation with rivaroxaban or enoxaparin followed by rivaroxaban to day 30 did not improve clinical outcomes and increased bleeding compared with prophylactic anticoagulation. Therefore, use of therapeutic-dose rivaroxaban, and other direct oral anticoagulants, should be avoided in these patients in the absence of an evidence-based indication for oral anticoagulation. FUNDING: Coalition COVID-19 Brazil, Bayer SA.

Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial

BACKGROUND: COVID-19 is associated with a prothrombotic state leading to adverse clinical outcomes. Whether therapeutic anticoagulation improves outcomes in patients hospitalised with COVID-19 is unknown. We aimed to compare the efficacy and safety of therapeutic versus prophylactic anticoagulation in this population. METHODS: We did a pragmatic, open-label (with blinded adjudication), multicentre, randomised, controlled trial, at 31 sites in Brazil. Patients (aged ≥18 years) hospitalised with COVID-19 and elevated D-dimer concentration, and who had COVID-19 symptoms for up to 14 days before randomisation, were randomly assigned (1:1) to receive either therapeutic or prophylactic anticoagulation. Therapeutic anticoagulation was in-hospital oral rivaroxaban (20 mg or 15 mg daily) for stable patients, or initial subcutaneous enoxaparin (1 mg/kg twice per day) or intravenous unfractionated heparin (to achieve a 0·3­0·7 IU/mL anti-Xa concentration) for clinically unstable patients, followed by rivaroxaban to day 30. Prophylactic anticoagulation was standard in-hospital enoxaparin or unfractionated heparin. The primary efficacy outcome was a hierarchical analysis of time to death, duration of hospitalisation, or duration of supplemental oxygen to day 30, analysed with the win ratio method (a ratio >1 reflects a better outcome in the therapeutic anticoagulation group) in the intention-to-treat population. The primary safety outcome was major or clinically relevant non-major bleeding through 30 days. This study is registered with ClinicalTrials.gov (NCT04394377) and is completed. FINDINGS: From June 24, 2020, to Feb 26, 2021, 3331 patients were screened and 615 were randomly allocated (311 [50%] to the therapeutic anticoagulation group and 304 [50%] to the prophylactic anticoagulation group). 576 (94%) were clinically stable and 39 (6%) clinically unstable. One patient, in the therapeutic group, was lost to follow-up because of withdrawal of consent and was not included in the primary analysis. The primary efficacy outcome was not different between patients assigned therapeutic or prophylactic anticoagulation, with 28 899 (34·8%) wins in the therapeutic group and 34 288 (41·3%) in the prophylactic group (win ratio 0·86 [95% CI 0·59­1·22], p=0·40). Consistent results were seen in clinically stable and clinically unstable patients. The primary safety outcome of major or clinically relevant non-major bleeding occurred in 26 (8%) patients assigned therapeutic anticoagulation and seven (2%) assigned prophylactic anticoagulation (relative risk 3·64 [95% CI 1·61­8·27], p=0·0010). Allergic reaction to the study medication occurred in two (1%) patients in the therapeutic anticoagulation group and three (1%) in the prophylactic anticoagulation group. INTERPRETATION: In patients hospitalised with COVID-19 and elevated D-dimer concentration, in-hospital therapeutic anticoagulation with rivaroxaban or enoxaparin followed by rivaroxaban to day 30 did not improve clinical outcomes and increased bleeding compared with prophylactic anticoagulation. Therefore, use of therapeutic-dose rivaroxaban, and other direct oral anticoagulants, should be avoided in these patients in the absence of an evidence-based indication for oral anticoagulation.

Improvement of Andean Blueberries Postharvest Preservation Using Carvacrol/Alginate-Edible Coatings.

