Multicentre evaluation of a new point-of-care test for the determination of NT-proBNP in whole blood

BACKGROUND: The Roche CARDIAC proBNP point-of-care (POC) test is the first test intended for the quantitative determination of N-terminal pro-brain natriuretic peptide (NT-proBNP) in whole blood as an aid in the diagnosis of suspected congestive heart failure, in the monitoring of patients with compensated left-ventricular dysfunction and in the risk stratification of patients with acute coronary syndromes. METHODS: A multicentre evaluation was carried out to assess the analytical performance of the POC NT-proBNP test at seven different sites. RESULTS: The majority of all coefficients of variation (CVs) obtained for within-series imprecision using native blood samples was below 10% for both 52 samples measured ten times and for 674 samples measured in duplicate. Using quality control material, the majority of CV values for day-to-day imprecision were below 14% for the low control level and below 13% for the high control level. In method comparisons for four lots of the POC NT-proBNP test with the laboratory reference method (Elecsys proBNP), the slope ranged from 0.93 to 1.10 and the intercept ranged from 1.8 to 6.9. The bias found between venous and arterial blood with the POC NT-proBNP method was < or =5%. All four lots of the POC NT-proBNP test investigated showed excellent agreement, with mean differences of between -5% and +4%. No significant interference was observed with lipaemic blood (triglyceride concentrations up to 6.3 mmol/L), icteric blood (bilirubin concentrations up to 582 micromol/L), haemolytic blood (haemoglobin concentrations up to 62 mg/L), biotin (up to 10 mg/L), rheumatoid factor (up to 42 IU/mL), or with 50 out of 52 standard or cardiological drugs in therapeutic concentrations. With bisoprolol and BNP, somewhat higher bias in the low NT-proBNP concentration range (<175 ng/L) was found. Haematocrit values between 28% and 58% had no influence on the test result. Interference may be caused by human anti-mouse antibodies (HAMA) types 1 and 2. No significant influence on the results with POC NT-proBNP was found using volumes of 140-165 muL. High NT-proBNP concentrations above the measuring range of the POC NT-proBNP test did not lead to false low results due to a potential high-dose hook effect. CONCLUSIONS: The POC NT-proBNP test showed good analytical performance and excellent agreement with the laboratory method. The POC NT-proBNP assay is therefore suitable in the POC setting.

Generic detection of coronaviruses and differentiation at the prototype strain level by reverse transcription-PCR and nonfluorescent low-density microarray

A nonfluorescent low-cost, low-density oligonucleotide array was designed for detecting the whole coronavirus genus after reverse transcription (RT)-PCR. The limit of detection was 15.7 copies/reaction. The clinical detection limit in patients with severe acute respiratory syndrome was 100 copies/sample. In 39 children suffering from coronavirus 229E, NL63, OC43, or HKU1, the sensitivity was equal to that of individual real-time RT-PCRs.

Stent thrombosis is associated with an impaired response to antiplatelet therapy

OBJECTIVES: We sought to evaluate the response to antiplatelet therapy in patients with stent thrombosis (ST). BACKGROUND: Stent thrombosis is associated with considerable morbidity and mortality. An impaired response to antiplatelet therapy might be related to an increased risk for ST. METHODS: Eighty-two patients were included in the present study: 23 patients with previous ST, 50 matched controls (coronary stenting without ST), and 9 healthy volunteers. Platelet aggregation (PA) was studied (optical aggregometry) under monotherapy with acetylsalicylic acid (ASA) 100 mg daily for one month, followed by dual therapy with ASA 100 mg and clopidogrel 75 mg daily (loading dose 300 mg) for another month. RESULTS: Maximal (5 and 20 micromol) adenosine diphosphate-induced PA was significantly higher in patients with ST compared with controls (5 micromol, p < 0.005; 20 micromol, p < 0.05) and volunteers (5 micromol, p < 0.005; 20 micromol, p < 0.05). Resistance to ASA (>20% aggregation with 0.5 mg/ml arachidonic acid) was more prevalent in patients with ST (48%) compared with control patients (32%, p = ns) and volunteers (0%, p = 0.01). Clopidogrel significantly reduced PA in all three groups, but intergroup differences persisted. Clopidogrel resistance (<10% relative change) was similar in patients with ST, control patients, and volunteers (4%, 6%, and 11%, respectively, all p = NS). However, combined ASA and clopidogrel resistance was more prevalent in patients with ST (52%) compared with controls (38%, p = NS) and volunteers (11%, p < 0.05). CONCLUSIONS: Patients with previous ST show an impaired response to antiplatelet therapy with ASA compared with controls and volunteers. Additional treatment with clopidogrel is not able to overcome these differences in PA. Acetylsalicylic acid but not clopidogrel resistance appears to be associated with ST.

