An online survey of UK women's attitudes to having children, the age they want children and the effect of the COVID-19 pandemic

STUDY QUESTION: What are women's views on having children, including the age they want to have them and other influences such as the coronavirus disease 2019 (COVID-19) pandemic? SUMMARY ANSWER: Women's views on having children, at their preferred age of 30 years, included their maternal urge and concerns about their biological clock and stability, while 19% said COVID-19 had affected their views. WHAT IS KNOWN ALREADY: Women globally are delaying the birth of their first child, with the average age of first birth approaching 32 years in some countries. The average age women have their first child in the UK is 30.7 years and over 50% of women aged 30 years are childless. The fertility rate stands at 1.3 in several European Union countries. Some people are not having their desired family size or are childless by circumstance. It is essential to understand people's attitudes to having children in different countries to identify trends so we can develop educational resources in an age-appropriate manner. STUDY DESIGN, SIZE, DURATION: We conducted an anonymous, online survey of multiple choice and open-ended questions. The survey was live for 32 days from 15 May 2020 to 16 June 2020 and was promoted using social media. PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 887 women from 44 countries participated in the survey. After filtering out women who did not consent, gave blank or incomplete responses, and those not in the UK, 411 responses remained. From the data, three areas of questioning were analysed: their views on having children, the ideal age they want to have children and the effects of the COVID-19 pandemic. Qualitative data were analysed by thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE: The average age (±SD) of the women who completed the survey was 32.2 years (±5.9), and they were mainly heterosexual (90.8%) and 84.8% had a university education. One-third of women were married/in a civil partnership (37.7%) and 36.0% were cohabitating. In relation to their views on having children, the main themes identified were: the maternal urge, the ticking of the biological clock, why did no one teach us this?, the need for stability and balance in their life, pressure to start a family and considering other ways to have a family. When asked 'In an ideal world, at what age approximately would you like to have had or have children?' a normal distribution was observed with a mean age of 29.9 (±3.3) years. When asked 'What factors have led you to decide on that particular age?' the most frequent choice was 'I am developing my career'. Three themes emerged from the qualitative question on why they chose that age: the need for stability and balance in their life, the importance of finding the right time and life experiences. The majority of women felt that the COVID-19 pandemic had not affected their decision to have children (72.3%), but 19.1% said it had. The qualitative comments showed they had concerns about instability in their life, such as finances and careers, and delays in fertility treatment. LIMITATIONS, REASONS FOR CAUTION: The survey was promoted on social media only and the women who answered the survey were highly educated. WIDER IMPLICATIONS OF THE FINDINGS: The women surveyed ideally want children at age 30 years but there are obstacles in their way, such as the need to develop their career. Global tailored fertility education is essential to ensure people make informed reproductive choices. In addition, it is essential for supportive working environments and affordable childcare to be in place in every country. STUDY FUNDING/COMPETING INTEREST(S): J.C.H. is founder of www.globalwomenconnected.com and Reproductive Health at Work, and author of the book Your Fertile Years. This project was funded by the Institute for Women's Health, UCL. TRIAL REGISTRATION NUMBER: N/A

Oxytocin and chronic pain in humans

Oxytocin (OT) is a long known neuropeptide, and it's uses in clinical practice, mainly those regarding obstetrics have been thoroughly studied. However, there's been an increasing interest in identifying other roles OT plays in emotion, cognition, perception and higher cognitive processing. OT is also believed o have a mayor role in the physiology and physiopathol-ogy of pain. We have reviewed existent literature and current human studies on the relationship between OT and chronic pain. The present work compiles a significant number of research papers and may cast some light on a remarkably interesting and promising matter. © 2019 Ediciones Doyma, S.L. All rights reserved

Neuropsychiatric conditions and probable cause of deathof Maurice Ravel

The renowned French composer and musician, Maurice Ravel (1875-1937) exhibited a perplexing case of progressive degenerative neurological symptoms, namely amnesia, aphasia, apraxia, amusia, and alexia. The symptoms started when Ravel was only fairly young, at 57, five years prior to his death in 1937. He was surgically intervened in what was known then as an exploratory craniotomy and passed away. There are a number of publications in which his life and known medical history were dissected and analyzed in an attempt to diagnose the ailment that Ravel suffered. Many diagnoses have been considered, among them Alzheimer’s disease, Pick Disease, primary progressive aphasia, corticobasal degeneration, and complications of head injury following a car crash in 1932. Since an autopsy was not performed, an exact diagnosis is rather unlikely, and no one has been able to confirm or deny any of the aforementioned hypotheses. The authors conducted an extensive revision of existent literature and propose some original ideas regarding Ravel’s neurological condition, mainly the psychological impact of Ravel’s life and experiences and the way they may have influenced his musical genius

