Baseline characteristics of patients in the reduction of events with darbepoetin alfa in heart failure trial (RED-HF)

<p>Aims: This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital admission for worsening heart failure, and improve other outcomes.</p> <p>Methods and results: Key demographic, clinical, and laboratory findings, along with baseline treatment, are reported and compared with those of patients in other recent clinical trials in heart failure. Compared with other recent trials, RED-HF enrolled more elderly [mean age 70 (SD 11.4) years], female (41%), and black (9%) patients. RED-HF patients more often had diabetes (46%) and renal impairment (72% had an estimated glomerular filtration rate <60 mL/min/1.73 m2). Patients in RED-HF had heart failure of longer duration [5.3 (5.4) years], worse NYHA class (35% II, 63% III, and 2% IV), and more signs of congestion. Mean EF was 30% (6.8%). RED-HF patients were well treated at randomization, and pharmacological therapy at baseline was broadly similar to that of other recent trials, taking account of study-specific inclusion/exclusion criteria. Median (interquartile range) haemoglobin at baseline was 112 (106–117) g/L.</p> <p>Conclusion: The anaemic patients enrolled in RED-HF were older, moderately to markedly symptomatic, and had extensive co-morbidity.</p&gt

Children’s discursive constructions of the ‘self’

The ways in which children construct and assign meaning to the ‘self’ could have an impact on their social and emotional well-being, including their coping skills, relationship formation, and behaviour. Furthermore, a child’s understanding of the ‘self’ could influence the way in which they make meaning out of their experiences and internalize these experiences as a means of understanding one’s abilities and self-worth. Conditions of poverty and oppression could negatively impact the development of the self-concept and a child’s overall well-being. Such conditions exist in South Africa, where the aftermath of apartheid’s system of structural racism continues in the form of social inequity, poverty, and violence. This study utilized a child participation framework to explore children’s discursive constructions of and meanings assigned to the ‘self’ within two urban communities of the Western Cape, South Africa. Eight focus group discussions were conducted amongst fifty-four children between the ages of nine to twelve. Thematic and discourse analysis were used to analyse the findings. The themes of childhood, social connectedness, and children’s spaces were identified as key influences on a child’s self-concept. Four underlying discourses emerged within the themes as central to the participant’s self-constructions. These included; (1) ‘forfeited childhood,’ (2) ‘vulnerability and helplessness,’ (3) ‘preserving the integrity of the self,’ and (4) opportunitiwes for escape.