Edible coatings are attractive strategies for blueberries postharvest preservation. In this work, carvacrol/alginate coatings were developed for application on Andean blueberries. Coating formulations were prepared based on blends of sodium alginate (2% w/v), carvacrol (0%, 0.03%, 0.06% or 0.09%), glycerol, and water and applied to the fruits by dip-coating. Then, the fruits were immersed in a calcium batch to induce a crosslink reaction. Changes in the physicochemical and microbiological characteristics of the blueberries were monitored during 21 days of storage at 4 °C. Coated blueberries were better preserved throughout the 21 days of storage because of their lower respiration rate and water loss, in comparison with the uncoated ones. Besides, the coatings enhanced the appearance and the gloss of the fruits. Control fruits showed a significant decrease in the firmness, while, in the coated fruits, this critical postharvest quality was preserved during the entire storage. Coating formulations with 0.09% of carvacrol was the most effective in preventing mesophilic aerobic bacteria and molds/yeasts growth on the fruits during the storage. Edible carvacrol/alginate coatings can be considered as a useful alternative to complement the benefits of refrigerated storage by delaying post-harvest spoilage of Andean blueberries.

Factores asociados al desarrollo de hidrocefalia dependiente de derivación ventrículo peritoneal en pacientes operados de aneurismas cerebrales

RESUMEN Introducción: Diversos factores pueden estar asociados al desarrollo de hidrocefalia en pacientes operados de aneurismas cerebrales que luego son dependientes de derivación ventrículo peritoneal, pueden estar dados por obstrucción mecánica o inflamatoria con disminución de la absorción del líquido cefalorraquídeo (LCR). Objetivo: Determinar factores asociados al desarrollo de hidrocefalia dependiente de derivación ventrículo peritoneal en pacientes con aneurismas cerebrales que han recibido tratamiento quirúrgico para clipaje. Metodología: Estudio observacional, descriptivo, retrospectivo de corte transversal de expedientes clínicos de 171 pacientes operados de aneurismas cerebrales en el Hospital de Clínicas desde el año 2013 hasta febrero del 2020. Resultados: Se han analizado 171 casos operados de aneurismas cerebrales, la mayoría del sexo femenino (71%), con un rango de edad de 17-77 años (mediana 53 años). El 7,6 % desarrolló hidrocefalia con requerimiento de derivación ventrículo peritoneal. De estos pacientes el 61,5 % tuvieron antecedentes de craniectomía descompresiva (p< 0,001). El 84,6 % presentó vasoespasmo tanto clínico como radiológico (p < 0,001). Las localizaciones más frecuentes fueron en las arterias carótida interna y cerebral media con 38,9 % para ambos. La escala de Fisher IV fue la más frecuente con 76,9%, luego Fisher II con 15,3 % (p= 0,14). El 62,2 % fueron operados durante la fase aguda (p= 0,03). Conclusión: Se ha observado en este estudio factores con asociación estadísticamente significativas con el desarrollo de hidrocefalia como la presencia de vasoespasmo y los operados de craniectomía descompresiva los cuales están acordes a la literatura, respecto a la fase de la enfermedad en la que se realizó la cirugía, en este estudio se observó predominio en la fase aguda, en contraste a lo que se observa en varias fuentes bibliográficas.

ABSTRACT Introduction: Various factors may be associated with the development of hydrocephalus in patients operated on for cerebral aneurysms that are later dependent on peritoneal ventricular shunt, may be due to mechanical or inflammatory obstruction with decreased absorption of cerebrospinal fluid (CSF). Objective: To determine factors associated with the development of peritoneal ventricular shunt-dependent hydrocephalus in patients with cerebral aneurysms who have received surgical treatment for clipping. Methods: Observational, descriptive, retrospective cross-sectional study of clinical records of 171 patients operated on for cerebral aneurysms at the Hospital de Clínicas from 2013 to February 2020. Results: 171 cases operated on for cerebral aneurysms have been analyzed, most of the female sex (71%), with an age range of 17-77 years (median 53 years). 7.6 % developed hydrocephalus with a peritoneal ventricle shunt requirement. Of these patients, 61.5% had a history of decompressive craniectomy (p <0.001). 84.6% presented both clinical and radiological vasospasm (p <0.001). The most frequent locations were in the internal carotid and middle cerebral arteries with 38.9% for both. The Fisher IV scale was the most frequent with 76.9%, then Fisher II with 15.3% (p = 0.14). 62.2% underwent surgery during the acute phase (p = 0.03). Conclusion: Factors with a statistically significant association with the development of hydrocephalus have been observed in this study, such as the presence of vasospasm and those undergoing decompressive craniectomy, which are in accordance with the literature, unlike what occurs with the phase of the disease in the that surgery was performed, which in our study showed a predominance in the acute phase, in contrast to what is observed in various bibliographic sources.

