Benefit finding in renal transplantation and its association with psychological and clinical correlates:A prospective study

OBJECTIVES: The identification of positive psychological changes, including benefit finding (BF), in chronic illness has gained substantial interest. However, less is known about BF in the context of a positive medical intervention. End-stage renal disease (ESRD) can be regarded as a burdensome condition, but transplantation is expected to restore physical and psychological functioning to a large extent after a period of illness. The aim of this study was to examine (1) changes in BF from pre- to 12 months post-transplantation, (2) the concurrent association of disease-related characteristics and optimism to BF, and (3) the potential causal relations between BF and distress. METHODS: In this longitudinal study, 319 patients completed questionnaires before, 3 months, 6 months, and/or 12 months post-transplantation. Multilevel models were used for the analyses. Measures included the Illness Cognitions Questionnaire to measure BF, the Life Orientation Test to measure optimism, and the General Health Questionnaire to measure distress. RESULTS: Benefit finding increased from pre- to post-transplantation. Fewer symptoms and comorbidities, and more optimism, were related to more BF over all time-points. The direction of the relation between BF and distress changed over time. Before transplantation, distress predicted an increase in BF, whereas post-transplantation, distress predicted a decrease in BF. The causal relation between BF and distress post-transplantation appeared to be reciprocal. CONCLUSIONS: A positive medical intervention such as renal transplantation might facilitate the development of BF. This study indicates the need for longitudinal research on the relation between BF and psychological health in the face of positive events. Statement of contribution What is already known on this subject? Benefit finding refers to the identification of positive psychological changes following a negative life event. Individuals can experience benefit finding following chronic illness. The positive event of kidney transplantation is associated with improvements in patients' physical and psychological functioning. What does this study add? Benefit finding increases from pre- to post-kidney transplantation. Fewer symptoms and comorbidities, and higher optimism are related to more benefit finding. Before transplantation, distress predicts an increase in benefit finding. After transplantation, there appears to be a reciprocal relation between distress and benefit finding such that distress predicts a decrease in benefit finding and benefit finding predicts a decrease in distress

CUBN as a Novel Locus for End-Stage Renal Disease: Insights from Renal Transplantation

Chronic kidney disease (CKD) is a complex disorder. As genome-wide association studies identified cubilin gene CUBN as a locus for albuminuria, and urinary protein loss is a risk factor for progressive CKD, we tested the hypothesis that common genetic variants in CUBN are associated with end-stage renal disease (ESRD) and proteinuria. First, a total of 1142 patients with ESRD, admitted for renal transplantation, and 1186 donors were genotyped for SNPs rs7918972 and rs1801239 (case-control study). The rs7918972 minor allele frequency (MAF) was higher in ESRD patients comparing to kidney donors, implicating an increased risk for ESRD (OR 1.39, p = 0.0004) in native kidneys. Second, after transplantation recipients were followed for 5.8 [3.8–9.2] years (longitudinal study) documenting ESRD in transplanted kidneys – graft failure (GF). During post-transplant follow-up 92 (9.6%) cases of death-censored GF occurred. Donor rs7918972 MAF, representing genotype of the transplanted kidney, was 16.3% in GF vs 10.7% in cases with functioning graft. Consistently, a multivariate Cox regression analysis showed that donor rs7918972 is a predictor of GF, although statistical significance was not reached (HR 1.53, p = 0.055). There was no association of recipient rs7918972 with GF. Rs1801239 was not associated with ESRD or GF. In line with an association with the outcome, donor rs7918972 was associated with elevated proteinuria levels cross-sectionally at 1 year after transplantation. Thus, we identified CUBN rs7918972 as a novel risk variant for renal function loss in two independent settings: ESRD in native kidneys and GF in transplanted kidneys

How does Brazil measure up? Comparing rankings through the lenses of nation brand indexes

A considerable amount of literature has been published on nation brand and yet not much regarding measurement. The purpose of this paper is to examine nation brand indexes and explore the unbalanced outcomes of a country’s position in these recognized instruments. Although research has been carried out on nation brand, no single study exists comparing a country in four diverse nation brand indexes, which are the reputable ones by Anholt (2007), Fetscherin (2010), Fombrun (2014) and Anholt and Govers (2014). This paper also reflects on the critical studies perspective of the place branding research domain, discussed by Lucarelli and Berg (2011). After a qualitative approach applied to Brazil, it is believed that these indexes mutually support and complement each other - even though they use different approaches, methodologies, samples, and data. Moreover, each of them has their own strengths and weaknesses in terms of accuracy and rationality. Findings from this paper’s evaluation may guide nation brand managers, governments, and researchers to recognize that indexes should be taken into account when analysing a nation brand and its complex image. Therefore, this paper contributes to existing knowledge on the critical studies perspective of the contemporary theoretical structure of the place branding research domain by providing a comparative study based on real data-based rankings of nation brand indexes

The construction of the SEDAS: a new suicide-attitude questionnaire

Objective: Only two scales exist for measuring attitudes towards suicidal behaviour. Because of theoretical and methodological limitations of both scales, the SEDAS was constructed to offer an alternative instrument. Method: The semantic differential scale, from which the SEDAS was devised, consisted of 36 items (pairs of adjectives) constructed to measure attitudes towards suicidal behaviour of different actors in various situations. It was administered to 142 Dutch SOS-telephone volunteers for seven different actor/situation sets. Results: Item analysis reduced the number of suitable items to 15. Simultaneous component analysis revealed two dimensions on which the actor/situation sets were scored: health/illness and acceptance/rejection, jointly accounting for 47% of variance. Psychometrics of the instrument in terms of internal consistency (values between 0.70 and 0.86), item-rest correlation and test-retest correlation (between 0.63 and 0.87) are acceptable to good. Conclusion: The SEDAS may be of value in population surveys, and facilitate effect evaluation of staff training and suicide prevention programmes

Considering complexities in unique African planning approaches: Abstracting the role of African Urban residents

Africa is currently the fastest urbanising region in the world and has subsequently become the centre of continuously growing attention from planning practitioners and academics. Many of these scholars argue for a unique African planning approach in light of the failure of the African urban landscape to emulate Western models of urbanisation. However, whilst practitioners and academics are deliberating concepts like decolonisation and African urbanism, African urban residents have been labouring nonstop to create sustainable living environments and meaningful lives for themselves. This paper aims to showcase how these residents have proven themselves to be active agents in constructing sustainable human settlements rather than simply being passive victims of relentless structural processes beyond their control. It argues the failure of unique African planning approaches and decolonisation attempts to recognise and more importantly, incorporate the solutions provided by the said African residents, because of the inherent Western ideals and ways of thinking guiding global planning approaches. The paper employs theory-based sampling as part of a qualitative inquiry into African urbanism, decolonisation and sustainable human settlement development, before turning to case studies in South Africa and Zambia to consider the complexities within these concepts and support the line of argument. The subsequent discussion begs the question of the role and interference required from planning practitioners and academics within the rapidly changing African urban landscape. It also explores the causative position of African residents in creating sustainable human settlements, highlighting the instances where they have created unique solutions to planning problems and have shaped the urban landscape to suit their own needs and circumstances, challenging Western rationalities underpinning African planning approaches. The paper concludes that abstracting the role of African urban residents in creating a unique African planning approach, may hold potential to create more sustainable and just human settlements in Africa