Differential effects of captopril and nitrates on muscle sympathetic nerve activity in volunteers

BACKGROUND The sympathetic nervous system (SNS) is an important regulator of cardiovascular function. Activation of SNS plays an important role in the pathophysiology and the prognosis of cardiovascular diseases such as heart failure, acute coronary syndromes, arrhythmia, and possibly hypertension. Vasodilators such as adenosine and sodium nitroprusside are known to activate SNS via baroreflex mechanisms. Because vasodilators are widely used in the treatment of patients with cardiovascular diseases, the aim of the present study was to assess the influence of clinically used dosages of isosorbide dinitrate and captopril on sympathetic nerve activity at rest and during stimulatory maneuvers. METHODS AND RESULTS Twenty-eight healthy volunteers were included in this double-blind placebo-controlled study, and muscle sympathetic nerve activity (MSA; with microelectrodes in the peroneal nerve), blood pressure, heart rate, and neurohumoral parameters were measured before and 90 minutes after the oral administration of 40 mg isosorbide dinitrate or 6.25 mg captopril. Furthermore, a 3-minute mental stress test and a cold pressor test were performed before and 90 minutes after drug administration. Resting MSA did not change after captopril and decreased compared with placebo (P < .05 versus placebo), whereas isosorbide dinitrate led to a marked increase in MSA (P < .05). Systolic blood pressure was reduced by isosorbide dinitrate (P < .05), whereas captopril decreased diastolic blood pressure (P < .05). The increases in MSA, blood pressure, and heart rate during mental stress were comparable before and after drug administration regardless of the medication. During cold pressor test, MSA and systolic and diastolic blood pressures increased to the same degree independent of treatment, but after isosorbide dinitrate, the increase in MSA seemed to be less pronounced. Heart rate did not change during cold stimulation. Plasma renin activity increased after captopril and isosorbide dinitrate (P < .05), whereas placebo had no effect. Endothelin-1 increased after placebo and isosorbide dinitrate (P < .05) but not after captopril. CONCLUSIONS Thus, captopril suppressed MSA despite lowering of diastolic blood pressure but allowed normal adaptation of the SNS during mental or physical stress. In contrast, the nitrate strongly activated the SNS under baseline conditions. These findings demonstrate that vasodilators differentially interact with the SNS, which could be of importance in therapeutic strategies for the treatment of patients with cardiovascular diseases.

Differentiating atrioventricular nodal reentrant tachycardia from tachycardia via concealed accessory pathway.

Studies analyzing the diagnostic value of 12-lead electrocardiographic criteria differentiating slow-fast atrioventricular nodal reentrant tachycardia (AVNRT) from atrioventricular reentrant tachycardia (AVRT) due to concealed accessory pathway have shown inconsistent results. In 97 patients (50 with AVNRT, 47 with AVRT) 12-lead electrocardiograms (ECGs) were recorded during sinus rhythm and tachycardia (QRS <120 ms). The ECGs were blinded for diagnosis and patient and analyzed independently by 2 electrophysiologists. The studied criteria differentiating AVNRT from AVRT included pseudo-r'/S, the presence of a retrograde P wave, RP interval, ST-segment depression >/=2 mm with the number and location of the affected leads, QRS amplitude, and cycle length alternans.

Role of NonO-histone interaction in TNFalpha-suppressed prolyl-4-hydroxylase alpha1.