Síndrome de stendhal : Una revisión histórica y clínica

Podría decirse que una de las pocas cualidades comunes a todos los seres humanos es la capacidad de apreciar la belleza. Si bien, es cierto que el objeto considerado como bello cambia de una persona a otra, la admiración y profunda emoción que experimenta un espectador en trance, es la misma. En ocasiones, esta experiencia puede llevar una persona hasta el borde mismo de la existencia. Una condición muy rara, conocida como síndrome estético, y en algunos casos, síndrome de Stendhal, comprende un cuadro clínico en el que la presencia de una magnífica y bella pieza de arte o arquitectura, produce síntomas disautonómicos como taquicardia, diaforesis, dolor torácico y pérdida de la consciencia. Presentamos aquí una revisión clínica e histórica de esta condición.It could be argued that one of the few unifying qualities all human beings share is the ability to appreciate beauty. While the object of beauty may change from one person to another, the awe and the thrill experienced by an enthralled beholder remains the same. Sometimes, this experience can be so overwhelming it can bring someone to the edge of existence. A very rare condition, known as aesthetic syndrome and, more commonly, Stendhal syndrome, entails a clinical phenomenon in which the presence of a beautiful piece of work or architecture causes dysautonomic symptoms such as tachycardia, diaphoresis, chest pains and loss of consciousness. We present an historical and clinical review of this condition. © 2018, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved

Oliver Sacks, masterful teacher and spokesman of neurology : A reflectión ; Oliver sacks, mestre e divulgador da neurologia : Reflexão

Como es cierto sobre muchas ciencias, el conocimiento en medicina solía ser protegido con el máximo secreto, y solo quienes dedicaban sus vidas a sanar podían acceder a él. Hoy, en la era de la información, todos saben, y más importante, todas las personas quieren y buscan tener conocimiento sobre medicina. Es entonces cuando resulta crucial la existencia de científicos dispuestos y capaces de difundir el conocimiento técnico para todas las personas. En este propósito, Oliver Sacks no tenía igual. Con su estilo narrativo único y su contagiosa sonrisa, fue una luz para los pacientes y las personas que, a tientas en la oscuridad, buscaban respuestas y fue un ejemplo para todos en el campo de la neurociencia.As is true about many sciences, knowledge in medicine used to be kept under the utmost secrecy, private only to those few persons that devoted their lives to healing. Today, however, in the era of information, everybody knows and, more importantly, everybody wants to know about medicine. It is then when the existence of scientists willing and able to divulge technical knowledge for all people becomes crucial. For this purpose there was none other like Oliver Sacks. With his unique tell-tale writing style and his contagious smile, he was a beacon for patients and people stumbling in the dark, looking for answers, and an example for everyone in the field of neuroscience. © 2017, Universidad de Antioquia. All Rights Reserved

An online survey of UK women’s attitudes to having children, the age they want children and the effect of the COVID-19 pandemic = Una encuesta en línea de mujeres del Reino Unido, sus perspectivas sobre tener hijos, la edad a la que quieren hijos y el efecto de la pandemia de COVID-19

