An investigation of factors associated with health anxiety in a non-clinical sample

Background and rationale unlike many other anxiety disorders, health anxiety has received relatively little attention in research until recently. Further research is required to better understand this difficulty, and thereby improve clinical interventions designed to address it. Substantial over-lap has been proposed between health anxiety and obsessive-compulsive disorder, and this link was utilised to identify a number of factors' worthy of exploration with respect to health anxiety. Method This study investigated how worry, intolerance of uncertainty, self-ambivalence and attachment insecurity were related to health anxiety. It also explored mediating relationships between these factors, based on a theoretically informed understanding of how they may be related. The study employed a correlational, cross-sectional design and had a non-clinical sample. A web- based survey was completed by 249 participants. The sample was predominantly female (81.5%) and had a mean age of 23.1 (SD=6.4). Results Intolerance of uncertainty was found to be a predictor of health anxiety after mood was controlled for. In addition, the relationship between these variables was found to be mediated by worry. A relationship between self-ambivalence and health anxiety was found, and this was shown to be mediated by intolerance of uncertainty. A relationship between attachment insecurity and health anxiety was not found at the .05 significance level. Attachment insecurity was found to be related to intolerance of uncertainty, and this relationship was shown to be mediated by self-ambivalence. Discussion The results are discussed in the context of previous findings. The role of intolerance of uncertainty in particular is considered, as analyses suggest it is both correlated with and a predictor of health anxiety. The relevance of the study findings to a transdiagnostic approach to treating anxiety is discussed. Methodological limitations of the study, areas for future research and clinical implications of the results are also considered.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

T2 heterogeneity as an in vivo marker of microstructural integrity in medial temporal lobe subfields in ageing and mild cognitive impairment

A better understanding of early brain changes that precede loss of independence in diseases like Alzheimer's disease (AD) is critical for development of disease-modifying therapies. Quantitative MRI, such as T2 relaxometry, can identify microstructural changes relevant to early stages of pathology. Recent evidence suggests heterogeneity of T2 may be a more informative MRI measure of early pathology than absolute T2. Here we test whether T2 markers of brain integrity precede the volume changes we know are present in established AD and whether such changes are most marked in medial temporal lobe (MTL) subfields known to be most affected early in AD. We show that T2 heterogeneity was greater in people with mild cognitive impairment (MCI; n = 49) compared to healthy older controls (n = 99) in all MTL subfields, but this increase was greatest in MTL cortices, and smallest in dentate gyrus. This reflects the spatio-temporal progression of neurodegeneration in AD. T2 heterogeneity in CA1-3 and entorhinal cortex and volume of entorhinal cortex showed some ability to predict cognitive decline, where absolute T2 could not, however further studies are required to verify this result. Increases in T2 heterogeneity in MTL cortices may reflect localised pathological change and may present as one of the earliest detectible brain changes prior to atrophy. Finally, we describe a mechanism by which memory, as measured by accuracy and reaction time on a paired associate learning task, deteriorates with age. Age-related memory deficits were explained in part by lower subfield volumes, which in turn were directly associated with greater T2 heterogeneity. We propose that tissue with high T2 heterogeneity represents extant tissue at risk of permanent damage but with the potential for therapeutic rescue. This has implications for early detection of neurodegenerative diseases and the study of brain-behaviour relationships

Edith Steins Beitrag zu heutigen Debatten über die personale Identität

Cilj je rada osvijetliti i vrednovati doprinos E. Stein raspravama o personalnom identitetu. U radu se polazi od teze da odgovor na pitanje o personalnom identitetu ovisi o shvaćanju osobe i njezinom razvoju do osobnosti, pri čemu kod E. Stein ključnu ulogu ima koncepcija ljudskog sebstva. U tu svrhu s osloncem u filozofskom djelu E. Stein najprije će se pokazati koje značenje za pitanje personalnog identiteta ima njezin pokušaj misliti sveze između ja, duše i tijela u odnosu na sebstvo. To pretpostavlja bistrenje pojmova “ja”, “jezgra osobe”, “duša” i višeznačnog izraza “sebstvo”. Potom će se pokazati na koji je način Steinovoj uspjelo povezivanjem filozofije svijesti i klasične filozofije bitka naći pristup “pravom sebstvu”, tj. na koji način prevladavanje “suprotnosti ja-života i bitka” predstavlja pristup “pravom sebstvu” čovjeka. To nam omogućuje pokazati u čemu je aktualni i originalni doprinos njezine teorije sebstva, kako u odnosu na klasična rješenja tog problema, tako i u odnosu na aktualne rasprave o personalnom identitetu i pitanju sebstva kako se ono postavlja u neuroznanostima.Ziel der vorliegenden Arbeit liegt im Versuch, Edith Steins Beitrag zur aktuellen Diskussion über die personale Identität zu erhellen und zu würdigen. Dabei gehen wir von der These aus, dass die Antwort auf die Frage nach der personalen Identität von der Theorie der Person und ihrer Entwicklung zur Personalität abhängt, wobei Steins Konzeption des menschlichen Selbst eine Schlüsselrolle zukommt. In Anlehnung an Steins philosophische Werke soll gezeigt werden, welche Bedeutung Steins Versuch, “Ich”, “Seele” und “Leib” im Hinblick auf das “Selbst” zusammenzudenken, für die Frage der personalen Identität hat. Das setzt die Klärung der Begriffe “Ich”, “Kern der Person”, “Seele” und des mehrdeutigen Ausdrucks vom “Selbst” voraus. Danach soll gezeigt werden, dass es Edith Stein durch die Verbindung moderner Bewusstseinsphilosophie mit klassischer Seinsmetaphysik gelungen ist, den Zugang zum “wahren Selbst” des Menschen zu finden, bzw. auf welche Weise die Überwindung “des Gegensatzes von Ich-leben und Sein” den Zugang zum “wahren Selbst” des Menschen darstellt. Auf dieser Grundlage versucht die Autorin auf folgende Frage zu antworten: Worin liegt die Aktualität von Steins Theorie vom Selbst sowohl im Hinblick auf die klassische Lösungsvariante dieses Problems, als auch im Hinblick auf die aktuelle Diskussion zur personalen Identität und der Frage nach dem Selbst, wie sie in den Neurowissenschaften gestellt wird