Inflammation is a key process in cardiovascular diseases. The extracellular matrix (ECM) of the vasculature is a major target of inflammatory cytokines, and TNFalpha regulates ECM metabolism by affecting collagen production. In this study, we have examined the pathways mediating TNFalpha-induced suppression of prolyl-4 hydroxylase alpha1 (P4Halpha1), the rate-limiting isoform of P4H responsible for procollagen hydroxylation, maturation, and organization. Using human aortic smooth muscle cells, we found that TNFalpha activated the MKK4-JNK1 pathway, which induced histone (H) 4 lysine 12 acetylation within the TNFalpha response element in the P4Halpha1 promoter. The acetylated-H4 then recruited a transcription factor, NonO, which, in turn, recruited HDACs and induced H3 lysine 9 deacetylation, thereby inhibiting transcription of the P4Halpha1 promoter. Furthermore, we found that TNFalpha oxidized DJ-1, which may be essential for the NonO-P4Halpha1 interaction because treatment with gene specific siRNA to knockout DJ-1 eliminated the TNFalpha-induced NonO-P4Halpha1 interaction and its suppression. Our findings may be relevant to aortic aneurysm and dissection and the stability of the fibrous cap of atherosclerotic plaque in which collagen metabolism is important in arterial remodeling. Defining this cytokine-mediated regulatory pathway may provide novel molecular targets for therapeutic intervention in preventing plaque rupture and acute coronary occlusion.

Drug-eluting stents vs. bare metal stents in patients with cardiogenic shock: a comparison by propensity score analysis.

BACKGROUND In patients with cardiogenic shock, data on the comparative safety and efficacy of drug-eluting stents (DESs) vs. bare metal stents (BMSs) are lacking. We sought to assess the performance of DESs compared with BMSs among patients with cardiogenic shock undergoing percutaneous coronary intervention (PCI). METHODS Out of 236 patients with acute coronary syndromes complicated by cardiogenic shock, 203 were included in the final analysis. The primary endpoint included death, and the secondary endpoint of major adverse cardiac and cerebrovascular events (MACCEs) included the composite of death, myocardial infarction, any repeat revascularization and stroke. Patients were followed for a minimum of 30 days and up to 4 years. As stent assignment was not random, we performed a propensity score analysis to minimize potential bias. RESULTS Among patients treated with DESs, there was a lower risk of the primary and secondary endpoints compared with BMSs at 30 days (29 vs. 56%, P < 0.001; 34 vs. 58%, P = 0.001, respectively) and during long-term follow-up [hazard ratio 0.43, 95% confidence interval (CI) 0.29-0.65, P < 0.001; hazard ratio 0.49, 95% CI 0.34-0.71, P < 0.001, respectively]. After propensity score adjustment, all-cause mortality was reduced among patients treated with DESs compared with BMSs both at 30 days [adjusted odds ratio (OR) 0.26, 95% CI 0.11-0.62; P = 0.002] and during long-term follow-up (adjusted hazard ratio 0.40, 95% CI 0.22-0.72; P = 0.002). The rate of MACCE was lower among patients treated with DESs compared with those treated with BMSs at 30 days (adjusted OR 0.42, 95% CI 0.19-0.95; P = 0.036). The difference in MACCEs between devices approached significance during long-term follow-up (adjusted hazard ratio 0.60, 95% CI 0.34-1.01; P = 0.052). CONCLUSION DESs appear to be associated with improved clinical outcomes, including a reduction in all-cause mortality compared with BMSs among patients undergoing PCI for cardiogenic shock, possibly because of a pacification of the infarct-related artery by anti-inflammatory drug. The results of this observational study require confirmation in an appropriately powered randomized trial.

Competitive fitness in coronaviruses is not correlated with size or number of double-membrane vesicles under reduced-temperature growth conditions.

