AimsFor most of us, visual imagery is a fundamental feature of day-to-day subjective experience. It is thought to play multiple cognitive roles.1 However, there is widespread variation in the ...subjective intensity of visual imagery, ranging from extreme vividness to complete absence. The term aphantasia was coined recently to describe the latter, which is usually lifelong. While rarer, cases of acquired aphantasia can provide mechanistic insight. Isolated cases have long been reported,2 with some attempts at theoretical synthesis.3 4 We give a preliminary description of 88 such cases identified from among ~14,000 people contacting us in the wake of publicity surrounding Aphantasia.MethodsCases were selected from individuals contacting us spontaneously reporting reduced or absent intensity of visual imagery. Contacts were asked to complete two measures of visual imagery, the Vividness of Visual Imagery Questionnaire (VVIQ) and Imagery Questionnaire (IQ).5 ResultsCases were divided into those in with a strong probability of a neurological cause (n=39), a psychological cause (n=20) and those about which we cannot yet be confident (n=29). Functional aphantasia appears likely to account for some of the cases in the third category. The commonest precipitating events were head injury (n=19), affective disorder (n=17) and stroke (n=13). Other causes included surgery (postoperative) (n=7), drugs (n=6), infectious or inflammatory disease (n=3), neurodegenerative disease (n=3), and seizure disorders (n=2). For subjects completing the VVIQ (n=29), the mean score was 20.1/80 (range 16-32,) indicating marked reduction of imagery vividness. Localizable lesions were predominantly right sided (n=6) and occurred in posterior cortical areas, particularly occipital and parietal, as well as two cases associated with damage to temporal cortex. Some cases reported other impairments, including impaired memory (n=12), prosopagnosia (n=5) and navigational difficulties (n=2). Of cases who reported on their dreams (n=28), around half had lost visual dreaming, a third had preserved visual dreaming and the remainder had visual dreaming of reduced intensity.ConclusionsTo our knowledge, this is the largest reported case series of acquired loss of visual imagery. Both neurological and psychological disorders can be responsible for acquired aphantasia. Our series includes cases of probable functional aphantasia. Further detailed analysis of these cases is required.References Pearson. Nat. Rev. Neurosci. 2019;20:624634. Zago, et al. Cognit. Neuropsychiatry 2011;16:481504. Farah. Cognition 1984;18:245272. Bartolomeo. Cortex 2002;38:357378. Zeman, et al. Cortex 2020;130:426440.
ObjectiveTo establish a detailed phenotype of LGI1-antibody patients long-term through a cognitive, neuropsychiatric and quality of life (QoL) battery, and relate outcomes to biochemical, clinical ...and genetic factors.Methods60 patients have now undergone detailed evaluation for the LGI1-QoL study, extending the previously-reported preliminary cohort. Selected assessments included domains clinically observed as impaired such as emotionality, fatigue and QoL.ResultsPatients (40 male) aged 44–92 were assessed at a median of three years post-onset (range 4 months-15 years). Compared to published thresholds in age-appropriate healthy controls, 32% were impaired on the Addenbrooke’s Cognitive Examination-Revised, 39% on the Frontal Assessment Battery, 39–52% on two different fatigue scales, 43–51% on the two different measures of the carer-reported Neuropsychiatric Inventory Questionnaire, and 40% on the Life Satisfaction Questionnaire (LSQ) – Life as a Whole. LGI1-antibody patients were significantly (p≤0.05) more impaired on five LSQ sub-domains compared to an available dataset for healthy elders.Analysis of retrospective pre- and post-illness analyses of LSQ, the EQ-5D-5L, another patient-related QoL measure, and the Modified Rankin Scale showed significant (p≤0.01) decreases in most domains. Further clinical and paraclinical correlations will be presented.ConclusionsMany LGI1-antibody patients demonstrate sustained deficits across cognitive, neuropsychiatric, carer-reported and QoL domains.