Alteraciones cognitivas en pacientes operados de aneurismas cerebrales en el Hospital de Clínicas

RESUMEN Introducción: la hemorragia subaracnoidea por sí misma puede dar lugar a un daño cerebral, por esto, en pacientes sin complicaciones los trastornos cognitivos pueden estar presentes. Objetivos: analizar las alteraciones neuropsicológicos en los pacientes operados de aneurismas cerebrales y los factores que se asocian a su desarrollo. Metodología: estudio analítico, observacional, ambispectivo, 2013-2020, que incluyó pacientes operados de aneurismas cerebrales rotos en el Hospital de Clínicas. La evaluación cognitiva se realizó con el mini examen cognitivo de Lobo. Se consideró alterado cuando la puntuación fue menor a 27. Se analizaron 12 variables asociando las mismas con el tema de estudio. Los datos fueron analizados con Epiinfo 7.2. Resultados: La edad mayor a 60 años se asoció al déficit cognitivo de forma significativa, así como también la lateralidad a izquierda, el uso de clipado temporario durante la cirugía, la ruptura del aneurisma en el intraoperatorio, el vasoespasmo y la hidrocefalia. No se asoció significativamente con el desarrollo de un trastorno cognitivo; el sexo, el nivel de escolaridad, la cantidad de sangre cisternal, la localización del aneurisma, el Glasgow de ingreso ni la fase en la cual se realzó la cirugía. Discusión: en general los hallazgos coinciden con la literatura. Llamó la atención que la escala de Fisher en la muestra estudiada no demostró tener una asociación significativa con el trastorno cognitivo, sin embargo, hay datos en la literatura que sostienen que la cantidad de sangre cisternal al ingreso es un fuerte predictor del estado cognitivo del paciente al alta.

ABSTRACT Introduction: subarachnoid hemorrhage itself can lead to brain damage, so in uncomplicated patient's cognitive disorders may be present. Objective: To analyze the cognitive impairments in patients following clipping of ruptured aneurysms and the factors that are associated with their development. Methodology: analytical, observational, ambispective study, 2013-2020, including patients operated for ruptured aneurysms at the Hospital de Clínicas. The cognitive evaluation was performed with the Lobo mini cognitive exam. It was considered altered when the score was less than 27. Twelve variables were analyzed associating them with the study topic. The data was analyzed with Epiinfo 7.2. Results: Age over 60 years was significantly associated with cognitive deficit, as well as left laterality, the use of temporary clipping during surgery, intraoperative aneurysm rupture, vasospasm, and hydrocephalus. It was not significantly associated with the development of a cognitive disorder; sex, level of education, amount of cisternal blood, location of the aneurysm, admission Glasgow, and the timing in which the surgery was performed. Discussion: In general, the findings coincide with the literature. It was noteworthy that the Fisher scale in the studied sample did not show to have a significant association with cognitive disorder, however, there are data in the literature that maintain that the amount of cisternal blood on admission is a strong predictor of the patient's cognitive state at discharge.

Morphological, Electrical, and Chemical Characteristics of Poly(sodium 4-styrenesulfonate) Coated PVDF Ultrafiltration Membranes after Plasma Treatment.