Positive-stranded viruses synthesize their RNA in membrane-bound organelles, but it is not clear how this benefits the virus or the host. For coronaviruses, these organelles take the form of double-membrane vesicles (DMVs) interconnected by a convoluted membrane network. We used electron microscopy to identify murine coronaviruses with mutations in nsp3 and nsp14 that replicated normally while producing only half the normal amount of DMVs under low-temperature growth conditions. Viruses with mutations in nsp5 and nsp16 produced small DMVs but also replicated normally. Quantitative reverse transcriptase PCR (RT-PCR) confirmed that the most strongly affected of these, the nsp3 mutant, produced more viral RNA than wild-type virus. Competitive growth assays were carried out in both continuous and primary cells to better understand the contribution of DMVs to viral fitness. Surprisingly, several viruses that produced fewer or smaller DMVs showed a higher fitness than wild-type virus at the reduced temperature, suggesting that larger and more numerous DMVs do not necessarily confer a competitive advantage in primary or continuous cell culture. For the first time, this directly demonstrates that replication and organelle formation may be, at least in part, studied separately during infection with positive-stranded RNA virus. IMPORTANCE The viruses that cause severe acute respiratory syndrome (SARS), poliomyelitis, and hepatitis C all replicate in double-membrane vesicles (DMVs). The big question about DMVs is why they exist in the first place. In this study, we looked at thousands of infected cells and identified two coronavirus mutants that made half as many organelles as normal and two others that made typical numbers but smaller organelles. Despite differences in DMV size and number, all four mutants replicated as efficiently as wild-type virus. To better understand the relative importance of replicative organelles, we carried out competitive fitness experiments. None of these viruses was found to be significantly less fit than wild-type, and two were actually fitter in tests in two kinds of cells. This suggests that viruses have evolved to have tremendous plasticity in the ability to form membrane-associated replication complexes and that large and numerous DMVs are not exclusively associated with efficient coronavirus replication.

Murine coronavirus ubiquitin-like domain is important for papain-like protease stability and viral pathogenesis

Ubiquitin-like domains (Ubls) now are recognized as common elements adjacent to viral and cellular proteases; however, their function is unclear. Structural studies of the papain-like protease (PLP) domains of coronaviruses (CoVs) revealed an adjacent Ubl domain in severe acute respiratory syndrome CoV, Middle East respiratory syndrome CoV, and the murine CoV, mouse hepatitis virus (MHV). Here, we tested the effect of altering the Ubl adjacent to PLP2 of MHV on enzyme activity, viral replication, and pathogenesis. Using deletion and substitution approaches, we identified sites within the Ubl domain, residues 785 to 787 of nonstructural protein 3, which negatively affect protease activity, and valine residues 785 and 787, which negatively affect deubiquitinating activity. Using reverse genetics, we engineered Ubl mutant viruses and found that AM2 (V787S) and AM3 (V785S) viruses replicate efficiently at 37°C but generate smaller plaques than wild-type (WT) virus, and AM2 is defective for replication at higher temperatures. To evaluate the effect of the mutation on protease activity, we purified WT and Ubl mutant PLP2 and found that the proteases exhibit similar specific activities at 25°C. However, the thermal stability of the Ubl mutant PLP2 was significantly reduced at 30°C, thereby reducing the total enzymatic activity. To determine if the destabilizing mutation affects viral pathogenesis, we infected C57BL/6 mice with WT or AM2 virus and found that the mutant virus is highly attenuated, yet it replicates sufficiently to elicit protective immunity. These studies revealed that modulating the Ubl domain adjacent to the PLP reduces protease stability and viral pathogenesis, revealing a novel approach to coronavirus attenuation. IMPORTANCE Introducing mutations into a protein or virus can have either direct or indirect effects on function. We asked if changes in the Ubl domain, a conserved domain adjacent to the coronavirus papain-like protease, altered the viral protease activity or affected viral replication or pathogenesis. Our studies using purified wild-type and Ubl mutant proteases revealed that mutations in the viral Ubl domain destabilize and inactivate the adjacent viral protease. Furthermore, we show that a CoV encoding the mutant Ubl domain is unable to replicate at high temperature or cause lethal disease in mice. Our results identify the coronavirus Ubl domain as a novel modulator of viral protease stability and reveal manipulating the Ubl domain as a new approach for attenuating coronavirus replication and pathogenesis.

Quantifying the vestibulo-ocular reflex with video-oculography: nature and frequency of artifacts

Video-oculography devices are now used to quantify the vestibulo-ocular reflex (VOR) at the bedside using the head impulse test (HIT). Little is known about the impact of disruptive phenomena (e.g. corrective saccades, nystagmus, fixation losses, eye-blink artifacts) on quantitative VOR assessment in acute vertigo. This study systematically characterized the frequency, nature, and impact of artifacts on HIT VOR measures. From a prospective study of 26 patients with acute vestibular syndrome (16 vestibular neuritis, 10 stroke), we classified findings using a structured coding manual. Of 1,358 individual HIT traces, 72% had abnormal disruptive saccades, 44% had at least one artifact, and 42% were uninterpretable. Physicians using quantitative recording devices to measure head impulse VOR responses for clinical diagnosis should be aware of the potential impact of disruptive eye movements and measurement artifacts.