Resumen: PREGUNTA DE ESTUDIO: ¿Cuáles son las opiniones de las mujeres sobre tener hijos, incluida la edad a la que quieren tenerlos y otras influencias como como la pandemia de la enfermedad por coronavirus 2019 (COVID-19)? RESPUESTA RESUMIDA: Las opiniones de las mujeres sobre tener hijos, a su edad preferida de 30 años, incluían su impulso maternal y sus preocupaciones. sobre su reloj biológico y estabilidad, mientras que el 19% dijo que COVID-19 había afectado sus puntos de vista. DISEÑO DEL ESTUDIO, TAMAÑO, DURACIÓN: Realizamos una encuesta anónima en línea de preguntas abiertas y de opción múltiple. los La encuesta estuvo activa durante 32 días, desde el 15 de mayo de 2020 hasta el 16 de junio de 2020, y se promocionó a través de las redes sociales. PARTICIPANTES/MATERIALES, ESCENARIO, MÉTODOS: Un total de 887 mujeres de 44 países participaron en la encuesta. Después de filtrar de las mujeres que no dieron su consentimiento, dieron respuestas en blanco o incompletas, y aquellas que no estaban en el Reino Unido, quedaron 411 respuestas. Desde los datos, se analizaron tres áreas de cuestionamiento: sus opiniones sobre tener hijos, la edad ideal a la que quieren tener hijos y los efectos de la pandemia de COVID-19. Los datos cualitativos fueron analizados por análisis temático. PRINCIPALES RESULTADOS Y EL PAPEL DEL AZAR: La edad media (§SD) de las mujeres que completaron la encuesta fue de 32,2 años. (§5.9), siendo mayoritariamente heterosexuales (90,8%) y 84,8% con estudios universitarios. Un tercio de las mujeres estaban casadas/en matrimonio pareja (37,7%) y 36,0% convivían. En relación a sus visiones sobre tener hijos, los principales temas identificados fueron: la urgencia, el tictac del reloj biológico, ¿por qué nadie nos enseñó esto?, la necesidad de estabilidad y equilibrio en su vida, presión para comenzar una familia y considerando otras maneras de tener una familia. Ante la pregunta 'En un mundo ideal, ¿a qué edad aproximadamente te gustaría tener tuvo o tiene hijos?’ se observó una distribución normal con una edad media de 29,9 (§3.3) años. Cuando se le preguntó ""¿Qué factores le han llevado decidir sobre esa edad en particular?’, la elección más frecuente fue ‘Estoy desarrollando mi carrera’. Tres temas surgieron de la cualitativa pregunta sobre por qué eligieron esa edad: la necesidad de estabilidad y equilibrio en su vida, la importancia de encontrar el momento adecuado y las experiencias de vida. La mayoría de las mujeres sintieron que la pandemia de COVID-19 no había afectado su decisión de tener hijos (72,3%), pero el 19,1% dijo tenía. Los comentarios cualitativos mostraron que tenían preocupaciones sobre la inestabilidad en su vida, como finanzas y carreras, y retrasos en la fertilidad. Tratamiento

The Sword of Damocles: Living with Neurofibromatosis Type 1

Both as a physician and as a patient, having neurofibromatosis type 1 has been an important part of my life. In my practice as a physician and as a professor, I have tried to reflect on the reality of living with a genetic condition and how it affects the way I live and practice medicine

The Sword of Damocles: Living with Neurofibromatosis Type 1.

Both as a physician and as a patient, having neurofibromatosis type 1 has been an important part of my life. In my practice as a physician and as a professor, I have tried to reflect on the reality of living with a genetic condition and how it affects the way I live and practice medicine

The Sword of Damocles: Living with Neurofibromatosis Type 1

Both as a physician and as a patient, having neurofibromatosis type 1 has been an important part of my life. In my practice as a physician and as a professor, I have tried to reflect on the reality of living with a genetic condition and how it affects the way I live and practice medicine

Brief history of Alice in wonderland syndrome: A perspective

El síndrome de Alicia en el país de las maravillas se caracteriza por alteraciones en la percepción somatomorfa y de los objetos del entorno. Su etiología no está plenamente esclarecida y existe un número significativo de condiciones médicas asociadas. Recientemente, los datos arrojados por una revisión sistemática5 muestran que entre 1955 y 2015 han sido reportados en la literatura 169 casos de pacientes con síndrome de Alicia en el país de las maravillas, de los cuales la gran mayoría corresponde a personas con una edad menor o igual a 18 años. Aun así, se cree que estos casos representan solo una pequeña parte de la verdadera prevalencia de este síndrome, principalmente debido a la carencia actual de una definición, clasificación y criterios diagnósticos apropiados dentro de parámetros internacionales y debido a la falta de datos epidemiológicos fiables que den cuenta de su verdadera magnitud. Los autores consideran importante encontrar en la historia las pistas ocultas sobre el origen de este síndrome y sus implicaciones clínicas. (Tomado del texto)Alice in Wonderland syndrome is characterized by disturbances in somatoform perception and of objects in the environment. Its etiology is not adequately clarified and there are a significant number of associated medical conditions. The data from a systematic review5 showed that between 1955 and 2015, 169 cases of patients with Alice's syndrome in Wonderland have been reported in the literature, of which the vast majority correspond to people younger than or equal to 18 years. Even so, he believes that these cases represent only a small part of the true prevalence of this syndrome, mainly due to the current lack of a definition, classification and diagnostic criteria identified within international parameters and due to the lack of reliable epidemiological data that realize its true magnitude. The authors consider it important to find in history hidden clues about the origin of this syndrome and its clinical implications