A commercial ultrafiltration (UF) membrane (HFM-183 de Koch Membrane Systems) made of poly(vinylidene fluoride) (PVDF), was recovered with a negatively-charged polyelectrolyte (poly(sodium 4-styrenesulfonate)) (PSS), and the effects on its electric, chemical, and morphological properties were analyzed. Atomic force microscopy (AFM), liquid-liquid displacement porometry, Electrical Impedance Spectroscopy, X-ray photoelectron spectroscopy, and Raman spectroscopy were used to investigate the modifications induced by the deposition of PSS on the PVDF positively-charged membrane and after its treatment by a radio frequency Ar-plasma. These techniques confirmed a real deposition and posterior compaction of PSS with increasing roughness and decreasing pore sizes. The evolution of the electric resistances of the membranes confirmed crosslinking and compaction with shielding of the sulfonated groups from PSS. In this way, a membrane with a negatively-charged active layer and a pore size which was 60% lower than the original membrane was obtained. The composition of the additive used by manufacturers to modify PVDF to make it positively charged was obtained by different procedures, all of which depended upon the results of X-ray photoelectron spectroscopy, leading to fairly consistent results. This polymer, carrying positive charges, contains quaternary nitrogen, as confirmed by XPS. Moreover, Raman spectroscopy confirmed that PVDF changes from mostly the to the α phase, which is more stable as a substrate for the deposited PSS. The aim of the tested modifications was to increase the retention of divalent anions without reducing permeability.

Paranoid Thinking and Wellbeing. The Role of Doubt in Pharmacological and Metacognitive Therapies.

INTRODUCTION: Pathological confidence in one's thoughts is a key mechanism of chronic paranoid thinking. For this reason, many of the current therapies focus on trying to reduce it. In fact, the way some antipsychotics (e.g., haloperidol) work seems to be through the induction of doubt. Because of the impact of these pathological thoughts on positive health, studying the well-being of people who experience paranoid thoughts is fundamental. The first objective of this research is to apply the Complete State Model of Health (CSMH) to a sample of patients characterized by the presence of paranoid thinking. Our second objective is to evaluate the impact of therapies based on reducing pathological confidence on patients' well-being. METHODS: Sixty participants with SCID-5 confirmed DSM-5 diagnosis related with paranoid thinking and without mood symptoms were recruited. In order to test the existence of a two continua model of mental health (CSMH), we conducted a parallel analysis and an exploratory factor analysis. To test our hypothesis regarding the partially mediating role of doubt between paranoid thinking and patients' well-being, we conducted a biased corrected bootstrapping procedure. RESULTS: As expected, two different unipolar dimensions emerged from the measures used to assess paranoid thinking and positive health (two continua model of mental health). When patients received metacognitive and pharmacological treatment, more paranoid thinking led to more doubt in all thoughts, which in turn affected well-being. The analyses carried out confirmed the partial mediating role of doubt. CONCLUSION: Despite the efficacy shown by both metacognitive therapies and antipsychotics, it seems that they not only reduce pathological confidence, but can also affect other thoughts not linked to delirium. This effect of generalization of doubt in all thoughts negatively affected patients' well-being and quality of life.

Post-traumatic cognitions and quality of life in terrorism victims: the role of well-being in indirect versus direct exposure.

BACKGROUND: The effect of indirect (versus direct) exposure to a traumatic event on the quality of life of terrorist attack victims has received considerable attention in the literature. However, more research is required to examine whether the symptoms and underlying processes caused by both types of exposure are equivalent. Our main hypothesis is that well-being plays a different role depending on indirect vs. direct trauma exposure. METHODS: In this cross-sectional study, eighty direct victims of 11-M terrorist attacks (people who were traveling in trains where bombs were placed) and two-hundred indirect victims (individuals highly exposed to the 11-M terrorist attacks through communications media) voluntarily participated without compensation. To test our hypothesis regarding the mediating role of indirect exposure, we conducted a biased corrected bootstrapping procedure. To test our hypothesis regarding the moderating role of direct exposure, data were subjected to a hierarchical regression analysis. RESULTS: As predicted, for indirect trauma exposure, well-being mediated the relationship between post-traumatic dysfunctional cognitions and trauma symptoms. However, for direct trauma exposure, well-being moderated the relationship between post-traumatic dysfunctional cognitions and trauma symptoms. CONCLUSIONS: The results of our study indicate that the different role of well-being found between indirect (causal factor) and direct exposure (protective factor) should be taken into consideration in interventions designed to improve victims' health.