Influenza vaccination as a primary or secondary prevention for cardiovascular diseases: A systematic review of the literature

Background: Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide. CVD mainly comprise of coronary heart disease and stroke and were ranked first and fourth respectively amongst leading causes of death in the United States. Influenza (flu) causes annual outbreaks and pandemics and is increasingly recognized as an important trigger for acute coronary syndromes and stroke. Influenza vaccination is an inexpensive and effective strategy for prevention of influenza related complications in high risk individuals. Though it is recommended for all CVD patients, Influenza vaccine is still used at suboptimal levels in these patients owing to prevailing controversy related to its effectiveness in preventing CVD. This review was undertaken to critically assess the effectiveness of influenza vaccination as a primary or secondary prevention method for CVD. ^ Methods: A systematic review was conducted using electronic databases OVID MEDLINE, PUBMED (National Library of Medicine), EMBASE, GOOGLE SCHOLAR and TRIP (Turning Research into Practice). The study search was limited to peer-reviewed articles published in English language from January 1970 through May 2012. The case control studies, cohort studies and randomized controlled trials related to influenza vaccination and CVD, with data on at least one of the outcomes were identified. In the review, only population-based epidemiologic studies in all ethnic groups and of either sex and with age limitation of 30 yrs or above, with clinical CVD outcomes of interest were included. ^ Results: Of the 16 studies (8 case control studies, 6 cohort studies and 2 randomized controlled trials) that met the inclusion criteria, 14 studies reported that there was a significant benefit in u influenza vaccination as primary or secondary prevention method for preventing new cardiovascular events. In contrary to the above findings, two studies mentioned that there was no significant benefit of vaccination in CVD prevention. ^ Conclusion: The available body of evidence in the review elucidates that vaccination against influenza is associated with reduction in the risk of new CVD events, hospitalization for coronary heart disease and stroke and as well as the risk of death. The study findings disclose that the influenza vaccination is very effective in CVD prevention and should be encouraged for the high risk population. However, larger and more future studies like randomized control trials are needed to further evaluate and confirm these findings. ^

Neuromodulación sacral como alternativa terapéutica en la disinergia vesico esfinteriana.

Presentamos una experiencia y comentarios sobre neuromodulación y vejiga neurogénica. Evaluamos 32 pacientes con estimulación percutánea previa (PNE), positiva en 20 casos y negativa en 12. Los diagnósticos en las PNE negativas fueron: 7 vejigas hiperrrefléxicas, 3 vejigas neurógenas atónicas no obstructivas, 1 síndrome cortical con vejiga neurógena no inhibida y un síndrome doloroso vesical. Los mejores resultados son en vejigas hiperrrefléxicas con mejoría del 60-70%, con un seguimiento de hasta 4 años.

El perfil de los consumidores de productos de comercio justo. Análisis de las variables que influyen en su intención de compra