Thresholds for adding degraded tropical forest to the conservation estate

Logged and disturbed forests are often viewed as degraded and depauperate environments compared with primary forest. However, they are dynamic ecosystems1 that provide refugia for large amounts of biodiversity2, 3, so we cannot afford to underestimate their conservation value4. Here we present empirically defined thresholds for categorizing the conservation value of logged forests, using one of the most comprehensive assessments of taxon responses to habitat degradation in any tropical forest environment. We analysed the impact of logging intensity on the individual occurrence patterns of 1,681 taxa belonging to 86 taxonomic orders and 126 functional groups in Sabah, Malaysia. Our results demonstrate the existence of two conservation-relevant thresholds. First, lightly logged forests (68%) of their biomass removed, and these are likely to require more expensive measures to recover their biodiversity value. Overall, our data confirm that primary forests are irreplaceable5, but they also reinforce the message that logged forests retain considerable conservation value that should not be overlooked

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes

Thresholds for adding degraded tropical forest to the conservation estate

Logged and disturbed forests are often viewed as degraded and depauperate environments compared with primary forest. However, they are dynamic ecosystems1 that provide refugia for large amounts of biodiversity2,3, so we cannot afford to underestimate their conservation value4. Here we present empirically defined thresholds for categorizing the conservation value of logged forests, using one of the most comprehensive assessments of taxon responses to habitat degradation in any tropical forest environment. We analysed the impact of logging intensity on the individual occurrence patterns of 1,681 taxa belonging to 86 taxonomic orders and 126 functional groups in Sabah, Malaysia. Our results demonstrate the existence of two conservation-relevant thresholds. First, lightly logged forests (68%) of their biomass removed, and these are likely to require more expensive measures to recover their biodiversity value. Overall, our data confirm that primary forests are irreplaceable5, but they also reinforce the message that logged forests retain considerable conservation value that should not be overlooked

Testing a global standard for quantifying species recovery and assessing conservation impact.

Recognizing the imperative to evaluate species recovery and conservation impact, in 2012 the International Union for Conservation of Nature (IUCN) called for development of a "Green List of Species" (now the IUCN Green Status of Species). A draft Green Status framework for assessing species' progress toward recovery, published in 2018, proposed 2 separate but interlinked components: a standardized method (i.e., measurement against benchmarks of species' viability, functionality, and preimpact distribution) to determine current species recovery status (herein species recovery score) and application of that method to estimate past and potential future impacts of conservation based on 4 metrics (conservation legacy, conservation dependence, conservation gain, and recovery potential). We tested the framework with 181 species representing diverse taxa, life histories, biomes, and IUCN Red List categories (extinction risk). Based on the observed distribution of species' recovery scores, we propose the following species recovery categories: fully recovered, slightly depleted, moderately depleted, largely depleted, critically depleted, extinct in the wild, and indeterminate. Fifty-nine percent of tested species were considered largely or critically depleted. Although there was a negative relationship between extinction risk and species recovery score, variation was considerable. Some species in lower risk categories were assessed as farther from recovery than those at higher risk. This emphasizes that species recovery is conceptually different from extinction risk and reinforces the utility of the IUCN Green Status of Species to more fully understand species conservation status. Although extinction risk did not predict conservation legacy, conservation dependence, or conservation gain, it was positively correlated with recovery potential. Only 1.7% of tested species were categorized as zero across all 4 of these conservation impact metrics, indicating that conservation has, or will, play a role in improving or maintaining species status for the vast majority of these species. Based on our results, we devised an updated assessment framework that introduces the option of using a dynamic baseline to assess future impacts of conservation over the short term to avoid misleading results which were generated in a small number of cases, and redefines short term as 10 years to better align with conservation planning. These changes are reflected in the IUCN Green Status of Species Standard