El estudio del bienestar en la escuela es una prioridad, teniendo en cuenta que la calidad de vida de las comunidades educativas y en especial de los docentes se ve afectada por las actuales y ...exigentes condiciones laborales. Esto justifica la necesidad de contar con instrumentos idóneos de evaluación. El objetivo del estudio fue validar el Cuestionario de Bienestar Laboral General – qBLG- Blanch, Cervantes, Cantera y Sahagún (2010), a través del análisis de sus propiedades psicométricas. La muestra incidental estuvo conformada por 604 docentes de Pasto, Colombia, (M = 48 años, DE = 11,7). El análisis de consistencia interna y el análisis factorial confirmatorio de la estructura original de 6 factores mostraron valores y ajustes óptimos, confirmando que el modelo original posee confiabilidad y validez, y que la factorización de la escala es la más adecuada para medir el bienestar laboral en Colombia y de manera particular en San Juan de Pasto. El análisis de invarianza corrobora la robustez del modelo teórico, sugiriendo la calidad de la medida indistintamente al género. El análisis de resultados sugiere que aspectos como el Agotamiento Físico, la Saturación Mental y la Percepción de Incapacidad, impactan de manera relevante el bienestar de los docentes evaluados.
BackgroundThe number of private and online providers of STI tests is increasing in the Netherlands. The autonomy and accessibility of online self-testing may contribute to timely diagnosis, lower ...healthcare costs and shorter waiting lists at STI clinics. But ill-informed self-testing can also lead to underdiagnosis and insufficient partnermanagement of STIs. To improve linkage to high quality private testing providers the online advice application Advies.chat was launched in 2017. We assessed process indicators for the successful implementation of this online advice instrument in 2018.MethodsThe application generates tailored advices based on clinical guidelines. The questionnaire takes into account personal characteristics, sexual behaviour, sexual risks and symptoms. The advice refers to STI testing providers if testing is indicated and explains which specific STIs need to be tested for. All test advices refer to GP’s and the specific diagnostic tests offered by selected online testing providers. Key populations (MSM, sex workers and young people < 25 years) are also referred to STI clinics. Anonymous process data from the Advies.chat database were analysed.ResultsAdvies. chat was visited 337,736 times in 2018; 113,257 visitors started the questionnaire, 17,449 the chatbot. Visits increased on Sundays, peaked on Mondays and decreased during the week. The most indicated reason for using Advies.chat was the ‘possibility of being STI or HIV infected’ (75%). Around 60% finished the questionnaire, leading to 65,736 advices and 8,700 clicks to online self-test providers.ConclusionOnline self-management tools can play a keyrole in improving the quality of the growing online STI testing market. Advies.chat shows that online triage and tailored advice is feasible and increases traffic to quality testing providers. The contribution of Advies.chat to the estimated 430,000 consultations at GP’s and STI clinics in the Netherlands is sizable. Methods need to be developed to assess the impact of online self-management and self-testing on STI control.DisclosureNo significant relationships.
Introduction and objectivesPatients with pulmonary arteriovenous malformations (PAVMs) are at high risk of cerebral abscess with life-changing morbidity and mortality. These patients often ...concurrently have hereditary haemorrhagic telangiectasia (HHT). A recent study of patients with PAVMs/HHT at a single institution suggested several environmental associations with cerebral abscess, particularly dental care, higher iron intake, and long-haul flights.1 For example, 4/37 (10.8%) cerebral abscess patients reported their abscess occurred after long-distance travel.MethodsIn order to capture data on wider exposure of this population to such risk factors, an online questionnaire was developed using Survey Monkey. In total, 139 non-biassed questions gathered data online about an individual’s HHT and/or PAVM phenotype, and environmental factors of relevance to cerebral abscess and other study foci in our group. With ethical approval (16/LO/1909), participants were recruited following advertisement through global HHT support networks.ResultsThe survey opened on 31 st May 2017. Within 7 weeks, 449 patients with self-reported HHT had completed the questionnaire. The majority (≥60%) were North Americans, with Europeans constituting the second largest group. 229 (51%) had PAVMs, usually diagnosed in their twenties to fifties. 89/229 (38.9%) had been treated by PAVM embolization and 13 (5.7%) by surgery. 17 (7.42%) had experienced a cerebral abscess and 46 gave a family history of cerebral abscess. Preliminary analysis of long-distance travel data revealed most patients rarely travelled for ≥3 hours. 266 participants reported the number of flights they had taken in their lifetime of durations<4 hours, 4–8 hours and ≥8 hours. In total, an estimated 27,722 hours were flown giving a mean average of 122 hours, i.e., approximately 10 long-distance flights per lifetime.ConclusionsThis survey provides a large dataset from individuals with PAVMs/HHT, captured without a bias toward flight usage as in flight-specific surveys. The data suggest long-distance travel is less common than previously thought for the HHT population, which adds greater weight to the previously published association1 between long-distance travel and cerebral abscess risk. This approach should enable the development of better tools to predict and reduce the risk of cerebral abscess for these patients.ReferenceBootheret al. Clin Infect Dis2017, Apr 19. doi:10.1093/cid/cix373