El consumo mundial, impulsor del desarrollo y crecimiento económico de los pueblos, no ha sido igual para todas las naciones, ya que sus efectos han sido diferentes para los ciudadanos de los países del Norte y los del Sur, principalmente por dos razones: una, porque han originado complejos y diferentes estilos de vida y aspiraciones, lo que ha originado grandes diferencias entre los individuos de unos y otros países, y, dos, por su falta de valores sociales y éticos. Ante esta situación, la sociedad en su conjunto debe tomar conciencia de este hecho, y a través de un consumo responsable y de un mayor conocimiento de las relaciones comerciales entre los pueblos, debe optar por consumir productos elaborados bajo criterios de justicia y equidad. Para ayudar a alcanzar estos objetivos de equidad, solidaridad, justicia y ética, nació el Comercio Justo, que, en el caso de España, llegó con veinte años de retraso en la década de los ochenta. Aunque a día de hoy sus ventas crecen a un buen ritmo, siguen siendo inferiores al resto de los países europeos, por cuatro razones: (1) el desconocimiento que la mayoría de los potenciales consumidores tienen de este movimiento social; (2) la dificultad de acceder a los productos que comercializan; (3) el poco impulso que se ofrece desde las Administraciones Públicas; y, (4) porque hay pocas investigaciones en las que se haya analizado el Comercio Justo desde la perspectiva de la demanda, lo que ha implicado que no haya un conocimiento profundo sobre los consumidores de este tipo de productos y sobre sus motivaciones de compra. En base a todo lo expuesto, el presente trabajo se concibe como un estudio exploratorio, que tiene como objetivo principal analizar el perfil de los consumidores y no consumidores de productos de Comercio Justo, sus motivaciones de compra y no compra, así como las variables que influyen en la intención de compra futura, tanto en el segmento de consumidores actuales, como en el segmento de no consumidores de este tipo de productos. Para la realización de este trabajo, se ha utilizado, por una parte, una metodología cualitativa, que ha permitido acceder a la información sobre las opiniones y actitudes que intervienen en los procesos de decisión de compra; y, por otra, una metodología cuantitativa, a través de una encuesta online dirigida a 6.500 individuos, que ha permitido tener información, a través de sendos análisis descriptivos univariante y bivariante, de los individuos encuestados sobre el objeto del estudio. Para validar los modelos y contrastar las hipótesis planteadas, se ha utilizado el análisis de fiabilidad y validación de las escalas de medición seleccionadas (Alpha de Cronbach); el análisis factorial exploratorio, para comprobar la dimensionalidad y validez convergente de las escalas de medida; el análisis factorial confirmatorio, para validar la idoneidad de los modelos de medida propuestos; la regresión logística, para comprobar la validez del modelo general de la probabilidad de la compra o no compra de productos de Comercio Justo; y la regresión lineal múltiple, para comprobar la validez de los modelos específicos de intención de compra futura en los segmentos de compradores y de no compradores. Para realizar todos estos análisis, se han utilizado las herramientas informáticas SPSS v21 y AMOS. Las principales conclusiones del trabajo son: (1) que se deben establecer unos criterios claros que definan quién es quién en el movimiento de Comercio Justo, sus fines, sus objetivos, los productos que comercializan, así como su funcionamiento y desarrollo en España; (2) que, a pesar de las grandes ventajas y posibilidades del Comercio Justo, hay una falta de demanda de estos productos por parte de los consumidores responsables, debido principalmente a la falta de información-comunicación sobre el propio movimiento, y, muy especialmente, a la falta de información sobre los productos, los canales de comercialización, las políticas de precios, las políticas de comunicación, etc., y a la necesidad de que estos productos estén accesibles en los lugares donde los consumidores hacen su compra habitual; y (3) que el Comercio Justo español debe afrontar una serie de desafíos, como son la coordinación entre las diferentes organizaciones que participan en su desarrollo; la sensibilización de los consumidores; la creación de una imagen de marca que defina de una manera clara y sencilla qué es el Comercio Justo; la orientación al cliente y no al producto; y extender la red de comercialización de productos de Comercio Justo a los canales donde los consumidores hacen su compra habitualmente. ABSTRACT Global consumption, the driver of economic growth and development of nations, is not the same for all countries, since its effects have been different on people coming from the North or the South. This is due mainly to two reasons: firstly, because they have developed complex and different lifestyles and aspirations, which have led to significant differences between individuals of one country and another and secondly, because they lack social and ethical values. Given this situation, society as a whole should be aware of this fact, and through responsible consumption and a greater knowledge of trade relations between countries, should opt for consuming products produced with criteria of justice and equity. Fair Trade began as a way to help reach these goals of equity, solidarity, justice and ethics. In the case of Spain it did not start until 20 years later, in the eighties. Although today sales of Fair Trade products are growing at a good rate, they are still below that of other European countries, for four reasons: (1) unawareness of this social movement; (2) the difficult access to these products; (3) insufficient government support; (4) the limited research carried out to analyse Fair Trade from the perspective of demand, resulting in a lack of knowledge about this type of consumer and their purchasing motivations. Based on the above, the present study is designed as an exploratory investigation, aimed at analyzing the profile of consumers and non-consumers of Fair Trade, their motivations for buying and not buying, as well as the variables which influence future purchase intention in both the current consumer segment, and the non-user segment of such products. To carry out this study we have used, on the one hand, a qualitative methodology, to obtain information about the views and attitudes involved in the purchase decision process; and on the other, a quantitative methodology, through an online survey of 6,500 individuals, which provided information through two separate univariate and bivariate descriptive analysis, of the individuals interviewed about the object of this study. To validate the models and contrast hypotheses, we have used the reliability analysis and validation of the selected measurement scales (Cronbach's Alpha); exploratory factor analysis to verify the dimensionality and convergent validity of the measurement scales; confirmatory factor analysis to validate the adequacy of the models of measurement proposed; logistic regression, to verify the validity of the general model of the probability of buying or not buying Fair Trade products; and multiple linear regression to test the validity of specific models in future purchase intention in the segments of buyers and non-buyers. To carry out these analyses, we used SPSS v21 software tools and AMOS. The principal conclusions of the investigation are: (1) the need to establish clear criteria which define who is who in the Fair Trade movement, its goals, objectives, the products they sell, as well as its operation and development in Spain; (2) that despite the great advantages and possibilities of Fair Trade, there is a lack of demand for these products by responsible consumers, mainly due to the lack of information-communication about the movement itself, and especially on the range of products, sales channels, pricing policies, communication policies, etc., and the need for these products to be available in places where consumers make their usual purchase; and (3) that Spanish Fair Trade must address a number of challenges such as: coordination between the different organizations involved in trade development; consumer awareness; creation of a brand image that defines in a clear and simple way what Fair Trade is; focus on the customer rather than the product; and expansion of the network of Fair Trade sales outlets to include the channels where consumers usually make their purchases.