Affective and cognitive validation of thoughts: An appraisal perspective on anger, disgust, surprise, and awe.

Anger, disgust, surprise, and awe are multifaceted emotions. Both anger and disgust are associated with feeling unpleasant as well as experiencing a sense of confidence, whereas surprise and awe tend to be more pleasant emotions that are associated with doubt. Most prior work has examined how appraisals (confidence, pleasantness) lead people to experience different emotions or to experience different levels of intensity within the same emotion. Instead, the current research focused on the consequences (rather the antecedents) of appraisals of emotion, and it focuses specifically on the consequences for thought usage rather than the consequences for generating many or few thoughts. We show that when these four emotions are induced following thought generation, thoughts can be used either more or less with each emotion depending on whether the pleasantness/unpleasantness or confidence/doubt appraisal is made salient. In five experiments, it was predicted and found that anger and disgust following thought generation led to more thought use than surprise and awe when a confidence appraisal for the emotion was encouraged, but led to less thought use than surprise and awe when a pleasantness appraisal was made salient. The current studies are the first to reveal that different appraisals can lead to different (even opposite) outcomes on thought usage within the same experimental design. (PsycINFO Database Record

Social (dis)order and psychosocial trauma: Look earlier, look outside, and look beyond the persons.

The most common and extreme suffering humankind has ever experienced comes from interpersonal and collective intentional violence. In dealing with traumatic outcomes psychology must overcome the mutually constitutive interaction between the (dis)order of a given macro or microsocial context and the mental health of the persons living in it. Social psychologist Ignacio Martín-Baró addressed in a preferential way the study of civil war in El Salvador in terms of intergroup hostility and polarization. He also approached the aftereffects of war by means of a theoretical core assumption: that traumatic experience rooted in collective violence (a human-made stressor) should be understood bearing in mind its social roots (pretraumatic situation), its personal and collective harm (collective injury), and the destruction of the social fabric. These are the arguments for his conceptualization of psychosocial trauma. Twenty-six years after the violent murder of Martín-Baró, along with 5 Jesuit priests, a housekeeper, and his teenage daughter, the current authors have adopted his general framework. Based on new theoretical insights and supporting data, the authors propose an expanded 4-dimension theoretical argument on psychosocial trauma: (a) pretrauma conditions based on social distress, (b) shared network of fear leading to breakdown of core social assumptions, (c) the outgroup as a target of negative emotions, and (d) destruction of family ties and community networks.

Validity and Reliability of the Spanish Version of the Revised Self-Monitoring Scale.

Self-Monitoring (SM) is a concept that refers to individual differences in this orientation toward regulation of social behavior. The goal of the present research was to provide a Spanish adaptation of Snyder and Gangestad's (1986) Revised SM Scale. After conducting an initial pilot study, results showed that the Spanish version of the scale had good internal reliability and adequate factor structure. In Study 1, analyses support a unidimensional structure of the scale (χ2/df = 2.64; GFI = .97; IFI = .97; TLI = .96; RMSEA = .06). In Study 2, the scale showed discriminant validity from other individual differences measures, such as Need for Cognition (r = 0.12 p = 0.14), Social Desirability (r = 0.06, p > .45) and Extraversion (r = 0.28 p = .001). In Study 3, the scale showed adequate test-retest reliability (r = 0.71, p < .001). Finally, using a paradigm of attitude-behavior consistenty, Study 4 showed that the validated scale also had good predictive validity (B = -0.819, p = .035).