La resilencia estudiada el conjunto de habilidades personales que permiten a un individuo un funcionamiento saludable en la adaptación a un contexto adverso y/o a un acontecimiento disruptivo en la ...vida diaria. En los últimos años, la resilencia ha sido un factor a tener en cuenta al evaluar el rendimiento deportivo. Esta investigación tiene como objetivo determinar el perfil del deportista resiliente en un grupo de jóvenes federados de Guipúzcoa (300 hombres y 135 mujeres, con edad media del8,61 años). Se ha utilizado un cuestionario "ad-hoc" compuesto de 3 cuestionario ya validados: La Escala de Resilienda (Wagnild y Young, 1993), la Escala de Diversión/Satisfacción (Balaguer, Atienza, et al., 1997) y el Cuestionario de Orientación Motivációnál al Ego y a la Tarea en el Deporte (Task and Ego Orientation in Sport Questionnaire, cuyo acronimo es TEOSQ) (Duda, 1989), y se han examinado las relaciones entre el nivel competitivo, el sexo, el carácter deportivo, la Orientación Motivációnál y la Diversión. Los resultados permiten concluir que las y los deportistas más resilientes, son quienes más se divierten y los que más motivados están hacia la práctica deportiva, sobre todo quienes están más orientados hacia la tarea. Además, la práctica de deportes individuales parece desarrollar en mayor medida las capacidades resilientes de los jóvenes. El tamaño de efecto resultante es de .288, efecto medio.
À partir d’un échantillon de 1 503 personnes, cette étude s’intéresse aux patients des centres d’assistance médicale à la procréation (AMP) pris en charge en France en 2020 afin d’interroger leur ...parcours médical comme leurs expériences de l’infertilité dans la vie professionnelle, intime, familiale et conjugale. Le questionnaire en ligne, composé de 178 questions, offre trois grandes familles de résultats : les domaines dans lesquels l’AMP donne satisfaction à une majorité de personnes ; les points de vigilance ; les résultats les plus frappants, notamment l’invisibilité des jeunes et des hommes parmi les patients, le pessimisme quant aux résultats de leur traitement et la difficile relation au corps pour les femmes. L’ensemble des résultats souligne l’importance d’une conception globale des patients infertiles, hommes et femmes, jeunes et moins jeunes, au-delà de la seule dimension médicale, pour une prise en compte aussi bien psychologique, sociale que professionnelle, sous-tendue par une équipe d’accompagnants élargie.
Abstract
Introduction:
The circadian system coordinates internal events in a daily schedule to make sure that the body systems are synchronized to environmental time and internal cues. One important ...behavioral aspect of the circadian system is the chronotype. It is usually assessed through subjective questionnaires, being the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ) one of the most used. It classifies individuals into three major categories: morning, evening and intermediate types. Recently, it has been hypothesized the existence of a fourth chronotype, the bimodal type, through an algorithm derived from the MEQ responses. Bimodals answer as morning-types in some questions, and as evening-types in others, resulting in an intermediate total score. To better characterize this phenotype, the present study aimed to detect and characterize the frequency of the bimodal chronotype in the EPISONO, a large population-based cohort, as well as to verify the association between bimodality and sleep parameters and genetic variation in the PER3 gene.
Methods:
A total of 1,042 participants completed a set of detailed sleep related questionnaires and underwent a polysomnography (PSG). An algorithm was used to classify bimodal individuals according to the number of morning-type/evening-type answers. Finally, genotyping of the variable number of tandem repeats (VNTR) polymorphism of the PER3 gene was performed by conventional polymerase chain reaction.
Results:
Of the 1,042 individuals who participated of the EPISONO, 857 had MEQ filled correctly. We found that 16% of our sample were bimodal types. We observed that bimodal individuals were significantly younger and had lower body mass index. The association between PER3 VNTR genotype or gender with bimodal chronotype were not significant. However, we found an association between bimodality and Epworth Sleepiness Scale (EES) and apnea-hypopnea index (AHI). Lastly, it was observed that the most significant predictors for bimodal chronotype were male gender, AHI and EES.
Conclusion:
In conclusion, the present work provides more evidence that the bimodal type might have to be considered when classifying chronotype and its association with young age and sleepiness may be due to the influence of social and environmental factors.
Support (If Any):
This work was supported by grants from AFIP, FAPESP and CNPq.
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