A PRÁXIS DO MERCADO EDITORIAL EVANGÉLICO. SIMILARIDADES E DIFERENÇAS ENTRE A PRODUÇÃO E DISTRIBUIÇÃO DO LIVRO EVANGÉLICO E DO LIVRO SECULAR NO BRASIL.

A presente pesquisa tem como objetivo estudar o segmento editorial evangélico no Brasil, buscando identificar a práxis da sua produção, comercialização e marketing, comparando-a ao segmento editorial secular. Comparar o perfil do leitor evangélico com o perfil do leitor brasileiro em geral e, ainda, a produção e venda do segmento editorial evangélico com a produção e venda do segmento editorial secular também fazem parte dos objetivos da pesquisa. A metodologia incluiu pesquisa bibliográfica e documental e um estudo de casos múltiplos holísticos, envolvendo as editoras Mundo Cristão e Ediouro-Agir. Verificou-se que a práxis da produção do livro evangélico é semelhante ao do livro secular e que o mercado editorial evangélico cresce mais que o mercado secular. Outro resultado relevante desta pesquisa de dissertação foi a verificação de que o leitor evangélico lê mais que o brasileiro em geral, dados estes, obtidos utilizando-se da mesma metodologia e base de dados dos índices oficiais.(AU)

A PRÁXIS DO MERCADO EDITORIAL EVANGÉLICO. SIMILARIDADES E DIFERENÇAS ENTRE A PRODUÇÃO E DISTRIBUIÇÃO DO LIVRO EVANGÉLICO E DO LIVRO SECULAR NO BRASIL.

A presente pesquisa tem como objetivo estudar o segmento editorial evangélico no Brasil, buscando identificar a práxis da sua produção, comercialização e marketing, comparando-a ao segmento editorial secular. Comparar o perfil do leitor evangélico com o perfil do leitor brasileiro em geral e, ainda, a produção e venda do segmento editorial evangélico com a produção e venda do segmento editorial secular também fazem parte dos objetivos da pesquisa. A metodologia incluiu pesquisa bibliográfica e documental e um estudo de casos múltiplos holísticos, envolvendo as editoras Mundo Cristão e Ediouro-Agir. Verificou-se que a práxis da produção do livro evangélico é semelhante ao do livro secular e que o mercado editorial evangélico cresce mais que o mercado secular. Outro resultado relevante desta pesquisa de dissertação foi a verificação de que o leitor evangélico lê mais que o brasileiro em geral, dados estes, obtidos utilizando-se da mesma metodologia e base de dados dos índices oficiais.(AU)