Quality of life in dilated cardiomyopathy with refractory chronic heart failure undergoing devices implantation

Heart failure is the final stage of most of cardiac diseases. It is a complex syndrome in which the patients should have the following features: symptoms of heart failure, typically shortness of breath at rest or during exertion, and/or fatigue; signs of fluid retention such as pulmonary congestion or ankle swelling; and objective evidence of an abnormality of the structure or function of the heart at rest. This progressive syndrome as a high incidence and prevalence and poor prognosis: four-year mortality is around 50% with 40% of the patients admitted to hospital dying or readmitted within a year. With ageing, many patients will develop chronic heart failure, which, because of its symptoms, patient’s awareness of their risk of dying, and the effects of therapy, together with frequent hospitalizations, has considerable impact on patient’s health-related quality of life.

Occupational exposure to poultry dust and effects on the respiratory system in workers

Farmers are occupationally exposed to many respiratory hazards at work and display higher rates of asthma and respiratory symptoms than other workers. Dust is one of the components present in poultry production that increases risk of adverse respiratory disease occurrence. Dust originates from poultry residues, molds, and feathers and is biologically active as it contains microorganisms. Exposure to dust is known to produce a variety of clinical responses, including asthma, chronic bronchitis, chronic airways obstructive disease (COPD), allergic alveolitis, and organic dust toxic syndrome (ODTS). A study was developed to determine particle contamination in seven poultry farms and correlate this with prevalence rate of respiratory defects and record by means of a questionnaire the presence of clinical symptoms associated with asthma and other allergy diseases by European Community Respiratory Health Survey. Poultry farm dust contamination was found to contain higher concentrations of particulate matter (PM) PM5 and PM10. Prevalence rate of obstructive pulmonary disorders was higher in individuals with longer exposure regardless of smoking status. In addition, a high prevalence for asthmatic (42.5%) and nasal (51.1%) symptoms was noted in poultry workers. Data thus show that poultry farm workers are more prone to suffer from respiratory ailments and this may be attributed to higher concentrations of PM found in the dust. Intervention programs aimed at reducing exposure to dust will ameliorate occupational working conditions and enhance the health of workers.

An application of structural equation modeling of test dispositional optimism as mediator or moderator in quality of life in patients with chronic disease

The aim of the present study was to test a hypothetical model to examine if dispositional optimism exerts a moderating or a mediating effect between personality traits and quality of life, in Portuguese patients with chronic diseases. A sample of 540 patients was recruited from central hospitals in various districts of Portugal. All patients completed self-reported questionnaires assessing socio-demographic and clinical variables, personality, dispositional optimism, and quality of life. Structural equation modeling (SEM) was used to analyze the moderating and mediating effects. Results suggest that dispositional optimism exerts a mediator rather than a moderator role between personality traits and quality of life, suggesting that “the expectation that good things will happen” contributes to a better general well-being and better mental functioning.

Optimism on quality of life in Portuguese chronic patients: moderator/mediator?

Objetivo: o otimismo tem sido demonstrado como uma variável importante no ajustamento da qualidade de vida de pessoas com doenças crônicas. O estudo tem como objetivo verificar se o otimismo exerce um efeito moderador ou mediador entre os traços de personalidade e a qualidade de vida, em portugueses com doenças crônicas. Métodos: os modelos de regressão linear múltipla foram usados para avaliar o efeito de moderação e mediação do otimismo na qualidade de vida. A amostra, constituída por 729 doentes, recrutados nos principais hospitais de Portugal responderam a questionários de autorresposta avaliando questões sócio-demográficas e clínicas, personalidade, otimismo disposicional, qualidade de vida e bem-estar subjetivo. Resultados: os resultados encontrados mostraram que o otimismo disposicional não exerce um papel moderador entre os traços de personalidade e a qualidade de vida. Controlando por idade, sexo, nível de escolaridade e percepção da severidade da doença, o efeito dos traços de personalidade na qualidade de vida e no bem-estar subjetivo foi mediado pelo otimismo (parcial e total), expecto para as associações, neuroticismo/abertura à experiência e à saúde física. Conclusão: o otimismo disposicional exerce apenas um papel mediador entre os traços de personalidade e qualidade de vida, em pessoas com doenças crônicas, sugerindo que 'a expectativa de que coisas boas vão acontecer' contribui para uma melhor qualidade de vida e melhor bem-estar subjetivo.